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Sentinel lymph node biopsy for staging breast cancer
I T Rubio1, S Korourian, C Cowan
1Department of Surgery, University of Arkansas for Medical Sciences, Arkansas Cancer Research Center, John L. McClellan Veteran's Administration Hospital, Little Rock 72205, USA.
American Journal of Surgery
|February 2, 1999
Summary
Sentinel lymph node (SLN) biopsy accurately predicts axillary lymph node (LN) status in breast cancer staging. This method is highly accurate and can reduce patient morbidity and healthcare costs without compromising staging.
Area of Science:
- Oncology
- Surgical Pathology
- Nuclear Medicine
Background:
- Accurate axillary lymph node (LN) staging is critical for breast cancer survival prediction.
- The histology of the first draining lymph node may predict the status of other axillary LNs.
Purpose of the Study:
- To evaluate if the sentinel lymph node (SLN) histology accurately predicts the histology of remaining axillary LNs.
- To assess the accuracy of SLN biopsy in breast cancer staging.
Main Methods:
- Fifty-five patients with operable invasive breast carcinoma and clinically negative axillary nodes were studied.
- Patients received Technetium-99 sulfur colloid injection around the primary tumor.
- A gamma detector probe identified and removed the SLN, followed by level I and II lymphadenectomy.
Main Results:
- The SLN was identified in 96.3% of patients.
- The SLN biopsy demonstrated high sensitivity (88.2%) and specificity (100%).
- Positive predictive value was 100%, negative predictive value was 94.6%, and overall accuracy was 96.2%.
Conclusions:
- Sentinel lymph node biopsy is a highly accurate method for breast cancer staging.
- SLN biopsy has the potential to reduce morbidity and cost in breast cancer management.
- Staging accuracy is maintained using SLN biopsy.