title: Different criteria for radioactive sentinel lymph nodes has different impact on sentinel node biopsy in breast cancer patients.
abstract: OBJECTIVE
  This study set out to determine the impact of different criteria for radioactive sentinel lymph nodes (SLNs) on sentinel lymph node biopsy (SLNB), and the optimal criteria for radioactive SLNs.
  
  
  METHODS
  Eighty-four breast cancer patients with cT1-2N0M0 were studied prospectively. Filtered technetium 99 m sulfur colloid was injected in peritumor parenchyma. Three different definitions of SLNs were adopted in each patient: (1) the lymph node with the highest radioactivity. (2) Any lymph node with an in vivo hot spot-to-background activity ratio of at least 3:1 or an ex vivo SLN-to-non-SLN ratio of at least 10:1. (3) All radioactive hot nodes.
  
  
  RESULTS
  With three different definitions, the success rate of sentinel node biopsy were all 96.4%, the sensitivity was 78.9%, 92.1%, 97.4% respectively; false negative rate 21.1%, 7.9%, 2.6% respectively; predicting accuracy 90.1%, 96.3%, 98.8% respectively (P < 0.05). The first, the first two, the first three, and the first four highest radioactive sentinel nodes identified 81.1%, 89.2%, 94.6%, 100% of the positive-SLN patients, respectively.
  
  
  CONCLUSIONS
  The different criteria for radioactive SLNs had different impact on the accuracy, sensitivity, and false negative rate, but not on the success rate, during sentinel node biopsy using radioactive sulfur colloid in breast cancer patients. The first four highest radioactive sentinel nodes could accurately predict the status of axillary metastases. J. Surg. Oncol. 2007;95:635-639. (c) 2007 Wiley-Liss, Inc.
authors.affiliation: Surgical oncology, Sir Run Run Shaw Hospital and Sir Run Run Shaw Clinical Medical Institute, Medical College of Zhejiang University, Hangzhou, Zhejiang Province, China.
authors.forename: Xiang-Yang
authors.initials: XY
authors.lastname: Song
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Yuan
authors.forename: Wen-Jun
authors.initials: WJ
authors.lastname: Chen
authors.forename: Tao
authors.initials: T
authors.lastname: Pan
authors.forename: Shu-Duo
authors.initials: SD
authors.lastname: Xie
authors.forename: Chuan
authors.initials: C
authors.lastname: Qin
authors.forename: Chen
authors.initials: C
authors.lastname: Lou
authors.forename: Mei
authors.initials: M
authors.lastname: Jin
authors.forename: Lin-Bo
authors.initials: LB
authors.lastname: Wang
authors.forename: Jin-Min
authors.initials: JM
authors.lastname: Wu
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology*; D008207:Lymphatic Metastasis; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D013671:Technetium Tc 99m Sulfur Colloid
chemical_list: D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid