title: Sentinel lymph node biopsy in multicentric breast cancer: five-year results in a large series from a single institution.
abstract: OBJECTIVE
  This study was designed to present the 5-year results of patients with multicentric breast cancer who underwent sentinel lymph node biopsy (SLNB) in a single institution.
  
  
  METHODS
  Between June 1999 and December 2007, 337 patients with multicentric breast cancer and a clinically negative axilla underwent lymphatic mapping by a single periareolar/peritumoral (n = 306) or a double peritumoral or subdermal injection (n = 31) of (99m)Tc-HSA nanocolloids. The sentinel lymph node (SLN) was evaluated by intraoperative frozen section and axillary dissection was performed only in cases of positive SLNB.
  
  
  RESULTS
  The median age of the patients was 48 (range, 22-81) years. The mean number of hot spots identified was 1.4 in the whole series, 1.3 in patients who received a single injection, and 1.7 in those who received a double injection (P < 0.001). The mean number of removed SLNs was 1.7 (median, 1; range, 1-7) with an identification rate of 100%. A total of 138 patients with negative SLNB (n = 134) or isolated tumor cells in the SLN (n = 4) did not receive completion axillary lymph node dissection (CALND). In these latter patients, a total of 27 events (19.5%) occurred with 3 patients (2.2%) developing axillary recurrences after a median follow-up of 5 years (range, 17-134 months).
  
  
  CONCLUSIONS
  Axillary lymph node reappearance was infrequent among patients with multicentric breast cancer, having negative SLNB and no CALND. We recommend SLNB as the standard procedure for nodal staging in patients with multicentric breast cancer and a clinically negative axilla.
authors.affiliation: Division of Senology, European Institute of Oncology, Milano, Italy. oreste.gentilini@ieo.it
authors.forename: Oreste
authors.initials: O
authors.lastname: Gentilini
authors.forename: Paolo
authors.initials: P
authors.lastname: Veronesi
authors.forename: Edoardo
authors.initials: E
authors.lastname: Botteri
authors.forename: Fiammetta
authors.initials: F
authors.lastname: Soggiu
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Trifirò
authors.forename: Germana
authors.initials: G
authors.lastname: Lissidini
authors.forename: Viviana
authors.initials: V
authors.lastname: Galimberti
authors.forename: Simona
authors.initials: S
authors.lastname: Musmeci
authors.forename: Paola Rafaniello
authors.initials: PR
authors.lastname: Raviele
authors.forename: Antonio
authors.initials: A
authors.lastname: Toesca
authors.forename: Silvia
authors.initials: S
authors.lastname: Ratini
authors.forename: Andres
authors.initials: A
authors.lastname: Del Castillo
authors.forename: Andres Del
authors.initials: AD
authors.lastname: Castillo
authors.forename: Marco
authors.initials: M
authors.lastname: Colleoni
authors.forename: Nina
authors.initials: N
authors.lastname: Talakhadze
authors.forename: Nicole
authors.initials: N
authors.lastname: Rotmensz
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Viale
authors.forename: Umberto
authors.initials: U
authors.lastname: Veronesi
authors.forename: Alberto
authors.initials: A
authors.lastname: Luini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D018275:Carcinoma, Lobular / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D015996:Survival Rate; D055815:Young Adult