Micrometastases in the sentinel lymph node – necessity of axillar lymph node dissection?

Česká verzia

Authors: J. Kotoč ¹; K. Kotočová ¹; J. Gatěk ¹ ; J. Duben ¹; P. Vážan ²; J. Bakala ³
Authors place of work: Chirurgické oddělení Nemocnice Atlas a. s., Zlín Univerzita Tomáše Bati, Zlín Primář: MUDr. Jiří Gatěk, Ph. D. ¹; Bioptická a cytologická laboratoř, Zlín Vedoucí lékař: MUDr. Josef Velecký ²; Oddělení nukleární medicíny, Krajská nemocnice Tomáše Bati, Zlín Primář: MUDr. Jiří Bakala ³
Published in the journal: Prakt. Lék. 2009; 89(10): 587-590
Category: Of different specialties

Summary

Either radical mastectomy with axillar lymphadenectomy or conservative surgery with axillar lymph node dissection are the standard treatments for patients with breast carcinoma. Sentinel lymph node biopsy is a new method that – if negative – allows axillar lymph node preservation and so minimizes major complications associated with this operation (especially lymphedema of the upper extremity). However, the development of the diagnostic means gave rise to new clinical entities – micrometastases and findings of clusters or solitary cells in the sentinel lymph node. Even though the probability of non-sentinel lymph node metastasis is only 10 %, all patients with the finding of micrometastases in the sentinel lymph node are currently indicated for axillar lymph node dissection. Based on the present retrospective study involving 398 females with breast carcinoma, the authors define a risk group for non-sentinel lymph node metastases. The other patients may be spared from successive axillar dissection.

Key words:
breast carcinoma, sentinel lymph node, micrometastasis axillar dissection.

Zdroje

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