Of the 12 patients with infiltrating lobular carcinoma who had micrometastatic disease
, only 7 agreed to undergo completion axillary dissection, and 2 (29%) of these patients were found to have additional positive node(s) on hematoxylin-eosin staining (Table 2).
The investigators identified two distinct phenotypes of nodal tumors: macro-metastatic disease in which there is extensive replacement and growth of metastases within the node, and micrometastatic disease
in which multiple normal-size nodes are partially replaced with metastases.
If those lymph nodes most directly in the immediate drainage path of the primary tumor (sentinel lymph nodes [SLNs]) could be consistently and unequivocally identified in colorectal resection specimens, and if they, in turn, could be subjected to thorough and meticulous pathologic examination, it is possible that more accurate pathologic staging, particularly of micrometastatic disease
, could be achieved.
To this end, the identification of micrometastatic disease
at the time of diagnosis and primary treatment has been an area of intense research interest for many years.
1-6] It is thought that improved detection of occult axillary disease may result in more accurate assessment of the prognosis of breast cancer patients, and several methods that increase the sensitivity of detection of micrometastatic disease
in axillary lymph nodes have been studied.
A stronger active-specific immune response in these earlier stage patients may be able to eradicate any micrometastatic disease
that may have escaped surgical removal, thus preventing recurrence and enhancing disease-free survival and overall survival.
of micrometastatic disease
, such as lung and breast cancer and
5 [micro]g/L have distant micrometastatic disease
and are thus unlikely to benefit from salvage RT.
adjuvant therapy after surgery to control micrometastatic disease
The fact that the PAP was the strongest predictor of long-term biochemical failure in patients with otherwise higher risk features reported here suggests that it may be a more accurate indicator of micrometastatic disease
compared with the Gleason score and the PSA level.
Sandwich" sequencing allows for treatment of systemic disease with chemotherapy while controlling micrometastatic disease
in the pelvis with radiation therapy (RT).
Available evidence suggests a lower rate of postoperative complications in patients who underwent completion lymph node dissection for micrometastatic disease
detected by SLNB, compared to those who underwent therapeutic lymph node dissection for clinically palpable disease.