Female breast cancer with 'clandestine' lymph node metastases.

OBJECTIVE

To determine whether or not breast cancer with 'clandestine' lymph node metastases differ in any important way from breast cancer with macrometastases.

METHODS

A study of 116 female breast cancers over a period of two years, whose axillary contents were immuno-stained prospectively to detect the possible presence of clandestine metastases, that is tumour cells identifiable only after monoclonal antibody immunostaining.

RESULTS

The prevalence of 'clandestine' lymph node metastases was 14.7%. The maximum number of 'clandestine' lymph node metastases was three per axilla. In the cases with 'clandestine' metastases the infiltrating lobular carcinoma (ILC) type was more frequently seen than in the node negative cases: (p = 0.038) (RR = 2.44; OR = 4.0). There was no difference in the hormone receptor status between the cases without lymph node metastases and with lymph node metastases, 'clandestine' or macrometastases.

CONCLUSION

No significant difference was found between breast cancers with 'clandestine' or with macrometastases with regard to their clinico-pathologic features and hormone receptor status. The detection of 'clandestine' metastases is a painstaking and time-consuming procedure which, so far, has not been shown to be of clinical significance.