title: Which hottest nodes can predict sentinel lymph node metastasis in breast cancer?
abstract: BACKGROUND
  In approximately 80% of breast cancer patients, the hottest sentinel lymph nodes (SLNs) can be used to predict nodal metastasis. We correlate the reliability of using these nodes to predict SLN metastasis with different lymphoscintigraphic patterns in breast cancer.
  
  
  METHODS
  SLN biopsies for T(1-2)N(o) breast cancer were performed on 467 patients. Lymphoscintigraphic patterns were divided into three groups by the number of draining routes using blue dye and radiocolloid and whether the hottest nodes were the first nodes in the channel.
  
  
  RESULTS
  The hottest SLNs detected 78 of 87 (90%) cases of SLN metastasis in the 399 patients with successful labeling of both blue dye and radiocolloid in their SLNs. False-negative rates were 0% (single-channel, first node), 58% (multi-channel, first node), and 71% (zero-channel, 0 hottest nodes) (FNR: SingleChanl versus ZeroChanl, P=0.005 and SingleChanl versus MultiChanl, P=0.037; Fisher's exact test).
  
  
  CONCLUSIONS
  We recommend a preoperative lymphoscintigram to distinguish the subset of breast-cancer patients with a single draining channel and whose hottest node is the first node.
authors.affiliation: Department of Surgery, College of Medicine, National Cheng Kung University, Tainan and Dou-Liou Branch, Taiwan.
authors.forename: Yao-Lung
authors.initials: YL
authors.lastname: Kuo
authors.forename: Wei-Jen
authors.initials: WJ
authors.lastname: Yao
authors.forename: Tsai-Wang
authors.initials: TW
authors.lastname: Chang
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008875:Middle Aged; D011300:Preoperative Care; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy