title: Sentinel lymph node biopsy in the treatment of breast cancer. Experience in 527 cases.
abstract: OBJECTIVE
  Knowledge of axillary lymph node status is a key aid to staging and prognosis and it represents a guideline for adjuvant therapy in breast cancer. Despite the morbidity it causes, complete axillary dissection was long the mainstay of treatment. Sentinel lymph node biopsy has proved so reliable in the evaluation of node involvement that axillary node dissection is now generally performed when sentinel node biopsy tests negative.
  
  
  METHODS
  In this 3-phase study, 50 patients were enrolled to evaluate the learning curve of sentinel node biopsy (phase 1, September 1997-January 1998); 256 patients (age range 27-81 years) with infiltrative breast cancer (T <3 cm, clinical N0) underwent level 1 lymph node dissection when the sentinel node tested negative at histopathology (phase 2, February 1998-March 2001); 221 patients with T <3 cm underwent dissection of the sentinel node when it tested negative for metastasis (phase 3, April 2001-March 2005).
  
  
  RESULTS
  The sentinel node was preoperatively detected in 98.6% of cases after peritumoral and intradermic injection of the radionuclide tracer and intraoperatively in 99% (90% with radio-guided surgery, 10% with vital staining). The sentinel node was positive in 15% of patients with T1 and metastatic in 65%.
  
  
  CONCLUSIONS
  Our results are in line with the published data; therefore, the study will go forward to examine the role of the micrometastasis in the sentinel node and of in-transit tumoral cells.
authors.affiliation: Department of Surgery, Second University of Naples, Naples, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Procaccini
authors.forename: R
authors.initials: R
authors.lastname: Ruggiero
authors.forename: G
authors.initials: G
authors.lastname: Docimo
authors.forename: F
authors.initials: F
authors.lastname: Iovino
authors.forename: F
authors.initials: F
authors.lastname: Procaccini
authors.forename: R
authors.initials: R
authors.lastname: De Luca
authors.forename: E
authors.initials: E
authors.lastname: Irlandese
authors.forename: S
authors.initials: S
authors.lastname: Gili
authors.forename: F
authors.initials: F
authors.lastname: Lo Schiavo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000601:surgery; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery; D004396:Coloring Agents; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000193:education; D013668:Technetium Tc 99m Aggregated Albumin
chemical_list: D004396:Coloring Agents; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin