Abstract

Background and objectiveRates of sentinel node (SN) identification and metastasis-positive SNs were compared between the group with highly selective indications for sentinel node biopsy (SNB) and the group with merely no contraindications for SNB (Groups A and B, respectively). Materials and methodsWe performed a single-center retrospective data analysis of 471 breast cancer patients treated during 2004–2010. Data on clinical and pathologic staging, frozen section results, radiological measurements and pathologic examination results were obtained from patient records. Patients were analyzed in two groups. Group A (n=143) had SNB performed only when the patients fulfilled to the following criteria: breast tumor no greater than 3cm in diameter, unifocal disease, no pure ductal carcinoma in situ, no history of previous breast or lymph node surgery, and no neoadjuvant chemotherapy. Indications for SNB were extended in Group B (n=328) so that inflammatory breast cancer and positive lymph nodes became the only exclusion criteria. ResultsThe rate of SN identification was 97.9% in Group A vs. 99.09% in Group B (P=0.29). SNs were metastasis positive and frozen sections false negative at comparable proportions in both groups. ConclusionsThe extension of indications for SNB did not reduce the rates of SN identification or did not create any impact on the rate of metastatic SNs.

Highlights

  • Sentinel node biopsy (SNB) has become a standard method to determine the metastatic involvement of regional lymph node basin in breast cancer

  • Group A (n = 143) had SNB performed only when the patients fulfilled to the following criteria: breast tumor no greater than 3 cm in diameter, unifocal disease, no pure ductal carcinoma in situ, no history of previous breast or lymph node surgery, and no neoadjuvant chemotherapy

  • The extension of indications for SNB did not reduce the rates of sentinel node (SN) identification or did not create any impact on the rate of metastatic SNs

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Summary

Introduction

Sentinel node biopsy (SNB) has become a standard method to determine the metastatic involvement of regional lymph node basin in breast cancer. The American Society of Clinical Oncology (ASCO) published the recommendations for SNB in 2005 [1] where it was stated that SNB should not be employed in case of T3 or T4 tumors, inflammatory breast cancer, ductal carcinoma in situ (DCIS) without mastectomy, nodes suspicious for metastasis, pregnancy, prior axillary surgery, previous nononcologic breast surgery, and after preoperative systemic therapy. Group A (n = 143) had SNB performed only when the patients fulfilled to the following criteria: breast tumor no greater than 3 cm in diameter, unifocal disease, no pure ductal carcinoma in situ, no history of previous breast or lymph node surgery, and no neoadjuvant chemotherapy. Indications for SNB were extended in Group B (n = 328) so that inflammatory breast cancer and positive lymph nodes became the only exclusion criteria.

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