Sentinel node biopsy in breast cancer: short time results show appropriate regional control
Abstract:
Sentinel node biopsy becomes a standard diagnostic and therapeutic tool in breast cancer in certain indications, while in other indications its validity is still reviewed. The authors present their experience with this method. In the years 2000-2006 700 patients underwent surgery. 704 sentinel node biopsies were performed (bilaterally in 4 cases), 7 times surgery was unsuccessful. In the unsuccessful cases immediate axillary lymph node dissection (ALND) was performed. 985 sentinel nodes were found, the average was 1.4 nodes, maximum 6 nodes. In 7 patients contralateral ALND for node positive contralateral cancer was necessary along with sentinel node biopsy. A positive sentinel lymph node (SLN) was found in 188 (26.9%) patients. A strong correlation between tumor size and lymph node positivity was found, 5.3% in pT1a, and 40.4% in pT2, respectively. The sentinel node metastases could be divided according to their size. The number of affected further nodes did correlate with this size, yet with the exception of isolated tumor cell detection, small size metastases did not exclude the possibility of further affection. Our findings support the role of sentinel node biopsy in breast cancer. 332 patients reached at least 2 years of follow up by the time of statistic evaluation, 2.5% of SLN negative and 5.6% of SLN positive patients experienced a recurrence. All of these recurrences were distant with no regional (axillary) involvement to this date. We conclude that sentinel node biopsy is not only a safe and accurate diagnostic tool, but it also provides acceptable regional control of the disease.