title: A prospective validation study of sentinel lymph node biopsy in multicentric breast cancer: SMMaC trial.
abstract: BACKGROUND
  Multicentric breast cancer is often considered a contra-indication for sentinel lymph node (SLN) biopsy due to concerns with sensitivity and false negative rate. To assess SLN feasibility and accuracy in multicentric breast cancer, the multi-institutional SMMaC trial was conducted.
  
  
  METHODS
  In this study 30 patients with multicentric breast cancer and a clinically negative axilla were prospectively included. Periareolar injection of radioisotope and blue dye was administered. In all patients SLN biopsy was validated by back-up completion axillary lymph node dissection.
  
  
  RESULTS
  the SLN was successfully identified in 30 of 30 patients (identification rate 100%). The incidence of axillary metastases was 66.7% (20/30). The false negative rate was 0% (0/20) and the sensitivity was 100% (20/20). The negative predictive value was 100% (10/10).
  
  
  CONCLUSIONS
  SLN biopsy in multicentric breast cancer seems feasible and accurate and should therefore be considered in patients with multicentric breast cancer and clinically negative axilla.
authors.affiliation: Department of Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek Ziekenhuis, Amsterdam, The Netherlands. Electronic address: rfdvanlaparra@tiscali.nl.
authors.forename: R F D
authors.initials: RF
authors.lastname: van la Parra
authors.affiliation: Department of Surgery, Gelderse Vallei Hospital, Ede, The Netherlands.
authors.forename: W K
authors.initials: WK
authors.lastname: de Roos
authors.affiliation: Department of Surgery, Maasstad Hospital, Rotterdam, The Netherlands.
authors.forename: C M E
authors.initials: CM
authors.lastname: Contant
authors.affiliation: Department of Nuclear Medicine, Gelderse Vallei Hospital, Ede, The Netherlands.
authors.forename: C D L
authors.initials: CD
authors.lastname: Bavelaar-Croon
authors.affiliation: Department of Nuclear Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
authors.forename: P C
authors.initials: PC
authors.lastname: Barneveld
authors.affiliation: Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Bosscha
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000601:surgery; D018275:Carcinoma, Lobular / Q000473:pathology* / Q000601:surgery; D004396:Coloring Agents; D005188:False Negative Reactions; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008408:Mastectomy; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology* / Q000601:surgery; D015609:Organotechnetium Compounds; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012394:Rosaniline Dyes; D021701:Sentinel Lymph Node Biopsy
chemical_list: D004396:Coloring Agents; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D012394:Rosaniline Dyes; C008769:sulfan blue
keywords: Axillary lymph node dissection; False negative rate; Multicentric breast cancer; Sentinel lymph node biopsy