The place of sentinel lymph node biopsy in patients with early stage breast cancer

The status of axilla is the most important prognostic factor in breast cancer. Therefore, axillary lymph node dissection is a standart part of breast cancer surgical treatment. However, the axillary lymph node dissection is the most important reason of morbidity for breast cancer surgery. Metastases in axillary lymph nodes was determined in 10-30 percent of clinically node negative patients with early stage breast cancer, and in others axillary lymph node dissection was unnecessarily done. Sentinel lymph node biopsy is commonly used in staging of axilla in patients with early stage breast cancer.Purpose: In this study, efficacy of sentinel lymph node biopsy has been invastigated in axilla negative patients with breast cancer. Sentinel lymph node identification and false negative rates were calculated and determination of the place of sentinel lymph node biopsy in evaluation of axilla in patients with early stage breast cancer was aimed.Materials and Methods: This prospective study was performed on 57 patients with early stage breast cancer who treated at the Department of Surgery in Medical Faculty of Çukurova University between March 2006 and March 2009. All patients were assigned to two groups and blue dye technique was performed on 33 patients in Group I, the combined technique was performed on 22 patients in Group II. Axillary lymph node dissection was performed after sentinel lymph node biopsy on 46 patients who have invasive breast cancer.Results: Sentinel lymph node was not detected in three patients, two patients in Group I and one patient in Group II. Sentinel lymph node identification rate was 94.7 percent for all patients, and it was 94.2 percent in Group I and 95.4 percent in Group II. Sensitivity was calculated 77.7 percent in Group I and 70.0 percent in Group II. False negative rate was 26.3 for all patients which was 22.2 percent in Group I and 30.0 percent in Group II. Sentinel lymph node identification rate was increased to 96.8 percent and false negative rate decreased to 0 percent when the first 15 patients within learning period was excluded from the statistical analysis. Lenfovascular invasion was found out to be the most important factor associated with involvement of axillary lymph nodes.Conclusion: In this study, sentinel lymph node biopsy is determined as a safe and effective technique on staging of axilla in patients with early stage breast cancer. Nevertheless, it has been thought that every medical center should perform sentinel lymph node biopsy and axillary lymph node dissection together untill getting experienced.