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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  ;  Ja Seung Koo  ;  Seho Park  ;  Seung Il Kim  ;  Byeong-Woo Park 
Citation
 JOURNAL OF BREAST CANCER, Vol.14(4) : 296-300, 2011 
Journal Title
JOURNAL OF BREAST CANCER
ISSN
 1738-6756 
Issue Date
2011
Keywords
Breast neoplasms ; False negative rate ; Sentinel lymph node biopsy
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.
Files in This Item:
T201105343.pdf Download
DOI
10.4048/jbc.2011.14.4.296
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Koo, Ja Seung(구자승) ORCID logo https://orcid.org/0000-0003-4546-4709
Kim, Seung Il(김승일)
Park, Byeong Woo(박병우) ORCID logo https://orcid.org/0000-0003-1353-2607
Park, Se Ho(박세호) ORCID logo https://orcid.org/0000-0001-8089-2755
Ban, Eun Jeong(반은정)
Lee, Jun Sang(이준상) ORCID logo https://orcid.org/0000-0002-4054-6900
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/95151
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