Sentinel lymph node biopsy, an alternative to elective axillary dissection for breast cancer - 09/09/11

Doi : 10.1016/S0002-9610(98)00276-1

Fiemu E Nwariaku, MD ^a,⁎, David M Euhus, MD ^a, Peter D Beitsch, MD ^a, Edward Clifford, MD ^a, William Erdman, MD ^b, Dana Mathews, MD ^b, Jorge Albores-Saavedra, MD ^c, Marilyn A Leitch, MD ^a, George N Peters, MD ^a
^a Department of Surgery (FEN, DME, PDB, EC, MAL, GNP), University of Texas Southwestern Medical Center and St. Paul Medical Center, Dallas, Texas, USA
^b Department of Nuclear Medicine (WE, DM), University of Texas Southwestern Medical Center and St. Paul Medical Center, Dallas, Texas, USA
^c Department of Surgical Pathology (JAS), University of Texas Southwestern Medical Center and St. Paul Medical Center, Dallas, Texas, USA

^*Requests for reprints should be addressed to Fiemu F. Nwariaku, MD, Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75235-9031

Abstract

Background: Axillary metastases remain an important prognostic indicator in breast cancer. Axillary lymphadenectomy (ALND) carries significant morbidity and is unnecessary in most patients with early breast cancer; thus, sentinel lymph node (SLN) biopsy has been advocated for axillary staging. We studied the SLN identification rate and its accuracy in predicting axillary metastases.

Methods: One hundred nineteen women with breast carcinoma underwent SLN and ALND. Lymphoscintigraphy was performed using Technetium⁹⁹ sulfur colloid supplemented by Isosulfan blue dye. Hematoxylin/eosin-stained lymph node sections were examined by light microscopy.

Results: The SLN identification rate was 81%. One SLN was negative (1%) in a patient with axillary disease. SLN histology correctly predicted the absence of axillary disease in 98.6%. Sensitivity, specificity, and positive and negative predictive values were 96%, 100%, 100%, and 99%, respectively.

Conclusions: Sentinel lymph node biopsy accurately predicts total axillary status and is valuable in the surgical staging of breast cancer.

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Vol 176 - N° 6

P. 529-531 - décembre 1998 Retour au numéro

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The evolving practice pattern of the breast surgeon with disappearance of open biopsy for nonpalpable lesions
Victor J Zannis, Kristina M Aliano

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Sentinel lymph node biopsy for staging breast cancer
Isabel T Rubio, Soheila Korourian, Christopher Cowan, David N Krag, Maureen Colvert, V.Suzanne Klimberg

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Sentinel lymph node biopsy, an alternative to elective axillary dissection for breast cancer - 09/09/11

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