title: [Prognostic and curative value of sentinel node in breast cancer. A 377 patients experience].
abstract: Sentinel node is defined as the first lymphnode receiving limphatic drain from the breast. Several studies show a very low recurrence rate to axillary and locoregional nodes in sentinel node negative patients who did not undergo axillary dissection. Our study aims to verify if complete axillary dissection could be replaced by sentinel node biopsy (SNB) in the staging and treatment of breast cancer. From January 2005 to December 2008, 377 patients (mean age 57.63) underwent SNB in the General Surgery unit of "San Giuseppe Moscati" Hospital in Avellino (Italy). All the patients underwent SNB with local anesthesia. Histologic studies were performed using GIVOM protocol (Veneto Breast cancer interdisciplinary group). Sixty five patients (17.2%) underwent a radical mastectomy with SNB and 312 (82.6%) patients underwent a quadrantectomy with SNB. Of this last group, 178 (47.2%) underwent a superior quadrant excision with SNB, 77 (20.4%) an inferior quadrant excision with SNB and 57 (15.1%) a central quadrant excision with SNB. Ductal carcinoma represented 57.3% of the tumous detected, lobular carcinoma was diagnosed in 16.4% of the cases, intraductal microinvasive carcinoma in 10.3%, ductal carcinoma in situ in 5.8% while the other histotypes were diagnosed in 10% of the tumours. All SNB+ patients (34.5%) underwent a radical axillary dissection in general anesthesia. Sixty nine (53%) patients were diagnosed with axillary node metastasis, after axillary dissection Micrometastasis resulted in 19.6% of the excised patients. The prevalence of axillary node metastasis was 26.4% (581/2198), while the incidence was 34.5% (130/377). The first axillary lymphnodes level was metastasized in 65.8% patients who had undergone an axillary dissection, level I and II in 268% and all the levels in 7.4%. Only one case (0.4%) of nodal metastatic recurrence has been diagnosed in patients who had undergone SNB alone, after a mean follow-up of 28.5 month. Apart from showing a very high diagnostic and staging accuracy, the high level of SN detection associated with a high predictive rate underline a lower complications rate if compared to complete nodal dissection.
authors: Unità Operativa di Chirurgia Generale, Azienda Ospedaliera "San Giuseppe Moscati", Avellino.
authors: Carlo
authors: C
authors: Iannace
authors: Lorenzo
authors: L
authors: Di Libero
authors: Maria
authors: M
authors: Lepore
authors: Noè
authors: N
authors: De Stefano
authors: Marcella
authors: M
authors: Buono
authors: Valerio
authors: V
authors: Sciascia
authors: Fiorenza
authors: F
authors: Manetta
authors: Marco
authors: M
authors: Giordano
authors: Giovanni
authors: G
authors: Scetta
authors: Roberto
authors: R
authors: Varriale
authors: Daniela
authors: D
authors: Esposito
authors: Ernesto
authors: E
authors: Tartaglia
authors: Umberto
authors: U
authors: Ferbo
authors: Paolo
authors: P
authors: Miletto
authors: Francesco
authors: F
authors: Caracciolo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy