CO-RELATION OF SENTINEL LYMPH NODE METASTASES WITH THE SIZE OF PRIMARY BREAST CARCINOMA

This is a cross-sectional study designed to explore the co-relation between the tumour size and incidence of metastases in the sentinel lymph node and was conducted at Departments of Pathology, Punjab Medical College, Faisalabad and Sheikh Zayed Hospital, Lahore and Departments of Surgery, Allied DHQ Hospitals, Faisalabad from July 2002 – June 2003. The sentinel lymph node (SLN) was identified in 80 cases of early (T1 T2) breast carcinoma by a localization technique using 1% Isosulphan Blue. The maximum size of the tumour was measured on gross examination and the margins were labelled with Alcian blue and fixed in Bouin’s fluid. The entire tumour was embedded and the size of the tumour was confirmed on microscopic examination. Similarly the entire SLN was embedded and the microscopic measurement of tumour deposit was made in every case. The SLN was successfully isolated in 80 cases. Right sided carcinoma was seen in 52.5%. Stage T1 was seen in 37.5% and 62.5% were of stage T2. Most of the tumours (65%) were located in the upper outer quadrant. Nearly all (97.5%) were infiltrating ductal carcinomas. The microscopic measurement of the size of tumour varied between 5-70mm and the size of the metastatic deposit of the tumour in the SLN varied from 2-22mm. It was noted that the involvement of SLN and non sentinel lymph node (NSLN) increased in relation to an increase in size of the primary tumour. The study concluded that as the size of the tumour increases, the chances of metastases occurring incre- ases and thus has a linear relationship.