title: False negative rate of sentinel lymph node biopsy in multicentric and multifocal breast cancers may be higher in cases with large additive tumor burden.
abstract: We aimed to evaluate the feasibility of sentinel lymph node biopsy (SLNB) in multicentric/ multifocal breast cancer. In this prospective study, 23 women with multicentric/multifocal breast cancer underwent SLNB at our institution from April 2002 to February 2006. Presence of preoperative axillary metastases was confirmed by FNA. Patients underwent sub-areolar radiopharmaceutical injection +/- isosulfan blue to perform SLNB, then completion ALND. The false-negative (FN) rate of SLNB was determined based upon final pathology. Twenty women with multicentric and three with multifocal invasive carcinoma were enrolled. The SLN identification rate was 100%. The overall FN rate of SLNB was 15% (95% CI 0.0466, 0.4281). Both cases with FN SLNB had multicentric disease, pathologic stage III breast cancer and a larger tumor burden compared with the study population. SLNB using sub-areolar injection is feasible for patients with multicentric/multifocal breast cancer yet may be associated with a higher FN rate in patients with large additive tumor burden.
authors.affiliation: Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Regina M
authors.initials: RM
authors.lastname: Fearmonti
authors.forename: Larissa I
authors.initials: LI
authors.lastname: Batista
authors.forename: Funda
authors.initials: F
authors.lastname: Meric-Bernstam
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bedrosian
authors.forename: Henry M
authors.initials: HM
authors.lastname: Kuerer
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Hunt
authors.forename: S
authors.initials: S
authors.lastname: Eva Singletary
authors.forename: Gildy V
authors.initials: GV
authors.lastname: Babiera
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D021701:Sentinel Lymph Node Biopsy; D047368:Tumor Burden