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Lelievre, L. et al.

Lelievre, Houvenaeghel, Buttarelli, Brenot-Rossi, Huiart, Tallet, Tarpin, Jacquemier,

Value of the sentinel lymph node procedure in patients with large size breast cancer.

BACKGROUND: Widely used in routine for small breast cancers, the sentinel lymph node (SN) biopsy is still discussed in tumors >/= 3 cm. METHODS: From 2000 to 2005, 152 patients with invasive breast tumor pT >/= 3 cm had a SN biopsy systematically followed by complete level I/II axillary dissection. Surgery was always the first stage of the treatment. Detection was done after injection of radioisotope followed by a lymphoscintigraphy and injection of Patent Blue. The SN procedure systematically included palpation of the axilla with removal of any enlarged (>1 cm) and/or abnormally firm node even if neither blue nor radioactive. The sentinel lymph node status was compared with the final axillary status. RESULTS: Tumor size ranged from 30 to 200 mm (median 42 mm). Lymphoscintigraphy was positive in 98% of the cases. At least one labeled sentinel node was retrieved in 97.4% of the patients. The median number of SN cleared out was 2 (range 1-9). The false negative risk was 4% (4/99). The false negative risk was not related to the tumor size and not related to the number of SN removed. CONCLUSIONS: This study shows that the SN procedure is feasible in patients with breast tumors >/= 3 cm with an acceptable false negative risk <5%, similar to false negatives reported for smaller tumors.[1]

References

Value of the sentinel lymph node procedure in patients with large size breast cancer. Lelievre, L., Houvenaeghel, G., Buttarelli, M., Brenot-Rossi, I., Huiart, L., Tallet, A., Tarpin, C., Jacquemier, J. Ann. Surg. Oncol. (2007) [Pubmed]

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