, Volume 16, Issue 9, pp 2659-2660
Date: 19 Jun 2009

Isolated Tumor Cells in Sentinel Lymph Node and Clinical Implications for Early Breast Cancer

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To The Editors:

Clinical decision-making on treatment for breast cancer is based on the highest possible level of evidence.1,2 Sentinel lymph node dissection (SLND) has become standard for assessing axillary nodal status for early breast cancer. Evidence of isolated tumor cells (ITC) or micrometastasis in sentinel lymph nodes (SLN) may influence surgeon’s decision on complete axillary lymph node dissection (CALND). Usually, serial sectioning and immunohistochemical staining are used to evaluate presence of ITC or micrometastasis. Could conventional clinicopathologic factors predict ITC status in SLN in patients with clinical axilla node-negative disease? What would be the clinical implications of this assessment?

To approach these questions, Mittendorf et al. in a recent issue of the Annals of Surgical Oncology evaluated clinicopathologic data for 3,557 patients with no clinical evidence of lymph node metastases undergoing SLND.3 Metastasis ≤0.2 mm was classified as ITC according to the ...