A 52-year-old woman undergoes sentinel lymph node biopsy for a 1.8 cm ER-positive, HER2-negative invasive ductal carcinoma. Two sentinel nodes are removed; both show isolated tumour cells (ITCs) only (< 0.2 mm deposits). According to current guidelines (AJNC/ASCO), the nodal stage is:
- A pN0(i+) ✓
- B pN1mi
- C pN1a
- D pN2a
Correct answer: A. pN0(i+)
Explanation
Isolated tumour cells (< 0.2 mm or < 200 cells) detected by IHC or H&E in sentinel nodes are staged pN0(i+), not pN1. Micrometastases (0.2–2 mm) are pN1mi, and macrometastases (> 2 mm) in 1–3 nodes are pN1a. pN0(i+) does not alter the indication for axillary dissection in luminal A-type tumours.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.