title: Sentinel node biopsy for breast cancer may have little to offer four-node-samplers. results of a prospective comparison study.
abstract: The aims of the study were to determine how often four node axillary sampling (4NAS) encompasses the sentinel node (SN) and to compare the relative sensitivity of 4NAS with sentinel node biopsy (SNB) for axillary node staging. 200 patients with breast cancer were preoperatively injected with 27 MBq 99m-Tc-labelled colloid adjacent to the tumour. At operation, standard 4NAS was performed. Each node was counted ex vivo using a probe. A search was then made to find a node with higher counts in vivo directed by the probe. If found, it was excised. Each node was submitted separately to pathology. A SN was identified in 191 patients (96%). The SN was contained in the 4NAS in 153 patients (80%) and identified separately in 38 patients (20%). Of 60 node-positive patients, 49 were positive by 4NAS and SNB, the SN was not identified in 2 and in 8 the SN was falsely negative compared with 4NAS. For 1 patient, the SN was positive and the 4NAS negative. SNB performed using radiolabelled colloid has no advantage over 4NAS when nodes are assessed by standard histological technique.
authors.affiliation: The Breast Unit, Nottingham City Hospital, Hucknall Road, NG5 1PB, Nottingham, UK. douglas.macmilan@btinternet.com
authors.forename: R D
authors.initials: RD
authors.lastname: Macmillan
authors.forename: D
authors.initials: D
authors.lastname: Barbera
authors.forename: D J
authors.initials: DJ
authors.lastname: Hadjiminas
authors.forename: R S
authors.initials: RS
authors.lastname: Rampaul
authors.forename: A H
authors.initials: AH
authors.lastname: Lee
authors.forename: S E
authors.initials: SE
authors.lastname: Pinder
authors.forename: I O
authors.initials: IO
authors.lastname: Ellis
authors.forename: R W
authors.initials: RW
authors.lastname: Blamey
authors.forename: J G
authors.initials: JG
authors.lastname: Geraghty
mesh_terms: D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D002985:Clinical Protocols; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000379:methods; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods / Q000592:standards*