Sentinel lymph node biopsy, an alternative to elective axillary dissection for breast cancer

• Published in: The American journal of surgery Vol. 176; no. 6; pp. 529 - 531
• Main Authors: Nwariaku, Fiemu E, Euhus, David M, Beitsch, Peter D, Clifford, Edward, Erdman, William, Mathews, Dana, Albores-Saavedra, Jorge, Leitch, Marilyn A, Peters, George N
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.1998; Elsevier Limited
• Subjects: Accuracy; Adult; Aged; Aged, 80 and over; Axilla; Biopsy; Biopsy - standards; Breast cancer; Breast carcinoma; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Eosine Yellowish-(YS); Feasibility Studies; Female; Hematoxylin; Histology; Humans; Identification; Light microscopy; Localization; Lumpectomy; Lymph Node Excision; Lymph nodes; Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Lymphatic Metastasis - diagnosis; Lymphatic system; Mammography; Mastectomy; Metastases; Metastasis; Middle Aged; Morbidity; Neoplasm Staging - methods; Optical microscopy; Patients; Predictive Value of Tests; Radionuclide Imaging; Sulfur; Technetium Tc 99m Sulfur Colloid; Womens health
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(98)00276-1

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 Technetium 99 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.