Preoperative selection of symptomatic breast cancer patients appropriate for lymphatic mapping and sentinel node biopsy.
BACKGROUND
This study examines whether preoperative ultrasound-assessed tumour diameter and diagnostic core biopsy-determined grade can be used to select those most likely to benefit from SLNB (i.e. those that are "node negative") before their definitive operation.


METHODS
Breast ultrasound (US) and a simultaneous core biopsy was performed in all patients at their initial presentation, and their estimates of tumor size and grade compared with the final pathological specimen (FPS).


RESULTS
Of the T1 group 47% had lymphatic metastases as did 49% of those with grade I or II cancers. By combining these measures, however, subgroups of patients with lower rates of nodal metastases were identified (32% of patients with T1, non-grade III disease had lymphatic disease while only 15% of those with T < 1.5 cm, non-grade III cancers had such metastases).


CONCLUSIONS
Combination of the US and ultrasound guided core biopsy (UGCB) may however identify subgroups unlikely to have axillary disease that are therefore suitable for SLNB.
Barry
M
M
Department of Surgery, Waterford Regional Hospital and Royal College of Surgeons in Ireland, Waterford, Ireland. mitchelbarry@hotmail.com
Cahill
R A
RA
Roche-Nagle
G
G
Landers
R
R
Walsh
D
D
Bouchier-Hayes
D J
DJ
Watson
R G K
RG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D018579:Patient Selection; D021701:Sentinel Lymph Node Biopsy; D014463:Ultrasonography