Metastases in the lymph glands also determine the prognosis of breast cancer. 15 years ago, the sentinel lymph gland procedure was introduced, where only a limited number of lymph glands is removed from the armpits and examined for the presence of metastases. With this procedure, small metastases, i.e. isolated tumour cells (smaller than or equal to 0.2 mm) or micrometastases (0.2 – 2 mm) are often found in the sentinel glands. The prognostic value of such small metastases in breast cancer is currently questioned. This dissertation describes a national cohort study that shows that small metastases negatively influence the prognosis. In patients that underwent chemotherapy or hormone therapy the prognosis was better. Therefore, these treatments should be considered with the presence of small metastases. Also the cancer did not return as quickly in the case of complete removal of the armpit glands. The dissertation also describes the role of the extensiveness and localisation of small metastases in the lymph gland and cost effectiveness aspects of the treatment.
|Qualification||Doctor of Philosophy|
|Award date||7 Sep 2012|
|Place of Publication||Maastricht|
|Publication status||Published - 1 Jan 2012|
- breast cancer
- isolated tumour cells