Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2007

01-02-2007

Value of the Sentinel Lymph Node Procedure in Patients With Large Size Breast Cancer

Authors: Loic Lelievre, MD, Gilles Houvenaeghel, MD, Max Buttarelli, MD, Isabelle Brenot-Rossi, MD, Laetitia Huiart, MD, Agnes Tallet, MD, Carole Tarpin, MD, Jocelyne Jacquemier, MD

Published in: Annals of Surgical Oncology | Issue 2/2007

Login to get access

Abstract

Background

Widely used in routine for small breast cancers, the sentinel lymph node (SN) biopsy is still discussed in tumors ≥ 3 cm.

Methods

From 2000 to 2005, 152 patients with invasive breast tumor pT ≥ 3 cm had a SN biopsy systematically followed by complete level I/II axillary dissection. Surgery was always the first stage of the treatment. Detection was done after injection of radioisotope followed by a lymphoscintigraphy and injection of Patent Blue. The SN procedure systematically included palpation of the axilla with removal of any enlarged (>1 cm) and/or abnormally firm node even if neither blue nor radioactive. The sentinel lymph node status was compared with the final axillary status.

Results

Tumor size ranged from 30 to 200 mm (median 42 mm). Lymphoscintigraphy was positive in 98% of the cases. At least one labeled sentinel node was retrieved in 97.4% of the patients. The median number of SN cleared out was 2 (range 1–9). The false negative risk was 4% (4/99). The false negative risk was not related to the tumor size and not related to the number of SN removed.

Conclusions

This study shows that the SN procedure is feasible in patients with breast tumors ≥ 3 cm with an acceptable false negative risk <5%, similar to false negatives reported for smaller tumors.
Literature
1.
Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg 1994; 220:391–398PubMedCrossRef
2.
Krag D, Weaver D, Ashikaga T, et. al. The sentinel node in breast cancer-a multicenter validation study. N Engl J Med 1998; 339(14):941–946PubMedCrossRef
3.
Schwartz GF, Giuliano AE, Veronesi U, and the Consensus Conference Committee. Proceedings of the consensus conference on the role of sentinel node biopsy in carcinoma of the breast. The Breast Journal 2002; 8(3):126–138CrossRef
4.
European Working Group for Breast Screening Pathology. Pathologic work-up of sentinel lymph nodes in breast cancer. Review of current data to be considered for the formulation of guidelines. European Journal of Cancer 2003; 39:1654–1667CrossRef
5.
Veronesi U, Paganelli G, Viale G, et al. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med 2003; 349:546–553PubMedCrossRef
6.
Swenson K.K, Nissen MJ, Ceronsky CRN, Swenson L, Lee MW, Tuttle TM. Comparison of side effects between sentinel lymph node and axillary lymph node dissection for breast cancer. Ann Surg Oncol 2002; 9(8):745–753PubMed
7.
Giuliano AE, Haigh PI, Brennan MB, et al. Prospective Observational Study of Sentinel Lymphadenectomy Without Further Axillary Dissection in Patients With Sentinel Node–Negative Breast Cancer.J Clin Oncol 2000; 18(13):2553–2559. PubMed
8.
Rubens RD. The management of locally advanced breast cancer. Br J Cancer 1992; 65(2):145-147PubMed
9.
Wong SL, Chao C, Edwards MJ, et al. Accuracy of sentinel lymph node biopsy for patients with T2 and T3 breast cancers. Am Surg 2001; 67(6):522–528PubMed
10.
Bedrosian I, Reynolds C, Mick R, et al. Accuracy of sentinel lymph node biopsy in patients with large primary breast tumors. Cancer 2000; 88(11):2540–2545PubMedCrossRef
11.
Veronesi U, Paganelli G, Galimberti V, et al. Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes. Lancet 1997; 349(9069):1864–1867PubMedCrossRef
12.
Wong SL, Edwards MJ, Chao C, Simpson D, McMasters KM. The effect of lymphatic tumor burden on sentinel lymph node biopsy results. The Breast Journal 2002; 8(4):192–198PubMedCrossRef
13.
Martin RC 2nd, Chagpar A, Scoggins CR, et al. Clinicopathologic factors associated with false-negative sentinel lymph-node biopsy in breast cancer. Ann Surg. 2005;241(6):1005–1012PubMedCrossRef
14.
O’Hea BJ, Hill ADK, El-Shirbiny AM, et al. Sentinel lymph node biopsy in breast cancer : initial experience at memorial Sloan-Kettering cancer center. J Am Coll Surg 1998; 186(4):423–427PubMedCrossRef
15.
Noguchi M, Motomura K, Imoto S, et al. A multicenter validation study of sentinel lymph node biopsy by the Japanese Breast Cancer Society. Breast Cancer Res Treat 2000; 63(1):31–40PubMedCrossRef
16.
Wong SL, Abell TD, Chao C, Edwards MJ, McMasters KM. Optimal use of sentinel lymph node biopsy versus axillary lymph node dissection in patients with breast carcinoma. Cancer 2002; 95(3):478–487PubMedCrossRef
17.
Ivens D, Hoe AL, Podd TJ, Hamilton CR, Taylor I, Royle GT. Assessment of morbidity from complete axillary dissection. Br J Cancer 1992; 66(1):136–138PubMed
18.
Warmuth MA, Bowen G, Prosnitz LR, et al. Complications of axillary lymph node dissection for carcinoma of the breast: a report based on a patient survey. Cancer 1998; 83(7):1362–1368PubMedCrossRef
19.
Heusinger K, Lohberg C, Lux MP, et al. Assessment of breast cancer tumor size depends on method, histopathology and tumor size itself. Breast Cancer Res Treat 2005; 94(1):17–23PubMedCrossRef
20.
Houvenaeghel G, Martino M, Buttarelli M, et al. Sentinel lymph node negative breast cancer larger than 30 mm: is axillary lymph node dissection constantly necessary? Bull Cancer 2004; 91 (Suppl 4):S221–225PubMed
21.
Canavese G, Gipponi M, Catturich A, et al. Technical issues and pathologic implications of sentinel lymph node biopsy in early-stage breast cancer patients. J Surg Oncol 2001; 77(2):81–87PubMedCrossRef
22.
Barranger E, Antoine M, Grahek D, Callard P, Uzan S. Intraoperative imprint cytology of sentinel nodes in breast cancer. J Surg Oncol 2004; 86(3):128–133PubMedCrossRef
23.
Cohen LF, Breslin TM, Kuerer HM, Ross MI, Hunt KK, Sahin AA. Identification and evaluation of axillary sentinel lymph nodes in patients with breast carcinoma treated with neoadjuvant chemotherapy.Am J Surg Pathol 2000; 24(9):1266–1272PubMedCrossRef
24.
Mamounas EP. Sentinel lymph node biopsy after neoadjuvant systemic therapy. Surg Clin North Am 2003; 83(4):931–942PubMedCrossRef
25.
Shimazu K, Tamaki Y, Taguchi T, Akazawa K, Inoue T, Noguchi S. Sentinel lymph node biopsy using periareolar injection of radiocolloid for patients with neoadjuvant chemotherapy-treated breast carcinoma.Cancer 2004; 100(12):2555–2561PubMedCrossRef
26.
Stearns V, Ewing CA, Slack R, Penannen MF, Hayes DF, Tsangaris TN. Sentinel lymphadenectomy after neoadjuvant chemotherapy for breast cancer may reliably represent the axilla except for inflammatory breast cancer. Ann Surg Oncol. 2002;9(3):235–242PubMedCrossRef
Metadata
Title
Value of the Sentinel Lymph Node Procedure in Patients With Large Size Breast Cancer
Authors
Loic Lelievre, MD
Gilles Houvenaeghel, MD
Max Buttarelli, MD
Isabelle Brenot-Rossi, MD
Laetitia Huiart, MD
Agnes Tallet, MD
Carole Tarpin, MD
Jocelyne Jacquemier, MD
Publication date
01-02-2007
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 2/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-006-9232-4

Other articles of this Issue 2/2007

Annals of Surgical Oncology 2/2007 Go to the issue

OriginalPaper

Disparities in Colon Cancer Presentation and In-Hospital Mortality in Maryland: A Ten-Year Review

OriginalPaper

Anaplastic Thyroid Carcinoma: Expression Profile of Targets for Therapy Offers New Insights for Disease Treatment

OriginalPaper

Carcinoid of the Rectum Risk Stratification (CaRRS): A Strategy for Preoperative Outcome Assessment

OriginalPaper

Prognostic Factors for Pulmonary Metastasectomy in Hepatocellular Carcinoma

OriginalPaper

Expression of Carbohydrate Antigens in Human Esophageal Squamous Cell Carcinoma: Prognostic Application and Its Diagnostic Implications

OriginalPaper

Local Involvement of the Urinary Bladder in Primary Colorectal Cancer: Outcome with En Bloc Resection