[Our experience of the clinical application of sentinel node biopsy in breast cancer]

Systematical lymphadenectomy has been replaced by selective sentinel node biopsy in the initial staging of early breast cancer. The aim of this study was to assess the accuracy of the technique in its application phase, paying special attention to the follow-up of patients with negative sentinel node who did not undergo axillary lymphadenectomy.

A total of 168 patients with 169 stage I and II breast cancer lesions underwent sentinel lymph node biopsy in its application phase. The procedure was previously validated by our group and included lymphoscintigraphy performed with periareolar or intratumoral injection of 99mTc stannous colloid, and radioguided surgical detection on the following day.

Lymphoscintigraphic sentinel node localization was successful in 95.3% of the lesions (161/169) and axillary surgical detection in 90.5% (153/169), with 1.1 nodes excised per patient (range 1-4). Malignancy was found in 30.1% of the sentinel nodes removed (46/153), 11 of which were micrometastases (23.9%). Subsequent axillary dissection revealed that the sentinel node was the only node involved in 22/46 (47.8%). The sentinel node was found to be negative in the remaining 107/153 lesions (69.9%), and surgical treatment was considered to be complete. To date, the mean follow-up of the patients has been 20.4 months (range 3-49), and no axillary recurrences have been observed. Of the entire group, four patients developed distant metastases; one had concomitant mammary recurrence and died.

Application of sentinel node biopsy is safe and has improved our

This technique allows correct staging and probably maintains local control of the disease.