Japanese Journal of Clinical Oncology, Vol 29, Issue 1 11-15, Copyright © 1999 by Foundation for Promotion of Cancer Research
S Imoto and T Hasebe
BACKGROUND: Axillary lymph node dissection is an important procedure in the
surgical treatment of breast cancer. Axillary lymph node dissection is
still performed in over half of breast cancer patients having
histologically negative nodes, regardless of the morbidity in terms of
axillary pain, numbness and lymphedema. The first regional lymph nodes
draining a primary tumor are the sentinel lymph nodes. Sentinel node biopsy
is a promising surgical technique for predicting histological findings in
the remaining axillary lymph nodes, especially in patients with clinically
node-negative breast cancer, and a worldwide feasibility study is currently
in progress. METHODS: Intraoperative lymphatic mapping and sentinel node
biopsy were performed in the axilla by subcutaneous injection of blue dye
(indigocarmine) in 88 cases of stage 0-IIIB breast cancer. Sentinel lymph
nodes were identified by detecting blue-staining lymph nodes or dye-filled
lymphatic tracts after total or partial mastectomy. Finally, axillary lymph
node dissection was performed up to Levels I and II or more. RESULTS:
Sentinel lymph nodes were successfully identified in 65 of the 88 cases
(74%). In the final histological examination, the sentinel lymph nodes in
40 cases were negative, including four cases with
non-sentinel-node-positive breast cancer (specificity, 100%; sensitivity,
86%). In nine (31%) of the 29 cases with histologically node-positive
breast cancer, the sentinel lymph nodes were the only lymph nodes affected.
Axillary lymph node status was accurately predicted in 61 (94%) of the 65
cases. CONCLUSIONS: Although it was the initial experience at the National
Cancer Center Hospital East, sentinel node biopsy proved feasible and
successful. This method may be a reasonable alternative to the standard
axillary lymph node dissection in patients with early breast cancer.
ORIGINAL ARTICLE
Initial experience with sentinel node biopsy in breast cancer at the National Cancer Center Hospital East
Division of Breast Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. simoto@east.ncc.go.jp
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