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Extra-axillary sentinel node biopsy in breast cancer staging--is it necessary?
M Victorzon1, E Hämäläinen, M Svartbäck
1Department of Surgery, Vasa Central Hospital, Sandviksgatan 2-4, 65130, Vasa, Finland. mikael.victorzon@vshp.fi
Aims:
The aim of this study was to assess the value of lymphoscintigraphy in general and extra-axillary lymph node biopsy in particular, based on our experience with sentinel biopsy in 128 consecutive woman undergoing surgery for breast cancer.
Methods:
Sentinel node biopsy was performed with the aid of isotope, hand held gamma probe, blue dye and lymphoscintigraphy in 83 patients. Injection technique was peritumoral or intratumoral. Lymphoscintigraphy was performed 2-4 h following isotope injection.
Results:
Eighteen lymposcintigraphies were negative (21.7%). The sentinel node was found in 14 of these cases. We were unable to identify the sentinel node(s) in four patients (4/83; 4.8%). All in all 20/25 (80%) extra-axillary nodes were located and taken out. Only two of these (2/20, 10%) were positive for metastatic disease on histological examination. The adjuvant treatment plans for these patients were not altered in response to these findings. No positive extra-axillary node(s) with simultaneous normal axillary sentinel node was found.
Conclusions:
In this serie, lymphoscintigraphy and biopsy of extra-axillary sentinel nodes added nothing but time, risk and cost to the procedure.