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Sentinel node biopsy can replace four-node-sampling in staging early breast cancer
T Agarwal1, S K Kakkos, D A Cunningham
1Breast Unit, St. Mary's Hospital, Praed Street, London W2 1NY, UK.
Summary
Sentinel node (SN) biopsy is a sensitive method for breast cancer staging. In patients with identified SN, four-node axillary sampling offers no additional diagnostic information.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Four-node axillary sampling is a standard method for axillary staging in the UK for breast cancer.
- Sentinel node (SN) biopsy is an alternative staging technique.
Purpose of the Study:
- To evaluate the sensitivity of sentinel node (SN) biopsy.
- To compare SN biopsy with four-node axillary sampling for breast cancer staging.
Main Methods:
- SN identification was attempted in 234 patients with unifocal breast cancers using isotope-labelled nanocolloid and patent blue dye.
- SN were identified in 94.5% of patients.
- All patients had four-node sampling; those with positive SN on frozen section (FS) underwent axillary clearance.
Main Results:
- An average of 1.38 SN were identified per patient.
- Histological examination of SN alone identified all node-positive patients detected by four-node sampling.
Conclusions:
- Sentinel node biopsy is highly effective for axillary staging in breast cancer.
- Four-node axillary sampling provides no additional information when SN are successfully identified.