Accuracy of sentinel lymph node biopsy for the assessment of axillary status in patients with early (T1) Breast carcinoma | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2005]

Author(s):

1. Gunay Gurleyik: Department of Surgery, Haydarpasa Numune Teaching and Research Hospital, Istanbul, Turkey.

2. Fugen Aker: Department of Pathology, Haydarpasa Numune Teaching and Research -Hospital, Istanbul, Turkey.

3. Umit Sekmen: Department of Surgery, Haydarpasa Numune Teaching and Research Hospital, Istanbul, Turkey.

4. Abdullah Saglam: Department of Surgery, Haydarpasa Numune Teaching and Research Hospital, Istanbul, Turkey.

Abstract:

Objective: To determine the accuracy of SLN biopsy for the assessment of axillary status, and prognostic markers leading to lymphatic metastasis in patients with early (T1) breast cancer. Design: Cross-sectional study. Place and Duration of Study: Department of Surgery, Teaching and Research Hospital. Between January 2000 and August 2004. Patients and Methods: SLN mapping by blue dye method was performed on 39 patients with T1 breast carcinoma. SLNs, level 1 and 2 axillary nodes were dissected and excised. The size, pathologic features of the primary tumor, SLNs and other axillary nodes, and hormone receptors were evaluated by histopathologic examination. The rate of SLNs and non- SLNs involvement, and demographic, clinical and pathologic risk factors leading to nodal metastasis were established. The diagnostic accuracy of SLN for axillary status was calculated. Results: SLNs were identified in 37 (95%) patients. The axilla had metastasis in 11 (28%) patients. Malignant cells involved SLNs in 8 patients. Non-SLNs had metastasis in 3 patients without SLN involvement. The sensitivity, specificity and accuracy of SLN biopsy for predicting axillary status was calculated as 73%, 100% and 92% respectively. Four of 5 patients with non-SLN metastasis were pre-menopausal (p=0.03), and hormone receptor negative (p=0.04). All 5 patients had T1c tumors (p=0.14) and lymphovascular invasion (p=0.0004). Conclusion: SLN biopsy with high diagnostic accuracy may prevent unnecessary dissection of the axilla in the majority of patients with early (T1) breast carcinoma. Some risk factors as pre-menopausal status, absence of hormone receptors, and presence of lymphovascular invasion must be taken into account as important determinant of non-SLNs metastasis.

Page(s): 697-700

DOI: DOI not available

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 15, Issue: 11, Year: 2005

Keywords:

Breast , Lymphovascular invasion , Sentinel lymph node , T1 cancer , Hormone receptor , Blue dye

References:

[1] McDermotEtW O,'HigginsN O .2004 .Factorasffectinmgetastasetsonon-sentinel lymphnodesin breasctancerJ. Clin Pathol, 57 : 73-6.

[2] Woo .2001 .Predictintghestatuosfthenon-sentinaexlillarnyodes multicentsetrudy. Arch Surg, 136 : 563-8.

[3] Chu KU,Qi K .2000 .metastaseins patientwsithmetastatbicreasctarcinom ain sentinellymphnode. Cancer, 89 : 574-81.

[4] Tan LR .2001 .Treatme nimtplicationosfa positivseentinellymphnodebio forpatientswith early-stagbereastcarcinoma. Cane, 92 : 1769-74.

[5] McMasterKsM .2000 .Sentinellymphnodebiopsyforbreasctancera: suitablealternatitvoe routineaxiallydissectionin multiinstitutiopnraalcticwehenoptimatlechniqu eis used. J Clin Oncol, 18 : 2560-6.

[6] .1998 .The sentinenlodein breasctancera: multicentvearlidation study. NEngl JMed, 339 : 941-6.

[7] .2004 .Predictoorsfnon-sentinneoldemetastasinispatie withbreasctanceraftersentinenlode metastasisAr. ch Su, 139 : 648-51.

[8] .2003 .Predic factorfsorthe statusofnon-sentinneoldesin breasctanc patientwsithtumorpositivseentinenlodes. Breast Cancer Res Tret, 82 : 39-45.

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