Sentinel node biopsy and large (≥3 cm) breast cancer.

ANZ J Surg

Royal Adelaide Hospital, Adelaide, South Australia, Australia; University of Adelaide, Adelaide, South Australia, Australia.

Published: March 2014

AI Article Synopsis

  • Sentinel node biopsy is effective for staging large breast cancers, achieving a 4.9% false negative rate, similar to small tumors.
  • In a study of 100 patients with tumors averaging 3.91 cm, 65 had metastatic disease in axillary nodes.
  • The findings suggest that while sentinel node biopsy is reliable, more research is needed for comprehensive understanding in larger cancers due to higher metastasis rates.

Article Abstract

Background: Sentinel node biopsy is an accurate method for staging the axilla in early (small) breast cancers. However, data for the role of this technique for large breast cancers remain limited.

Method: From the Royal Adelaide Hospital Sentinel Node database and the SNAC trial database, 100 subjects were identified with clinically node negative, large (≥3 cm) primary breast cancer who had undergone sentinel node biopsy and immediate axillary clearance. The pathology results from the sentinel node and axillary specimens were analysed.

Results: Average tumour size was 3.91 cm (range 3-10 cm) and 65 of 100 cases had metastatic disease in the axillary nodes. A sentinel node was successfully identified in 93 out of 100 cases with an average of 1.75 sentinel nodes sampled. Sixty-two per cent (58 out of 93) were sentinel node positive and 43% (43 out of 100) had a positive non-sentinel node. The false negative rate following successful sentinel node identification was 4.9% (3 out of 61).

Conclusion: Sentinel node biopsy was an accurate tool for staging the axilla with a false negative rate comparable to that seen in small tumours. However, given the increased incidence of metastases with larger cancers, further prospective investigation is warranted.

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Source
http://dx.doi.org/10.1111/ans.12139DOI Listing

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