Feasibility of sentinel lymph node biopsy in multifocal/multicentric breast cancer

Sentinel lymph node (SLN) biopsy can replace axillary lymph node dissection (ALND) in prediction of nodal status in node-negative breast cancer. However, patients presenting with multifocal/multicentric (MF/MC) breast cancer are usually excluded from studies of SLN biopsy. This study evaluated the efficacy of SLN biopsy in patients with MF/MC breast cancer.

Breast cancer patients who underwent preoperative lymphoscintigraphy and SLN biopsy with backup ALND from 2004 to 2006 were retrospectively reviewed. Patients enrolled in this study had clinically node-negative unifocal or MF/MC breast cancer based on final histology. Sentinel node biopsy was performed with a 2-day protocol with intradermal radiocolloid injection on day one and SLN biopsy on day two. Histopathologic parameters and the efficacy of the SLN biopsy were compared between unifocal and MF/MC breast cancers.

This study enrolled 158 breast cancer patients; one hundred and thirty-five patients were diagnosed with unifocal and 23 with MF/MC breast cancer. The mean numbers of SLNs retrieved were 1.3 for the unifocal and 1.1 for the MF/MC groups. The identification rate, sensitivity, accuracy, and false-negative rate for unifocal and MF/MC breast cancers were 94.8%, 92.6%, 98.4%, and 7.4%; and 100%, 100%, 100%, and 0%, respectively. No significant differences were observed between the two groups for SLN identification, sensitivity, accuracy, and false-negative rate.

Sentinel lymph node biopsy using intradermal radiocolloid injection method is feasible for MF/MC breast cancer.