Accuracy of sentinel node biopsy in breast cancer patients with a high prevalence of axillary metastases

Abstract

Background: Sentinel lymph node biopsy (SLNB) has become a standard diagnostic tool for axillary staging of breast cancer and has many advantages in comparison with axillary dissection. the goal of our study was to determine accuracy and predictive value of SLNB for assessing the axillary lymph nodes involvement in breast cancer. Materials and Methods: Thirty three patients with breast cancer at Mehr and Taleghani hospitals in tehran between July 2005 and 2006 were randomly selected. All women underwent presurgical lymphoscintigraphic mapping followed by sentinel node biopsy guided by intraoperative gamma probe and blue dye. sentinel nodes were examined by standard hematoxylin and eosin (H&E) staining. Among studied patients, T1 stage accounted for 3%% of the patients, T2 for 6%, T3 for 66.7% and T4 for 24.3%. Statistical analyses were performed by evaluating of sensitivity, specificity, accuracy, and positive and negative predictive values of SLNB in comparison to axillary lymph node dissection (ALND). Results: The sentinel lymph nodes in 30.3% of patients were well imaged by lymphoscintigraphy. A mean of 4.8 sentinel lymph nodes were removed per patient. Sensitivity and specificity of SLNB were 92% and 87.5%, respectively. Totally, in comparison to ALND, the accuracy of SLNB was 90.9% and false negative rate of this method was also 8%. Conclusion: Our experience shows SLNB to be reliable and accurate for axillary staging in breast cancer patients with a high prevalence of axillary metastases and can be replaced diagnostic ALND in our breast cancer centers.