Mikrometastáza v sentinelové uzlině - Nutnost disekce axilárních uzlin?

Abstract

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.