Localização histologica das metastases nos linfonodos sentinelas e fatores de risco para predizer positividade dos linfonodos não-sentinelas em cancer de mama / Histologic localization of sentinel lymph nodes metastases and risk factors for prediction of non-sentinel lymph nodes positivity in breast cancer

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

INTRODUCTION: The complete axillary lymph node dissection is the standard treatment for patients with positive sentinel lymph node (SLN) in breast cancer. However, several studies report that 38 to 67% of patients with positive SLN do not have involvement of the non-sentinel lymph nodes (NSLN). OBJECTIVE: The purpose of this study is to explore the orphological characteristics of the primary breast tumor and the SLN metastases to define subsets of patients that will have receive greater benefit from complete axillary lymph node dissection (CALD). METHODS: We studied 546 women with invasive breast carcinoma that were submitted to sentinel lymph node biopsy from July 2002 to March 2007 (data from Instituto de Patologia de Campinas). One hundred and forty one patients (26%) had positive sentinel lymph node and 21 women refused to be submitted to CALD. Univariate analyses were performed using the chi-square test and Fisher exact test for individual variables to determine the association between the morphology of the mammary tumor and the SLN metastasis with the status of the NSLN. Multivariate analyses with logistic regression were done to evaluate the association between the statistically significant variables in univariate analyses with the axillary status. RESULTS: SLN from 546 patients with invasive breast cancer were studied. One hundred and forty one patients had SLN positive (26%) and 21 women refused to be submitted to CALD. Of the remaining 120 patients studied, 51 of them developed additional metastases in the NSLN (43%). Upon univariate analyses, tumor size, histologic type, nuclear grade, number of positive SLN and number of metastatic foci in the SLN were not associated with disease in the NSLN, while histologic grade III, peritumoral vascular invasion, size of the metastasis in SLN, disease localized in the lymph node parenchyma and extranodal extension were associated with additional metastases in NSLN. CONCLUSION: These risk factors were associated with greater probability to develop metastases in the NSLN

ASSUNTO(S)

axilla axila linfonodos mama - cancer metastase breast cancer limph nodes metastases

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