Widt-Levert LM, Tjan-Heijnen VCG, Bult P, et al. Stage migration in breast cancer: surgical decisions concerning isolated tumor cells and micro-metastases in the sentinel lymph node
Aims: Sentinel lymph node biopsy has replaced the axillary lymph node dissection (ALND) in primary surgery for breast cancer in many hospitals and is expected to become the standard of care in due time. Since the sentinel lymph node is subjected to more extensive pathologic examination than the lymph nodes in the axillary dissection specimen, more patients are found to be node positive (N+); however many of them contain micro-metastases (≤2 mm). The consequence may be an overshoot of therapy: additional surgery for non-metastatic lymph nodes or systemic adjuvant therapy.
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