AXILLARY LYMPH NODE DISSECTION IN PATIENTS WITH MICROMETASTASIS IN SENTINEL LYMPH NODE: NEW PREDILECTIONS

Aim. Indication for axillary lymph node dissection (ALND) in patients with breast cancer is recommended in presence of metastasis (>2 mm size) in sentinel lymphnode (LS) or for unidentified LS. Our study's intent proposes new predilections for ALND in presence of micrometastasis (size between 0.2 and 2 mm) in LS since they may not give metastatic involvement in other axillary lymphnodes. Methods. In our retrospective study we analyzed 1 119 patients's informations in a period of 7 years (2002/2009): 72 patients resulted positive for micrometastasis in LS. We analyzed cancer histology, size, grading. Results. Six patients of 72 positive micrometastasis LS were not subjected to ALND. We considered 66 patients: 13 patients were positive for metastasis in other axillary lymphnode; in 9 cases Tic and in 4 cases T2 (TNM classification); in 2 cases lobular infiltrated, in 11 cases ductal infiltrated (histology); in 7 cases were II stage, in 6 cases III stage (grading). Conclusion. Nineteen point seven percent of 66 patients with micrometastasis in LS is positive in other axillary lymphnode: this result confirms guide-lines's accuracy, it is not possible to avoid ALND in these patients. It appears that breast cancers responsible for metastasis in other axillary lymphnode have principally a size >1 cm, lobular infiltrated and ductal infiltrated histology and II-III grading.