Sentinel node biopsy for breast cancer larger than 3 cm in diameter.
BACKGROUND
Sentinel node biopsy (SNB) is a standard staging procedure in early breast cancer. Its suitability for larger tumours has been questioned. This study evaluated the reliability of SNB in women with invasive breast cancer larger than 3 cm in diameter who were clinically axillary node negative.


METHODS
Some 109 women with a tumour larger than 3 cm on pathological analysis were identified from the Swedish prospective SNB database. They were included if a completion axillary clearance was planned, regardless of SNB results.


RESULTS
The sentinel node detection rate was 103 (94.5 per cent) of 109. The overall false-negative rate was eight (13 per cent) of 64. Although a preoperative diagnosis of multifocal tumour was an exclusion criterion, 16 such cases were revealed on postoperative pathological examination. The false-negative rate in this subgroup was higher than that in women with a unifocal tumour (four (31 per cent) of 13 versus four (8 per cent) of 51; P = 0.012). No other significant predictors of a false-negative sentinel node biopsy were identified.


CONCLUSIONS
SNB is feasible in patients with unifocal breast tumours larger than 3 cm. When large tumour size coincides with multifocality, however, the false-negative rate seems to be increased and a completion axillary clearance should be considered even if the SNB is negative.
Schüle
J
J
Department of Surgery and Centre for Clinical Research Uppsala University, Central Hospital, Västerås, Sweden. janamarit@yahoo.com
Frisell
J
J
Ingvar
C
C
Bergkvist
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D005189:False Positive Reactions; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D015412:Mastectomy, Segmental / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011446:Prospective Studies; D012044:Regression Analysis; D021701:Sentinel Lymph Node Biopsy / Q000379:methods