Sentinel lymph node and breast cancer staging: final results of the Turin Multicenter Study.
OBJECTIVE
Validation of the sentinel node (SN) technique in breast cancer by means of lymphoscintigraphy.


METHODS
From December 1996 to January 1999 102 T1-T2 breast carcinoma cases were recruited in Turin. 99mTc-human serum albumin colloids were injected subdermally the day before surgery (mean activity, 5.2 +/- 2.5 MBq). Scintigraphic imaging was performed after injection. After identification of the SN during surgery by a hand-held gamma probe, the SN was excised and sent for histologic examination. SN histology was compared with that of other axillary nodes.


RESULTS
The SN detection rate was 86.3%; among 88 cases with an identified SN, 37 (42%) had axillary metastases; the SN was metastatic in 35 cases (sensitivity, 94.6%); in 51.3% of pN+ cases (19/37) the SN was the only metastatic site. In two of the 53 negative SNs, SN histology did not match with that of the remaining axilla (negative predictive value, 96.2%; staging accuracy, 97.7%).


CONCLUSIONS
Our results agree with those reported in the literature; however, except in clinical trials and experienced structures axillary lymph node dissection should not be abandoned when mandatory for prognostic purposes, considering that at present SN biopsy alone is not completely accurate for axillary staging, especially in the absence of an adequate learning period.
Casalegno
P S
PS
Unità Operativa di Chirurgia Oncologica, Università di Torino, Turin, Italy.
Sandrucci
S
S
Bellò
M
M
Durando
A
A
Danese
S
S
Silvestro
L
L
Pellerito
R
R
Testori
O
O
Roagna
R
R
Giai
M
M
Giani
R
R
Bussone
R
R
Favero
A
A
Bisi
G
G
Massobrio
M
M
Giardina
G
G
Mussa
G C
GC
Sismondi
P
P
Mussa
A
A
D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D007558:Italy; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*