[Relevance of the sentinel lymph node biopsy in breast multifocal and multicentric cancer].
OBJECTIVE
The sentinel lymph node biopsy is a gold standard in the management of breast cancer. Its role in multifocal or multicentric tumors is still evolving. The aim of this study is to assess the feasibility and pertinence of sentinel lymph node biopsy in multifocal and multicentric tumors based on a systematic review of literature.


METHODS
A systematic review was conducted searching in the following electronic databases PubMed using "sentinel lymph node biopsy", "breast cancer", "multifocal tumor", "multicentric tumor" and "multiple tumor" as keywords. We included original articles published between 2000 and 2014, both French and English, studying feasibility of sentinel lymph node biopsy in invasive breast cancer, multicentric and/or multifocal tumors. The first end point was success rate and false negative rate.


RESULTS
Twenty-six articles were included in this literature review, with 2212 cases (782 multifocal, 737 multicentric and 693 multiple tumors). Percentage of tumors whose stage was higher than stage T2 ranged from 0 to 86.3%. Success rate average was 83.1%. False negative average was 8.2%. False negative rate was less than 10% in 15 articles. Mean of sentinel lymph node biopsy was 2 (1-9). The average rate of sentinel lymph node positive was 50.6%. Axillary recurrence rate was 0.5%.


CONCLUSIONS
Despite the methodological biases of the studies included in this review of literature, the false negative rate of sentinel node biopsy in multifocal and multicentric breast cancers are less than 10% with a low rate of axillary recurrence. Despite the lack of randomized study, this procedure can be routinely performed in accordance with rigorous technical process.
Département de gynécologie-obstétrique, hôpital Maison Blanche, 45, rue Cognacq-Jay, 51092 Reims cedex, France; Université Reims - Champagne-Ardennes, 51, rue Cognacq-Jay, 51095 Reims cedex, France.
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Mosbah
Département de gynécologie-obstétrique, hôpital Maison Blanche, 45, rue Cognacq-Jay, 51092 Reims cedex, France; Université Reims - Champagne-Ardennes, 51, rue Cognacq-Jay, 51095 Reims cedex, France. Electronic address: Emilie_raimond@hotmail.com.
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Raimond
Département de gynécologie-obstétrique, hôpital Maison Blanche, 45, rue Cognacq-Jay, 51092 Reims cedex, France; Université Reims - Champagne-Ardennes, 51, rue Cognacq-Jay, 51095 Reims cedex, France.
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Pelissier
Département de gynécologie-obstétrique, hôpital Maison Blanche, 45, rue Cognacq-Jay, 51092 Reims cedex, France; Université Reims - Champagne-Ardennes, 51, rue Cognacq-Jay, 51095 Reims cedex, France.
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Hocedez
Département de gynécologie-obstétrique, hôpital Maison Blanche, 45, rue Cognacq-Jay, 51092 Reims cedex, France; Université Reims - Champagne-Ardennes, 51, rue Cognacq-Jay, 51095 Reims cedex, France.
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Graesslin
D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D021701:Sentinel Lymph Node Biopsy
Breast cancer; Cancer du sein; Ganglion sentinelle; Multicentric; Multicentrique; Multifocal; Sentinel lymph node