The effect of prior breast biopsy method and concurrent definitive breast procedure on success and accuracy of sentinel lymph node biopsy.
BACKGROUND
It has been suggested that sentinel lymph node (SLN) biopsy for breast cancer may be less accurate after excisional biopsy of the primary tumor compared with core needle biopsy. Furthermore, some have suggested an improved ability to identify the SLN when total mastectomy is performed compared with lumpectomy. This analysis was performed to determine the impact of the type of breast biopsy (needle vs. excisional) or definitive surgical procedure (lumpectomy vs. mastectomy) on the accuracy of SLN biopsy.


METHODS
The University of Louisville Breast Cancer Sentinel Lymph Node Study is a prospective multi-institutional study. Patients with clinical stage T1-2, N0 breast cancer were eligible. All patients underwent SLN biopsy and completion level I/II axillary dissection. Statistical comparison was performed by chi(2) analysis.


RESULTS
A total of 2206 patients were enrolled in the study. There were no statistically significant differences in SLN identification rate or false-negative rate between patients undergoing excisional versus needle biopsy. The SLN identification and false-negative rates also were not statistically different between patients who had total mastectomy compared with those who had a lumpectomy.


CONCLUSIONS
Excisional biopsy does not significantly affect the accuracy of SLN biopsy, nor does the type of definitive surgical procedure.
Wong
Sandra L
SL
Division of Surgical Oncology, Department of Surgery, J. Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, Kentucky 40202, USA.
Edwards
Michael J
MJ
Chao
Celia
C
Tuttle
Todd M
TM
Noyes
R Dirk
RD
Carlson
David J
DJ
Laidley
Alison L
AL
McGlothin
Terre Q
TQ
Ley
Philip B
PB
Brown
C Matthew
CM
Glaser
Rebecca L
RL
Pennington
Robert E
RE
Turk
Peter S
PS
Simpson
Diana
D
McMasters
Kelly M
KM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000473:pathology*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D015409:Mastectomy, Radical; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy