Value of the sentinel lymph node procedure in patients with large size breast cancer.
BACKGROUND
Widely used in routine for small breast cancers, the sentinel lymph node (SN) biopsy is still discussed in tumors >or= 3 cm.


METHODS
From 2000 to 2005, 152 patients with invasive breast tumor pT >or= 3 cm had a SN biopsy systematically followed by complete level I/II axillary dissection. Surgery was always the first stage of the treatment. Detection was done after injection of radioisotope followed by a lymphoscintigraphy and injection of Patent Blue. The SN procedure systematically included palpation of the axilla with removal of any enlarged (>1 cm) and/or abnormally firm node even if neither blue nor radioactive. The sentinel lymph node status was compared with the final axillary status.


RESULTS
Tumor size ranged from 30 to 200 mm (median 42 mm). Lymphoscintigraphy was positive in 98% of the cases. At least one labeled sentinel node was retrieved in 97.4% of the patients. The median number of SN cleared out was 2 (range 1-9). The false negative risk was 4% (4/99). The false negative risk was not related to the tumor size and not related to the number of SN removed.


CONCLUSIONS
This study shows that the SN procedure is feasible in patients with breast tumors >or= 3 cm with an acceptable false negative risk <5%, similar to false negatives reported for smaller tumors.
Lelievre
Loic
L
Department of Surgery, Institut Paoli-Calmettes, 232 Bd Sainte Marguerite, Marseilles, France. lelievrel@marseille.fnclcc.fr
Houvenaeghel
Gilles
G
Buttarelli
Max
M
Brenot-Rossi
Isabelle
I
Huiart
Laetitia
L
Tallet
Agnes
A
Tarpin
Carole
C
Jacquemier
Jocelyne
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000473:pathology*; D005188:False Negative Reactions; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008408:Mastectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy