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Published on: June 1, 2019
Sentinel node dissection as definitive treatment for node negative breast cancer patients
R Ponzone1, N Biglia, F Maggiorotto
1Academic Gynaecological Oncology Unit, Institute for Cancer Research and Treatment (IRCC) of Candiolo, Mauriziano Umberto I Hospital, Largo Turati 62, 10128 Turin, Italy. rponzone@mauriziano.it
Summary
Radioguided sentinel node dissection accurately assesses nodal status in breast cancer patients. This method helps determine if cancer has spread to the axilla, guiding treatment decisions effectively.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Sentinel node status is crucial for breast cancer staging and treatment planning.
- Accurate assessment of axillary lymph nodes can prevent unnecessary morbidity from complete axillary dissection.
Purpose of the Study:
- To evaluate the performance and reliability of radioguided sentinel node dissection (SNSD) for breast cancer.
- To assess the accuracy of intraoperative histologic evaluation of sentinel nodes.
Main Methods:
- Retrospective analysis of 212 women with primary invasive breast tumors (<3 cm) undergoing radioguided SNSD using 99mTc-colloidal albumin.
- Completion axillary node dissection was performed for positive sentinel nodes or unidentified nodes.
Main Results:
- Sentinel nodes were identified in 207/212 patients (97.6%).
- Tumor diameter was significantly associated with sentinel node status (p<0.000).
- Per-operative histologic evaluation showed 67.3% sensitivity and 90.4% negative predictive value.
Conclusions:
- Radioguided SNSD is a reliable method for assessing nodal status in most breast cancer patients.
- Both preoperative lymphoscintigraphy and intraoperative histology provide valuable information.
- No subset of sentinel node-positive patients could be identified for whom axillary node dissection could be safely avoided.
