ABSTRACT
If one delves in the fields of medical history, it may happen that who was the first to make a statement in some area is challenged by
others. To my knowledge, micrometastases were originally named so by Huvos et al,1 because they had been supposed to be detectable only by microscopy instead of being picked up at gross examination. A noninclusive size limit of 2 mm was suggested by these authors, who found no survival disadvantage for breast cancer patients with only micrometastases as compared to those with no metastasis at all, after a minimum follow-up of 8 years. Although this study suffers from low patient numbers (only 18 patients with micrometastasis) and lack of detail on the pathologic assessment of the lymph nodes (probably meaning that a single hematoxylin and eosin (H&E)-stained slide was assessed for each), it can be credited for a definition of micrometastases. It also suggested that not only the number of metastatic nodes but also the tumor burden in the lymph nodes may be an important aspect of nodal involvement.
