Sentinel lymph node biopsy in early breast cancer: the first 100 cases performed in a teaching institute.
BACKGROUND
The histologic status of axillary lymph nodes is one of the most important prognostic factors in breast cancer and influences the management of these patients. Axillary lymph node dissection was traditionally performed in all patients to obtain this information but this procedure carries a considerable rate of complications. Recently, sentinel lymph node biopsy has emerged as an accurate and minimally invasive tool for predicting the axillary nodal status and has become the standard of care in selected patients with breast cancer.


OBJECTIVE
To examine the accuracy of SLN biopsies performed by surgical residents during surgical resident training.


METHODS
This prospective, randomized controlled study included 100 consecutive patients with clinically early breast cancer (T1-T2, N0, M0). Lymphatic mapping was performed using radiotracers, blue dye, or both. Formal axillary lymph node dissection completed the operations in all patients. All operations were performed by surgical residents under the supervision of senior surgeons.


RESULTS
The overall rate of identification of sentinel lymph nodes was 92%. The accuracy of SLN biopsy in reflecting the axillary nodal status was 96% with a false negative rate of 5.7%.


CONCLUSIONS
Sentinel lymph node biopsy is an accurate method for the evaluation and staging of regional lymph nodes in breast cancer patients. A dedicated instruction program for surgical residents may increase the standard of care and lead to highly trained surgeons in the management of early breast cancer.
Mahajna
Ahmad
A
Department of Surgery A, Rambam Medical Center, Technion Faculty of Medicine, Haifa, Israel.
Hershko
Dan D
DD
Israelit
Shlomi
S
Abu-Salih
Adel
A
Keidar
Zohar
Z
Krausz
Michael M
MM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001365:Axilla / Q000473:pathology / Q000601:surgery; D001943:Breast Neoplasms / Q000175:diagnosis*; D005188:False Negative Reactions; D005260:Female; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*