Prognostic impact of macrometastasis linear size in sentinel node biopsy for breast carcinoma

AIM: The aim of the present study was to evaluate the risk of axillary non-sentinel lymph-node metastases (ALN) in breast cancer patients presenting macrometastasis (Mac-m) in the sentinel lymph node (SN). MATERIALS AND METHODS: A retrospective series of 1464 breast cancers from patients who underwent ALN dissection following the diagnosis of Mac-m in the sentinel node (SN) was studied. In all the cases the MAC-m linear size was evaluated and correlated with presence or absence of non-SN ALN metastases. RESULTS: Non-SN metastases were detected in 644\1464 cases (43.98%). The risk of further axillary metastases ranged from 20.2% (37/183) in cases with Mac-m between 2 and 2.9 mm, to 65.3% (262/401) in cases with Mac-m measuring > 10 mm. The risk of non-SN ALN metastases showed a 3% increase, parallel to each mm increment in SN metastasis size. The data evaluated with the receiver operating characteristic (ROC) curve showed that the Mac-m could be subdivided according to a new cut-off of 7 mm. pT1 tumours, with Mac-m < 7 mm had a risk of non-SN ALN metastases of <30%. Furthermore 109/127 of these (85.8%) had 3 or less non-SN ALN -metastases. CONCLUSIONS: The present data give a detailed description on the risk of non-SN ALN involvement, that may be useful in the evaluation of breast cancer patients. It is suggested that a Mac-m size of <7 mm is related to a low residual axillary disease burden in breast cancer patients with small (pT1) tumours

Classification of mesic grasslands and their transitions of South Transdanubia (Hungary)

Relevés from meadows and pastures of South Transdanubia (Hungary) are evaluated by clustering and ordination methods. The relevé selection focused on the Arrhenatheretalia order but its transitions towards other types were also included. The groups of relevés are delimited and described according to differential, dominant and constant species. Ecological conditions of the groups were compared using indicator values. Nine groups were distinguished, four of them belonging strictly to the order Arrhenatheretalia. Each alliance of Arrhenatheretalia presented in the study area (Cynosurion, Arrhenatherion) was represented by two groups. Groups from these two alliances are separated along a light gradient, while groups of the same alliance differ in nutrient values. Within Cynosurion, the nutrient-poor group cannot be identified unambiguously as any syntaxa previously known from Hungary. The nutrient-rich Cynosurion meadows are similar to Lolio–Cynosuretum, however, they show a stronger relationship with wet meadows. Within Arrhenatherion, Pastinaco–Arrhenatheretum is recognised as a hay meadow of nutrient-rich soils. The other meadow type is similar to Filipendulo–Arrhenatheretum, thus raising syntaxonomical problems. There are transitional groups towards semi-dry and wet meadows, one dynamic phase and one outlier group among the other five clusters