Sentinel node biopsy in elderly breast cancer patients

Area of Science:

• Oncology
• Surgical Oncology
• Geriatric Medicine

Background:

• Sentinel lymph node biopsy (SLNB) is increasingly recognized as safe and accurate for axillary staging in breast cancer.
• However, older women (>or=70 years) with breast cancer often receive less extensive axillary surgery.
• This study evaluated SLNB safety and axillary recurrence rates in elderly breast cancer patients.

Purpose of the Study:

• To assess the safety and efficacy of sentinel node biopsy (SLNB) in elderly women (>=70 years) with operable breast cancer.
• To determine the rate of axillary recurrences following SLNB in this specific patient demographic.

Main Methods:

• A prospective study included 241 elderly patients (>=70 years) with operable breast cancer (<=3 cm) and clinically negative axillary nodes.
• Sentinel nodes were identified using 99mTc-labeled colloidal particles and examined via intraoperative frozen-section.
• Patients with positive sentinel nodes underwent immediate complete axillary dissection.

Main Results:

• 100% sentinel node identification rate achieved.
• 37.3% of patients had sentinel node metastasis; 56.7% of these had only the sentinel node involved.
• No axillary recurrences were observed at a median follow-up of 29.7 months, with an overall survival of 97.9%.

Conclusions:

• Sentinel node biopsy is a safe and accurate staging method for axillary nodes in elderly women with operable breast cancer (<3 cm).
• The absence of axillary recurrences supports SLNB as a viable alternative to complete axillary dissection in selected elderly patients.