Short Term Follow-up Data in Breast Cancer Patients with Sentinel Lymph Node Biopsy Alone

PURPOSE: Sentinel lymph node (SLN) dissection is now a widely used and accepted method for staging the axilla in breast cancer patients. The aim of this study was to determine the rate of axillary lymphatic recurrence and metastasis in breast cancer patients who had a negative SLNB. METHODS: A retrospective chart review from August of 2001 to December of 2003 was performed for all patients (n=89) who underwent a SLN biopsy and they had a negative SLN on the intraoperative frozen sections. Any additional axillary lymph node dissection was not performed even when the sentinel lymph node(s) were found to be positive by the permanent pathology. The patients received appropriate adjuvant therapy according to the characteristics of the primary tumor. All the patients who had breast conserving surgery received postoperative radiotherapy to the remaining breast, but not to the axilla. RESULTS: A mean of 4.92 LNs were removed per patient. Among the 89 patients whose sentinel lymph nodes were tumor-free on frozen section, 9 patients had metastatic lymph nodes on the permanent pathology. All the metastases were micrometastasis. Over a mean follow-up period of 53 months, one patient died of liver metastasis and one patient developed n ipsilateral breast recurrence. Only one patient developed an axillary recurrence. CONCLUSION: SLNB provides accurate staging of breast cancer and this might be a good alternative to routine axillary lymph node dissection with incurring less surgical morbidity.

Effect of Ionizing Radiation on Homotypic Cell Adhesion, Cell-Matrix Adhesion, Matrix Metalloproteinases Excretion of High Mucin Producing HM7 Colon Cancer Cells

PURPOSE: To investigate the effect of ionizing radiation on high mucin-producing colon cancer cells, we evaluated homotypic cell adhesion, cell-matrix adhesion, and matrix metalloproteinases (MMPs) on HM7 cells. METHODS: After an irradiation of 60 Gy for 48 hours on HM7 cells, we evaluated cellular proliferation, colony-forming ability, homotypic adhesion, cell-matrix binding, and integrin subunit expressions. Also, alterations of MMPs expression were analyzed by using zymography. RESULTS: Cell proliferation of HM7 colon cancer cells was not remarkably affected even after high doses of radiation; however, clonogenic cell growth was significantly affected. Homotypic cell-cell adhesion and cell adhesion to ECM components and basement membrane protein matrigel were significantly increased after irradiation. Radiation induced expressions of cell surface integrin alpha2, alpha3, and beta1 subunits of HM7 cells. The activities of secreted MMPs (MMP-9 and MMP-2) were remarkably inhibited by radiation. CONCLUSIONS: These finding suggest the biologic characteristics of high-mucin-producing colorectal carcinomas. Even though the radiation-associated cellular alterations of HM7 cells with or without matrix proteins were not remarkably different from other cancer cell types studied, the radio-resistant behavior of high mucin producing HM7 cells may explain the aggressive characteristics of mucinous colorectal carcinomas.