The clinical impact and outcomes of immunohistochemistry-only metastasis in breast cancer

Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
American journal of surgery (Impact Factor: 2.29). 09/2010; 200(3):368-73. DOI: 10.1016/j.amjsurg.2009.10.016
Source: PubMed


Modern surgical and pathological techniques can detect small-volume axillary metastases in breast cancer with unknown clinical significance.
A retrospective database review from 1996 through 2004 identified all patients with immunohistochemical (IHC)-only sentinel node (IHC-SN) metastases and compared them with negative controls (Neg-SN).
When comparing the 232 IHC-SN patients with the 252 Neg-SN controls, the IHC-SN patients had larger tumors, more lobular histology, a higher grade, and more HER2/neu positivity. They also received more systemic therapy. With a median follow-up of 5 years, there were no differences in recurrence-free survival or overall survival. In 123 IHC-SN patients treated with axillary dissection (axillary lymph node dissection), 16% had positive non-SLNs. Patients with positive non-SLNs tended to have worse outcomes.
IHC-only sentinel lymph node (SLN) metastases were associated with worse prognostic features and higher rates of systemic therapy. However, no outcomes differences were noted.

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