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The sentinel lymph node biopsy in breast cancer
J M Weerts1, S Maweja, I Tamigneaux
1Department of Senology, St. Joseph Clinics, Liège, Belgium.
Acta Chirurgica Belgica
|June 8, 2002
Summary
Sentinel lymph node biopsy is a reliable diagnostic approach for early breast cancer. Intradermal injection improved sentinel lymph node identification rates, showing promising accuracy in detecting metastases.
Area of Science:
- Oncology
- Surgical Pathology
- Diagnostic Imaging
Background:
- Sentinel lymph node (SLN) biopsy is a crucial staging procedure for breast cancer.
- Accurate SLN identification is vital to avoid unnecessary axillary dissection.
Purpose of the Study:
- To assess the feasibility and accuracy of sentinel lymph node biopsy in breast cancer patients.
- To evaluate different injection techniques for SLN identification.
Main Methods:
- Tc-99 labeled nanocolloid was injected either intramammarily (Group I) or intradermally (Group II) in T1-T2 N0 breast cancer patients.
- SLN was identified using a detection probe after primary tumor removal, followed by routine axillary dissection.
- SLNs were examined by routine histology, semi-serial slides, and immunoassay.
Main Results:
- SLN identification rates were 35% in Group I (intramammary) versus 93% in Group II (intradermal).
- 13% of SLNs were positive for metastasis by routine examination; 3 additional cases detected by immunohistology.
- False negative rate was 6.6% (4 patients with positive axillary nodes but negative SLN).
Conclusions:
- Sentinel lymph node biopsy is a reliable method for staging early breast cancer.
- Intradermal injection technique significantly improves SLN identification rates.
- Further studies may explore combining SLN biopsy with blue dye to reduce false negatives and assess survival impact.