Mona Duncan1, Amy Cech, Debra Wechter, Ravi Moonka. 1. Department of General, Vascular, and Thoracic Surgery, Virginia Mason Medical Center, C6-GSUR, PO Box 900, 1100 Ninth Ave., Seattle, WA 98111, USA.
Abstract
BACKGROUND: Criteria are needed that could be used to terminate a sentinel lymphadenectomy for breast cancer prior to removing every sentinel lymph node, without increasing false negative rates. METHODS: Quantitative information on the radioactivity and color of sentinel lymph nodes removed from 541 breast cancer patients was correlated with pathologic information to determine when a sentinel lymphadenectomy could be terminated based on characteristics of the initially removed nodes. RESULTS: Tumor was found in the first two sentinel lymph nodes removed in 127 of 129 node-positive patients. In 65% of patients who were able to be evaluated, the most radioactive lymph node was a positive lymph node. When any axillary lymph node was blue, then the first tumor-containing sentinel lymph node was also blue. CONCLUSIONS: Removal of the most radioactive lymph node does not insure accurate assessment of the axilla. Removal of two sentinel lymph nodes accurately staged 98.4% of node-positive patients and 99.6% of the entire study population.
BACKGROUND: Criteria are needed that could be used to terminate a sentinel lymphadenectomy for breast cancer prior to removing every sentinel lymph node, without increasing false negative rates. METHODS: Quantitative information on the radioactivity and color of sentinel lymph nodes removed from 541 breast cancerpatients was correlated with pathologic information to determine when a sentinel lymphadenectomy could be terminated based on characteristics of the initially removed nodes. RESULTS:Tumor was found in the first two sentinel lymph nodes removed in 127 of 129 node-positive patients. In 65% of patients who were able to be evaluated, the most radioactive lymph node was a positive lymph node. When any axillary lymph node was blue, then the first tumor-containing sentinel lymph node was also blue. CONCLUSIONS: Removal of the most radioactive lymph node does not insure accurate assessment of the axilla. Removal of two sentinel lymph nodes accurately staged 98.4% of node-positive patients and 99.6% of the entire study population.
Authors: Robert C G Martin; Anees Chagpar; Charles R Scoggins; Michael J Edwards; Lee Hagendoorn; Arnold J Stromberg; Kelly M McMasters Journal: Ann Surg Date: 2005-06 Impact factor: 12.969