Prognostic Significance of Residual Axillary Nodal Micrometastases and Isolated Tumor Cells After Neoadjuvant Chemotherapy for Breast Cancer

2019 ◽  
Vol 26 (11) ◽  
pp. 3502-3509 ◽  
Author(s):  
Stephanie M. Wong ◽  
Nora Almana ◽  
Jungeun Choi ◽  
Jiani Hu ◽  
Haley Gagnon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Tumor Cells ◽  
Prognostic Significance ◽  
Isolated Tumor Cells

Breast Cancer Survival in Relation to the Metastatic Tumor Burden in Axillary Lymph Nodes

2010 ◽  
Vol 28 (17) ◽  
pp. 2868-2873 ◽  
Author(s):  
Yvette Andersson ◽  
Jan Frisell ◽  
Maria Sylvan ◽  
Jana de Boniface ◽  
Leif Bergkvist
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Tumor Cells ◽  
Prognostic Significance ◽  
Axillary Lymph Nodes ◽  
Lymph Node Status ◽  
Axillary Lymph ◽  
Isolated Tumor Cells ◽  
Node Negative ◽  
Survival Difference

Purpose The aim of this study was to determine the prognostic significance of lymph node micrometastases in patients with breast cancer. Patients and Methods Between September 2000 and January 2004, 3,369 patients with breast cancer were included in a prospective cohort. According to their lymph node status, they were classified in the following four groups: 2,383 were node negative, 107 had isolated tumor cells, 123 had micrometastases, and 756 had macrometastases. Median follow-up time was 52 months. Kaplan-Meier estimates and the multivariate Cox proportional hazard regression model were used to analyze survival. Results Five-year cause-specific and event-free survival rates were lower for patients with micrometastases (pN1mi) than for node-negative (pN0) patients (94.1% v 96.9% and 79.6% v 87.1%, respectively; P = .020 and P = .032, respectively). There was no significant survival difference between node-negative patients and those with isolated tumor cells. The overall survival of pN1mi and pN0 patients did not differ. Conclusion This study demonstrates a worse prognosis for patients with micrometastases than for node-negative patients.

Sentinel Node Biopsy: Interpretation and Management of Patients With Immunohistochemistry-Positive Sentinel Nodes and Those With Micrometastases

2008 ◽  
Vol 26 (5) ◽  
pp. 698-702 ◽  
Author(s):  
Emiel J.T. Rutgers
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Sentinel Node ◽  
Tumor Cells ◽  
Clinical Decision Making ◽  
Prognostic Significance ◽  
Axillary Lymph ◽  
Isolated Tumor Cells ◽  
Sentinel Nodes ◽  
Node Metastasis

The sentinel node procedure is an adequate tool to identify lymph node metastasis in breast cancer. Sentinel nodes are generally examined with greater attention mainly to exclude, as reliably as possible, lymph node metastasis. To achieve this, many protocols are used, resulting in different rates of micrometastasis or isolated tumor cells encountered. Since the prognostic significance of isolated tumor cells or micrometastasis in the sentinel nodes, and the risk of further axillary lymph node involvement in patients with isolated tumor cells, is uncertain and at most limited, these findings may pose difficulties for clinicians in clinical decision making. Protocols that identify lymph node metastasis, from which the clinical relevance is known, are warranted. Unnecessary lymph node dissections should be avoided.

The prognostic significance of isolated tumor cells in the lymph nodes of gastric cancer patients

2010 ◽  
Vol 13 (3) ◽  
pp. 191-196 ◽  
Author(s):  
Takeo Fukagawa ◽  
Mitsuru Sasako ◽  
Seiji Ito ◽  
Hayao Nakanishi ◽  
Hisae Iinuma ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Prognostic Significance ◽  
Isolated Tumor Cells ◽  
Gastric Cancer Patients

scholarly journals Supervised Risk Predictor of Breast Cancer Based on Intrinsic Subtypes

2009 ◽  
Vol 27 (8) ◽  
pp. 1160-1167 ◽  
Author(s):  
Joel S. Parker ◽  
Michael Mullins ◽  
Maggie C.U. Cheang ◽  
Samuel Leung ◽  
David Voduc ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Risk Score ◽  
Tumor Size ◽  
Pathologic Complete Response ◽  
Prognostic Significance ◽  
Intrinsic Subtype ◽  
Cancer Prognosis ◽  
Intrinsic Subtypes ◽  
Node Negative

Purpose To improve on current standards for breast cancer prognosis and prediction of chemotherapy benefit by developing a risk model that incorporates the gene expression–based “intrinsic” subtypes luminal A, luminal B, HER2-enriched, and basal-like. Methods A 50-gene subtype predictor was developed using microarray and quantitative reverse transcriptase polymerase chain reaction data from 189 prototype samples. Test sets from 761 patients (no systemic therapy) were evaluated for prognosis, and 133 patients were evaluated for prediction of pathologic complete response (pCR) to a taxane and anthracycline regimen. Results The intrinsic subtypes as discrete entities showed prognostic significance (P = 2.26E-12) and remained significant in multivariable analyses that incorporated standard parameters (estrogen receptor status, histologic grade, tumor size, and node status). A prognostic model for node-negative breast cancer was built using intrinsic subtype and clinical information. The C-index estimate for the combined model (subtype and tumor size) was a significant improvement on either the clinicopathologic model or subtype model alone. The intrinsic subtype model predicted neoadjuvant chemotherapy efficacy with a negative predictive value for pCR of 97%. Conclusion Diagnosis by intrinsic subtype adds significant prognostic and predictive information to standard parameters for patients with breast cancer. The prognostic properties of the continuous risk score will be of value for the management of node-negative breast cancers. The subtypes and risk score can also be used to assess the likelihood of efficacy from neoadjuvant chemotherapy.

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