title: Sentinel node biopsy in breast cancer: the experience of Brescia Civic Hospital.
abstract: The accuracy of the sentinel node technique in the evaluation of axillary node involvement in breast cancer was evaluated in 83 consecutive patients with monofocal T1-2 carcinoma, who were clinically N0 and who underwent lymphoscintigraphy with 99mTc-colloid integrated with intraoperative sentinel node detection by a portable probe. Lymphoscintigraphy revealed at least one sentinel node in 75 patients (90.4%), always identified by the probe. In eight patients (9.6%) the sentinel node was detected neither by lymphoscintigraphy nor by the probe. All removed lymph nodes were analyzed by hematoxylin-eosin histology and the sentinel node by immunostaining. In 28/75 patients (37.3%) at least one metastatic axillary lymph node was detected; in 16 of the 28 N+ subjects (57%) only the sentinel node was positive. The false negative rate (sentinel node negative/other axillary lymph nodes positive) was 17.85% (5/28 patients). In 9/23 patients (39%) micrometastases were found in the sentinel node only. In conclusion, specific sentinel node positivity in 57% of cases supports the validity of the sentinel node concept. Moreover, nine patients would have been considered N0 by standard hematoxylin-eosin histology without sentinel node-aided immunostaining. A 17.8% false negative rate calls for caution in patients with negative sentinel nodes.
authors.affiliation: Divisione di Medicina Nucleare, Spedali Civili, Brescia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Pizzocaro
authors.forename: P L
authors.initials: PL
authors.lastname: Rossini
authors.forename: A
authors.initials: A
authors.lastname: Terzi
authors.forename: R
authors.initials: R
authors.lastname: Farfaglia
authors.forename: L
authors.initials: L
authors.lastname: Lazzari
authors.forename: E
authors.initials: E
authors.lastname: Simoncini
authors.forename: R
authors.initials: R
authors.lastname: Giubbini
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005188:False Negative Reactions; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D007558:Italy; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging / Q000592:standards; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*