Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2010 Jul;17(7):1854-61.
doi: 10.1245/s10434-010-0945-z. Epub 2010 Mar 19.

Sentinel node identification rate and nodal involvement in the EORTC 10981-22023 AMAROS trial

Marieke E Straver  1 , Philip Meijnen, Geertjan van Tienhoven, Cornelis J H van de Velde, Robert E Mansel, Jan Bogaerts, Nicole Duez, Luigi Cataliotti, Jean H G Klinkenbijl, Helen A Westenberg, Huub van der Mijle, Marko Snoj, Coen Hurkmans, Emiel J T Rutgers
Affiliations
Randomized Controlled Trial

Sentinel node identification rate and nodal involvement in the EORTC 10981-22023 AMAROS trial

Marieke E Straver et al. Ann Surg Oncol. 2010 Jul.

Abstract

Background: The randomized EORTC 10981-22023 AMAROS trial investigates whether breast cancer patients with a tumor-positive sentinel node biopsy (SNB) are best treated with an axillary lymph node dissection (ALND) or axillary radiotherapy (ART). The aim of the current substudy was to evaluate the identification rate and the nodal involvement.

Methods: The first 2,000 patients participating in the AMAROS trial were evaluated. Associations between the identification rate and technical, patient-, and tumor-related factors were evaluated. The outcome of the SNB procedure and potential further nodal involvement was assessed.

Results: In 65 patients, the sentinel node could not be identified. As a result, the sentinel node identification rate was 97% (1,888 of 1,953). Variables affecting the success rate were age, pathological tumor size, histology, year of accrual, and method of detection. The SNB results of 65% of the patients (n = 1,220) were negative and the patients underwent no further axillary treatment. The SNB results were positive in 34% of the patients (n = 647), including macrometastases (n = 409, 63%), micrometastases (n = 161, 25%), and isolated tumor cells (n = 77, 12%). Further nodal involvement in patients with macrometastases, micrometastases, and isolated tumor cells undergoing an ALND was 41, 18, and 18%, respectively.

Conclusions: With a 97% detection rate in this prospective international multicenter study, the SNB procedure is highly effective, especially when the combined method is used. Further nodal involvement in patients with micrometastases and isolated tumor cells in the sentinel node was similar-both were 18%.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Study design. Patients with clinically negative lymph nodes and tumors of <3 cm are randomized between ALND and axillary radiotherapy before the sentinel node biopsy procedure. In sentinel node–negative patients, no further axillary treatment is provided
Fig. 2
Fig. 2
Patient flow in the EORTC AMAROS trial regarding the identification and results of the SNB procedure. SN sentinel node; Macro macrometastases (>2 mm); Micro micrometastases (0.2–2 mm); ITC isolated tumor cells (<0.2 mm)
Fig. 3
Fig. 3
Drainage to the internal mammary chain seen on lymphoscintigraphy and the subsequent surgical removal. IMC internal mammary chain
See this image and copyright information in PMC

References

    1. Braithwaite LR. The flow of lymph from the ileocaecal angle, and its possible bearing on the cause of duodenal and gastric ulcer. Br J Surg. 1923;11:7–26. doi: 10.1002/bjs.1800114103. - DOI
    1. Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 1994;220:391–398. doi: 10.1097/00000658-199409000-00015. - DOI - PMC - PubMed
    1. Nieweg OE, Jansen L, Valdes Olmos RA, et al. Lymphatic mapping and sentinel lymph node biopsy in breast cancer. Eur J Nucl Med. 1999;26:S11–S16. doi: 10.1007/s002590050572. - DOI - PubMed
    1. van der Ploeg IM, Nieweg OE, van Rijk MC, Valdes Olmos RA, Kroon BB. Axillary recurrence after a tumour-negative sentinel node biopsy in breast cancer patients: a systematic review and meta-analysis of the literature. Eur J Surg Oncol. 2008;34:1277–1284. - PubMed
    1. Krag DN, Anderson SJ, Julian TB, et al. Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial. Lancet Oncol. 2007;8:881–888. doi: 10.1016/S1470-2045(07)70278-4. - DOI - PubMed

Publication types

MeSH terms