[Sentinel lymph node biopsy in breast cancer patients--results and experience after 500 sentinel lymph node biopsies].
BACKGROUND
Sentinel lymph node biopsy (SLNB) is a widely used technique for axillary staging in breast cancer patients. The principle to evaluate the axillary status of a breast cancer patient with a less invasive surgery than axillary lymph node dissection (ALND) meets the new minimally invasive concept in breast cancer surgery. Some breast cancer centers proceed to SLNB without ALND in SLN-negative patients.


METHODS
Between March 1998 and March 2002, 500 SLNBs were performed. After a learning period with SLNB and ALND in 75 patients with a sensitivity of 96.2% and a false-negative rate of 3.8%, SLNB alone without further ALND was performed in a group of patients. In addition, the feasibility of SLNBin patients with locally advanced breast cancer, in patients after neoadjuvant chemotherapy and in patients with multicentricity was evaluated. The combined method with blue dye and technetium-99m-labeled human albumin for identification of SLNs was applied.


RESULTS
500 SLNBs were performed. The identification rate was 86.2%. After exclusion of patients with neoadjuvant chemotherapy and patients with multicentricity, the identification rate was 94.5%. SLNs were positive in 41.3% of patients and negative in 58.7% of patients.


CONCLUSIONS
SLNB is an excellent method for axillary stag-ing and an alternative for ALND in a certain group of breast cancer patients.
Reitsamer
R
R
Landesklinik für Spezielle Gynäkologie und Brustambulanz, Salzburg, Austria. r.reitsamer@lks.at
Menzel
C
C
Peintinger
F
F
Cimpoca
W
W
Glück
S
S
Sinzinger
G
G
Rettenbacher
L
L
Kässmann
H
H
Hoffmann
A
A
Prokop
E
E
Strasser
F
F
Kiesler
J
J
Hutarew
G
G
Dietze
O
O
D001365:Axilla; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy