Resumo

VIEIRA, René Aloisio da Costa et al. Intramammary lymph node sentinel metastasis without metastasis in axilla: axillary lymph node dissection or conservative surgery?. Rev. Bras. Ginecol. Obstet. [online]. 2012, vol.34, n.10, pp. 478-482.  Epub 15-Maio-2012. ISSN 0100-7203.  http://dx.doi.org/10.1590/S0100-72032012005000001.

The sentinel lymph node biopsy is a standard treatment for patients with breast cancer and clinically negative axilla lymph node. The presence of an extra-axillary and intra-axillary (IM) sentinel lymph node (SLN) occurs in up to 2.6% of cases. In the presence of a metastatic IM SLN, axillary positivity may occur in up to 81% of cases. Due to the limited number of cases reported, there is no standard treatment for the association of metastatic SLN IM and non-metastatic axillary SLN . We add here two cases to the literature, one of them with metastatic disease in the axilla. The use of a nomogram demonstrated that the risk of axillary metastasis was less than 10% and the addition of these cases to the literature showed that in this situation the rate of axillary metastasis is 6.25%. We discuss the pros and cons of further axillary dissection in this situation.

Palavras-chave : Breast neoplasms [surgery]; Sentinel lymph node biopsy; Lymph nodes excision [methods]; Lymphatic metastasis; Nomograms; Case reports.