Last update:
16-Oct-2008

OBJECTIVE In recent years the intraoperative evaluation of sentinel lymph nodes has greatly changed the surgical management of patients with tumors. The purpose of the study was to evaluate whether the status of the sentinel lymph node accurately predicts the involvement of axillary lymph nodes in patients with breast cancer.

METHOD Intraoperative biopsy of sentinel lymph node was performed on 204 patients with primary breast cancer. Axillary lymph node dissection was performed in 108 patients. The frozen section findings were compared with those of the final histologic diagnoses of the sentinel lymph nodes and the axillary lymph nodes.

RESULTS The sentinel lymph node was positive for metastatic disease in 46% (93/204) and negative in 54% (111/204) of the cases. Frozen section diagnosis was false negative in 8% (10/121) of the cases. In 89 cases with positive and 19 cases with negative sentinel lymph node, an axillary lymph node dissection followed and metastatic disease was found in 53 (60%) and 4 (21%) cases, respectively. Metastases were located in one or more of the axillary nodes. In 40% (36/89) of the cases the sentinel lymph node was the only node involved.

CONCLUSIONS The results of this study show that in breast cancer a positive sentinel lymph node predicts the possibility of the involvement of one or more axillary nodes, while quite frequently it is the sole site of metastasis. However, an uninvolved sentinel lymph node does not guarantee complete absence of metastatic disease in the rest of the axillary lymph node.

Key words: Breast carcinoma, Micrometastases, Sentinel lymph node.