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Breast. 2014 Oct;23(5):561-6. doi: 10.1016/j.breast.2014.04.004. Epub 2014 May 27.

Prognostic value of isolated tumor cells and micrometastases of lymph nodes in early-stage breast cancer: a French sentinel node multicenter cohort study.

Author information

  • 1Institut Paoli Calmettes and CRCM, 232 Bd Sainte Marguerite, Marseille, France; Aix Marseille Université, France. Electronic address:
  • 2Institut René Gauducheau, Site hospitalier Nord, St Herblain, France.
  • 3Institut Gustave Roussy, 114 rue Edouard Vaillant, Villejuif, France.
  • 4Centre Oscar Lambret, 3 rue Frédéric Combenal, Lille, France.
  • 5Institut Paoli Calmettes and CRCM, 232 Bd Sainte Marguerite, Marseille, France.
  • 6Centre Léon Bérard, 28 rue Laennec, Lyon, France.
  • 7Centre Claudius Regaud, 20-24 rue du Pont St Pierre, Toulouse, France.
  • 8Centre René Huguenin, 35 rue Dailly, Saint Cloud, France.
  • 9Hôpital Tenon, 4 rue de la Chine, Paris, France.
  • 10Centre Georges François Leclerc, 1 rue du Professeur Marion, Dijon, France.
  • 11Hôpital de Grasse, Chemin de Clavary, Grasse, France.
  • 12Hôpital des Diaconnesses, 18 rue du Sergent Bauchat, Paris, France.
  • 13Centre Jean Perrin, 58 rue Montalembert, Clermont Ferrand, France.
  • 14Institut Bergonié, 229 Cours de l'Argonne, Bordeaux, France.
  • 15Institut Paoli Calmettes and CRCM, 232 Bd Sainte Marguerite, Marseille, France; Aix Marseille Université, France.
  • 16Biostatistic, France.


To define the prognostic value of isolated tumor cells (ITC), micrometastases (pN1mi) and macrometastases in early stage breast cancer (ESBC). We conducted a retrospective multicenter cohort study at 13 French sites. All the eligible patients who underwent SLNB from January 1999 to December 2008 were identified, and appropriate data were extracted from medical records and analyzed. Among 8001 patients, including 70% node-negative (n = 5588), 4% ITC (n = 305), 10% pN1mi (n = 794) and 16% macrometastases (n = 1314) with a median follow-up of 61.3 months, overall survival (OS) and recurrence-free survival (RFS) rates at 84 months were not statistically different in ITC or pN1mi compared to tumor-free nodes. Axillary recurrence (AR) was significantly more frequent in ITC (1.7%) and pN1mi (1.5%) compared to negative nodes (0.6%). Survival and AR rates of single macrometastases were not different from those of ITC or pN1mi. In case of 2 macrometastases or more, survival rates decreased and recurrence rates increased significantly. Micrometastases and ITC do not have a negative prognostic value. Single macrometastases might have an intermediate prognostic value while 2 macrometastases or more are associated with poorer prognosis.

Copyright © 2014 Elsevier Ltd. All rights reserved.


Breast cancer; Isolated tumor cells; Micrometastases; Prognosis; Sentinel lymph node biopsy

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