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How many sentinel lymph nodes are enough for accurate axillary staging in t1-2 breast cancer?

Authors
 Eun Jeong Ban  ;  Jun Sang Lee  ;  Byeong-Woo Park  ;  Seung Il Kim  ;  Seho Park  ;  Ja Seung Koo 
Citation
 Journal of Breast Cancer, Vol.14(4) : 296-300, 2011 
Journal Title
 Journal of Breast Cancer 
ISSN
 1738-6756 
Issue Date
2011
Abstract
PURPOSE: During a sentinel lymph node biopsy (SLNB) for breast cancer, the appropriate number of sentinel lymph nodes (SLNs) to be removed for accurate axillary staging is still controversial. We hypothesized that there might be an optimal threshold number of SLNs. We investigated how many SLNs should be removed to achieve an acceptable accuracy and ensure minimal morbidity. METHODS: We reviewed data of 328 patients with invasive breast cancer who underwent SLNB followed by complete level I and II axillary dissection between January 2004 and December 2005. The false negative rate (FNR) and accuracy of SLNB according to the number of removed SLNs were evaluated. RESULTS: The mean number of SLNs removed was 3.0 (range, 1-14), and that of total retrieved axillary lymph nodes was 17.5 (range, 10-40). In total, 111 (33.8%) patients had positive nodes on the permanent pathological report. Among them, 12 patients had negative SLNs; thus, the overall FNR of SLNB was 10.8% (12/111) and the accuracy was 96.3% (316/328). The FNR was 26.6% for a single SLN, 8.0% for two, and 11.1% for three. In cases where four or more SLNs were removed, the FNR decreased to 0% and accuracy reached 100%. CONCLUSION: Our data suggest that a SLNB should not only remove one or two of the hottest node(s) when other hot nodes exist. We also suggest that four might be an optimal threshold number of SLNs to be removed and that removal of more than four SLNs does not improve axillary staging accuracy.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/95151
DOI
10.4048/jbc.2011.14.4.296
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
구자승(Koo, Ja Seung) ; 김승일(Kim, Seung Il) ; 박병우(Park, Byeong Woo) ; 박세호(Park, Se Ho) ; 반은정(Ban, Eun Jeong) ; 이준상(Lee, Jun Sang)
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