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Accuracy of axillary staging using sentinel node biopsy or diagnostic axillary lymph node dissection--a case-control
Marjut Leidenius1, Leena Krogerus, Eija Tukiainen
1Breast Surgery Unit, Maria Hospital, Lapinlahdenkatu, Helsinki, Finland. marjut.leidenius@hus.fi
Summary
Sentinel node biopsy (SNB) and axillary lymph node dissection (ALND) show similar accuracy for breast cancer axillary staging. SNB did not upstage invasive ductal carcinoma but did for other histological types.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Accurate axillary staging is crucial for breast cancer treatment.
- Sentinel node biopsy (SNB) is a less invasive alternative to axillary lymph node dissection (ALND).
Purpose of the Study:
- To compare the accuracy of SNB versus ALND in staging breast cancer axillae.
- To evaluate the prevalence of axillary metastases between SNB and ALND groups.
Main Methods:
- Retrospective analysis of 166 breast cancer patients undergoing SNB.
- Pair-matched control group of patients who underwent ALND.
- Matching criteria included patient age, tumor grade, histological type, and size.
Main Results:
- Prevalence of axillary metastases was 37% in the SNB group and 31% in the ALND group (p=ns).
- Discordant findings occurred in 57 pairs; SNB identified metastases in 34, ALND in 23.
- SNB did not increase upstaging for invasive ductal carcinoma but did for other histological types.
Conclusions:
- SNB demonstrates comparable accuracy to ALND for axillary staging in breast cancer.
- SNB's utility in upstaging varies by histological type, being less effective for invasive ductal carcinoma.