The prognostic impact of occult nodal metastasis in early breast carcinoma

  • Daehoon ParkEmail author
  • Rolf Kåresen
  • Bjørn Naume
  • Marit Synnestvedt
  • Elsa Beraki
  • Torill Sauer
Cinical Trial


The clinical relevance of isolated tumor cell (ITC: ≤0.2 mm) and micrometastasis (MM: >0.2–2.0 mm) in axillary lymph nodes (ALNs) remains unknown. The aim of this study was to determine their prognostic significance. A total of 295 patients considered as pN0 after routine histological assessment, were reevaluated with ten-level cytokeratin immunohistochemistry (IHC) and two-level hematoxylin-eosin sections. Survival rates, i.e. disease-free survival (DFS), distant disease-free survival (DDFS) and breast cancer specific survival (BCSS) were compared with those of reevaluated node-negative patients. A total of 84 patients (28%) had ITC/MM identified on IHC sections. ITC had no impact on survival at a median 8.2 years of follow-up, whereas MM showed a trend toward poorer DFS (P = 0.091, log rank) and DDFS (P = 0.066) and significantly reduced BCSS (P = 0.016). In multivariate analyses, detection of MM was an independent prognostic factor for DDFS (P = 0.025) and BCSS (P = 0.01) in adjuvant un-treated patients. Micrometastases (MMs) in axillary lymph nodes have prognostic impact. This was not found for ITC. This finding supports the use of systemic adjuvant therapy in patients with MM.


Occult metastasis Axillary lymph node Invasive breast cancer Survival Prognosis 


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Copyright information

© Springer Science+Business Media, LLC. 2009

Authors and Affiliations

  • Daehoon Park
    • 1
    Email author
  • Rolf Kåresen
    • 2
  • Bjørn Naume
    • 3
  • Marit Synnestvedt
    • 3
  • Elsa Beraki
    • 1
  • Torill Sauer
    • 1
  1. 1.Department of Pathology, Oslo University HospitalUniversity of OsloOsloNorway
  2. 2.Department of Surgery, Oslo University HospitalUniversity of OsloOsloNorway
  3. 3.Department of Oncology, Oslo University HospitalThe Norwegian Radium HospitalOsloNorway

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