Assessment of clinical palpation of the axilla as a criterion for performing the sentinel node procedure in breast cancer.
OBJECTIVE
Clinically palpable lymph nodes (LNs) are regarded as a contraindication for performing the sentinel node (SN) procedure. Many studies have shown, however, that clinical assessment of axillary LNs is inaccurate. This study evaluated the reliability of clinical axillary LN assessment by experts and assessed whether inaccuracy can be related to LN size.


METHODS
Three hundred and one consecutive breast cancer patients undergoing either axillary dissection or SN were studied prospectively.


RESULTS
The risk of having metastasis to the LN was 40.4% if the preoperative clinical assessment was "non-palpable LN", 61.5% if the assessment was "palpable but benign LN" and 84.4% if it was "suspicious LN". There were no clinically significant differences in mean size either when the LN was palpable versus non-palpable, or when the LN had metastasis or not.


CONCLUSIONS
The clinical assessment of axillary LNs as a criterion for offering the SN procedure is of little value.
Lanng
C
C
Breast Surgery Clinic, Horsholm Hospital, Usserod Kongevej 102, DK-2970 Horsholm, Denmark. charl@fa.dk
Hoffmann
J
J
Galatius
H
H
Engel
U
U
D000328:Adult; D001365:Axilla / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010173:Palpation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy