Original article
Sentinel lymph node involvement—a predictor for axillary node status with breast cancer—Has the time come?

https://doi.org/10.1016/S0748-7983(98)92827-XGet rights and content

Aims

Axillary node dissection for breast cancer is important for staging and its prognostic value. Sentinel nodes are defined as the first nodes into which the primary cancer drains. This study investigates whether identification, removal and pathological examination of these nodes indicates whether the completion of axillary lymphadenectomy is required.

Methods

Using a vital dye injected at the primary tumour site, we were able to identify sentinel nodes in 96 out of 98 women examined.

Results

An average number of 2.7±1.2 nodes per patient were identified as sentinel nodes. In 83% of cases there was a correlation between the involvement of the sentinel nodes and the rest of the axillary nodes. In 14% of patients the sentinel nodes were the only nodes involved with tumour. In three cases the sentinel nodes were negative, but other axillary nodes were tumour-positive.

Conclusion

The major problem in routine application of this method to the decision to perform axillary lymph node dissection (ALND) is the time needed for pathological identification of lymph node involvement by tumour.

References (8)

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    Citation Excerpt :

    This more limited surgical procedure provides prognostic information regarding the status of the axillary lymph nodes and is associated with significantly less morbidity than standard axillary dissection, which can be avoided in patients with negative sentinel nodes (20). In patients with positive sentinel lymph nodes, it is well established that additional positive lymph nodes are present in 39–86% of patients. (13, 16, 21, 22). This would suggest the necessity for additional axillary treatment in the presence of positive sentinel nodes.

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