[Sentinel lymph node biosy in surgical treatment of breast carcinoma: prospective study]

Authors report the validity and accuracy of lymphatic mapping with sentinel node biopsy in patients with early breast cancer between 1998 and 2000.

Prospective study.

Department of Surgery, Atlas Hospital Zlin.

Lymphatic mapping and sentinel node biopsy using patentblue in patients with breast cancer was performed between 1998 and 2000. Combination of patentblue and radiocoloid Nanocoll Nycomed Amersham has been used from 2000. C-Track device (Care Wise Medical Product Morgan Hill) was applied for detection of radiocoloid in sentinel node. Gamma probe intraoperatively localised sentinel nodes. Lymphoscintigraphy was performed routinely. Patients were tested with routine hematoxylin & eosin staining. When the H&E staining in sentinel nodes was negative the immunohistochemical procedure was used. Following identification of sentinel nodes, axillary node dissection was applied. Axillary node dissection was abandoned by patients with tumor T1 and sentinel node negative.

In 124 cases, the sentinel node was successfully identified. 122 patients were women with unilateral and one woman with bilateral cancer. 1 was a male. Of these 124 cases 60 were node-positive and sentinel nodes metastasis was in 26 cases only. 1375 nonsentinel nodes were examined (a mean 13.4). 268 sentinel nodes were examined (a mean 2.2). Hematoxylin and eosin staining was used routinely and if no tumor was identified then imunohistochemical cytokeratin staining was performed. Imunohistochemical staining was used in 21 cases. Only in one patient micrometastases were identified. Three sentinel nodes were negative in patient with axillary disease.

This study demonstrates that sentinel node biopsy in patients with early breast cancer is safe and highly accurate an can be used to avoid axillary lymph node dissection.