title: Is the sentinel lymph node biopsy more sensitive for the identification of positive lymph nodes in breast cancer than the axillary lymph node dissection?
abstract: Since the routine clinical use of the sentinel lymph node (SLN) procedure, questions have been raised concerning an increase in the overall percentage of node-positive patients. The goal of our study was to compare the sensitivity of the SLN procedure and the axillary lymph node dissection (ALND) for the identification of positive lymph nodes in breast cancer. The incidence of axillary node metastasis in SLNB and ALND specimens from patients undergoing operative treatment of a primary breast carcinoma was compared retrospectively. Logistic regression models were used to analyze the effect of various predictors on the presence of positive lymph nodes. We constructed a multivariate model including the procedure and these predictors that have shown to be related to lymph node involvement in univariate analysis. The probability of finding positive lymph nodes was thus calculated in both groups correcting for relevant predictors of lymph node involvement. The SLNB group included 830 patients, the ALND group 320. In a multivariate analysis, adjusting for the number of foci, tumor location in the breast, tumor size, LVI, ER, PR, tumor grade and histological subtype, the probability of finding positive lymph nodes was higher with SLNB procedure than with an ALND. However, this difference was not statistically significant (OR 0.7635; CI 0.5334-1.0930, p 0.1404). For comparable tumors, SLNB procedure is at least as sensitive as ALND for detecting positive lymph nodes.
authors: Department of Oncology, KU Leuven, Gynaecological Oncology, University Hospitals Leuven, Leuven, Belgium ; Department of Oncology, KU Leuven, Gynaecological Oncology, University Hospitals Leuven, Leuven, Belgium.
authors: Ann
authors: A
authors: Smeets
authors: Emi
authors: E
authors: Yoshihara
authors: Annouschka
authors: A
authors: Laenen
authors: Anneleen
authors: A
authors: Reynders
authors: Julie
authors: J
authors: Soens
authors: Hans
authors: H
authors: Wildiers
authors: Robert
authors: R
authors: Paridaens
authors: Chantal
authors: C
authors: Van Ongeval
authors: Giuseppe
authors: G
authors: Floris
authors: Patrick
authors: P
authors: Neven
authors: Marie-Rose
authors: MR
authors: Christiaens
keywords: Axillary lymph node dissection; Breast cancer; Lymph nodes; Sentinel lymph node biopsy
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