Sentinel lymph node involvement--a predictor for axillary node status with breast cancer--has the time come?
OBJECTIVE
Axillary node dissection for breast cancer is important for staging and its prognostic value. Sentinel nodes are defined as the first nodes into which the primary cancer drains. This study investigates whether identification, removal and pathological examination of these nodes indicates whether the completion of axillary lymphadenectomy is required.


METHODS
Using a vital dye injected at the primary tumour site, we were able to identify sentinel nodes in 96 out of 98 women examined.


RESULTS
An average number of 2.7 +/- 1.2 nodes per patient were identified as sentinel nodes. In 83% of cases there was a correlation between the involvement of the sentinel nodes and the rest of the axillary nodes. In 14% of patients the sentinel nodes were the only nodes involved with tumour. In three cases the sentinel nodes were negative, but other axillary nodes were tumour-positive.


CONCLUSIONS
The major problem in routine application of this method to the decision to perform axillary lymph node dissection (ALND) is the time needed for pathological identification of lymph node involvement by tumor.
Koller
M
M
Breast Cancer Service, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Barsuk
D
D
Zippel
D
D
Engelberg
S
S
Ben-Ari
G
G
Papa
M Z
MZ
D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D004396:Coloring Agents / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008751:Methylene Blue / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis
D004396:Coloring Agents; D008751:Methylene Blue