title: Sentinel node biopsy in elderly breast cancer patients.
abstract: BACKGROUND
  Even if an increasing body of data suggests that sentinel node biopsy is a safe and accurate method of screening the axillary nodes for metastasis, there is a tendency to perform less extensive or no axillary surgery in older breast cancer women. The aim of this study therefore was to assess the safety of the procedure as well as the rate of axillary recurrences after sentinel node biopsy in this older population.
  
  
  METHODS
  Between May 1997 and March 2003, 241 consecutive elderly patients (>or=70 years) with operable breast cancer up to 3 cm and clinically negative axillary lymph nodes were entered into this study. Sentinel node was identified using 5-10 MBq of 99 mTc-labeled colloidal particles and examined with immediate complete intraoperative frozen-section.
  
  
  RESULTS
  The sentinel node identification rate was 100%. Ninety-seven percent of the patients underwent breast-conserving surgery. In 90 out of 241 patients (37.3%) the sentinel node was positive for metastasis and complete axillary dissection was immediately performed. In 56.7% of these patients the sentinel node was the only lymph node involved. Micrometastasis in the sentinel node was detected in 30 of the 90 (33.3%) patients. A total of 151 patients (62.7%) were sentinel node negative and no further surgical treatment was done. There were no axillary recurrences at a median followup of 29.7 months (range 3-87 months). The overall survival of this group of patients was 97.9%.
  
  
  CONCLUSIONS
  Sentinel node biopsy is a safe and accurate method of screening the axillary nodes for elderly women with operable breast cancer less than 3 cm. The absence of axillary recurrences after sentinel node biopsy without complete axillary dissection supports the hypothesis.
authors.affiliation: Department of Surgery, European Institute of Oncology, Via Ripamonti Milano 435 20141, Italy. roberto.gennari@ieo.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Gennari
authors.forename: Nicole
authors.initials: N
authors.lastname: Rotmensz
authors.forename: Elisa
authors.initials: E
authors.lastname: Perego
authors.forename: Gabriela
authors.initials: G
authors.lastname: dos Santos
authors.forename: Umberto
authors.initials: U
authors.lastname: Veronesi
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000601:surgery; D018275:Carcinoma, Lobular / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008408:Mastectomy / Q000379:methods; D015412:Mastectomy, Segmental; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D021701:Sentinel Lymph Node Biopsy; D016896:Treatment Outcome