Impact of non-axillary sentinel node biopsy on staging and treatment of breast cancer patients.

Abstract:

:The purpose of this study was to evaluate the occurrence of lymphatic drainage to non-axillary sentinel nodes and to determine the implications of this phenomenon. A total of 549 breast cancer patients underwent lymphoscintigraphy after intratumoural injection of (99m)Tc-nanocolloid. The sentinel node was intraoperatively identified with the aid of intratumoural administered patent blue dye and a gamma-ray detection probe. Histopathological examination of sentinel nodes included step-sectioning at six levels and immunohistochemical staining. A sentinel node outside level I or II of the axilla was found in 149 patients (27%): internal mammary sentinel nodes in 86 patients, other non-axillary sentinel nodes in 44 and both internal mammary and other non-axillary sentinel nodes in nineteen patients. The intra-operative identification rate was 80%. Internal mammary metastases were found in seventeen patients and metastases in other non-axillary sentinel nodes in ten patients. Staging improved in 13% of patients with non-axillary sentinel lymph nodes and their treatment strategy was changed in 17%. A small proportion of clinically node negative breast cancer patients can be staged more precisely by biopsy of sentinel nodes outside level I and II of the axilla, resulting in additional decision criteria for postoperative regional or systemic therapy.

journal_name

Br J Cancer

authors

Tanis PJ,Nieweg OE,Valdés Olmos RA,Peterse JL,Rutgers EJ,Hoefnagel CA,Kroon BB

doi

10.1038/sj.bjc.6600359

subject

Has Abstract

pub_date

2002-09-23 00:00:00

pages

705-10

issue

7

eissn

0007-0920

issn

1532-1827

journal_volume

87

pub_type

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