Sentinel lymph node biopsy in patients with multicentric/multifocal breast cancer: low false-negative rate and lack of axillary recurrence.
BACKGROUND
Accuracy of sentinel lymph node biopsy (SLNB) and rate of axillary recurrence in multicentric/multifocal (MC/MF) breast cancer are reported.


METHODS
From 1999 to 2006, 93 patients with MC/MF breast cancer underwent SLNB; 41 underwent axillary lymph node dissection regardless of SLN pathology (group 1), and 52 underwent axillary lymph node dissection only if an SLN was positive (group 2). Patient demographics, SLN techniques, and pathology were recorded.


RESULTS
There were no differences between the 2 groups with respect to patient age; tumor size, grade, stage, and histology; or method of SLN detection. The incidence of axillary metastasis was greater in group 1 patients (68%) compared with group 2 patients (12%) (P < .01). In group 1, the sensitivity and specificity of SLNB were 93% and 100%, respectively, with a false-negative rate of 7%. None of the 52 patients in group 2 experienced axillary recurrence (median follow-up 4.8 years).


CONCLUSIONS
The accuracy of SLNB in MC/MF breast cancer is comparable with that observed in unifocal breast cancer. Despite a lower rate of SLN positivity in patients undergoing SLNB only, axillary recurrence was not observed.
Holwitt
Dana M
DM
Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Gillanders
William E
WE
Aft
Rebecca L
RL
Eberlein
Timothy J
TJ
Margenthaler
Julie A
JA