caa a22 4500 445333189 CHVBK 20180317142744.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1245/s10434-010-1451-z doi (NATIONALLICENCE)springer-10.1245/s10434-010-1451-z Prognostic Value of Lymph Node Micrometastases in Breast Cancer: A Multicenter Cohort Study [Elektronische Daten] [Paul Gobardhan, Sjoerd Elias, Eva Madsen, Bob van Wely, Frits van den Wildenberg, Evert Theunissen, Miranda Ernst, Marike Kokke, Carmen van der Pol, Inne Borel Rinkes, Jan Wijsman, Vivian Bongers, Joost van Gorp, Thijs van Dalen] Background: To evaluate the prognostic meaning of lymph node micrometastases in breast cancer patients. Methods: Between January 2000 and January 2003, 1411 patients with a cT1-2N0 invasive breast carcinoma underwent surgery in 7 hospitals in the Netherlands. Sentinel lymph node biopsy was done in all patients. Based on lymph node status, patients were divided into 4 groups: pN0 (n=922), pN1micro (n=103), pN1a (n=285), and pN≥1b (n=101). Median follow-up was 6.4years. Results: At the end of follow-up, 1121 women were still alive (79.4%), 184 had died (13.0%), and 106 were lost to follow-up (7.5%). Breast cancer recurred in 244 patients: distant metastasis (n=165), locoregional relapse (n=83), and contralateral breast cancer (n=44). Following adjustment for possible confounding characteristics and for adjuvant systemic treatment, overall survival (OS) remained comparable for pN0 and pN1micro and was significantly worse for pN1a and pN≥1b (hazard ratio [HR] 1.18; 95% confidence interval [95% CI] 0.58-2.39, HR 2.47; 95% CI 1.69-3.63, HR 4.36; 95% CI 2.70-7.04, respectively). Disease-free survival (DFS) was similar too in the pN0 and pN1micro group, and worse for pN1a and pN≥1b (HR 0.96; 95% CI 0.56-1.67 vs HR 1.64; 95% CI 1.19-2.27, HR 2.95; CI 1.98-4.42). The distant metastases rate also did not differ significantly between the pN0 and pN1micro group and was worse for pN1a and pN≥1b (HR 1.22; 95% CI 0.60-2.49, HR 2.26; 95% CI 1.49-3.40, HR 3.49; CI 2.12-5.77). Conclusions: In breast cancer patients survival is not affected by the presence of micrometastatic lymph node involvement. The Author(s), 2010 Gobardhan Paul Department of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands aut Elias Sjoerd Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands aut Madsen Eva Department of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands aut van Wely Bob Department of Surgery, Canisius Hospital Nijmegen, Nijmegen, The Netherlands aut van den Wildenberg Frits Department of Surgery, Canisius Hospital Nijmegen, Nijmegen, The Netherlands aut Theunissen Evert Department of Surgery, St Antonius Hospital Utrecht, Utrecht, The Netherlands aut Ernst Miranda Department of Surgery, Jeroen Bosch Hospital's Hertogenbosch, Hertogenbosch, The Netherlands aut Kokke Marike Department of Surgery, Jeroen Bosch Hospital's Hertogenbosch, Hertogenbosch, The Netherlands aut van der Pol Carmen Department of Surgery, Reinier de Graaf Hospital Delft, Delft, The Netherlands aut Borel Rinkes Inne Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands aut Wijsman Jan Department of Surgery, Amphia Hospital Breda, Breda, The Netherlands aut Bongers Vivian Department of Nuclear Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands aut van Gorp Joost Department of Pathology, Diakonessenhuis Utrecht, Utrecht, The Netherlands aut van Dalen Thijs Department of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands aut Annals of Surgical Oncology Springer-Verlag 18/6(2011-06-01), 1657-1664 1068-9265 18:6<1657 2011 18 10434 https://doi.org/10.1245/s10434-010-1451-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1451-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Gobardhan Paul Department of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Elias Sjoerd Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Madsen Eva Department of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- van Wely Bob Department of Surgery, Canisius Hospital Nijmegen, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- van den Wildenberg Frits Department of Surgery, Canisius Hospital Nijmegen, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Theunissen Evert Department of Surgery, St Antonius Hospital Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Ernst Miranda Department of Surgery, Jeroen Bosch Hospital's Hertogenbosch, Hertogenbosch, The Netherlands aut NATIONALLICENCE 700 1- Kokke Marike Department of Surgery, Jeroen Bosch Hospital's Hertogenbosch, Hertogenbosch, The Netherlands aut NATIONALLICENCE 700 1- van der Pol Carmen Department of Surgery, Reinier de Graaf Hospital Delft, Delft, The Netherlands aut NATIONALLICENCE 700 1- Borel Rinkes Inne Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Wijsman Jan Department of Surgery, Amphia Hospital Breda, Breda, The Netherlands aut NATIONALLICENCE 700 1- Bongers Vivian Department of Nuclear Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- van Gorp Joost Department of Pathology, Diakonessenhuis Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- van Dalen Thijs Department of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/6(2011-06-01), 1657-1664 1068-9265 18:6<1657 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer