This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mendez, J. E. Articles by Sclafani, L. M. Search for Related Content PubMed PubMed Citation Articles by Mendez, J. E. Articles by Sclafani, L. M.

Can Sentinel Lymph Node Biopsy Be Omitted in Patients With Favorable Breast Cancer Histology?

Department of Surgery, Breast Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, MRI 1026, New York, New York 10021

Correspondence: Address correspondence and reprint requests to: Lisa M. Sclafani, MD; E-mail: sclafanl{at}mskcc.org

Background: The widespread use of sentinel lymph node biopsy (SLNB) to replace axillary dissection has broadened the indications for axillary staging in breast cancer. Recent studies have demonstrated a finite risk of lymphedema and sensory morbidity associated with SLNB. We undertook this study to determine whether SLNB could be omitted in clinically node-negative patients with favorable-histology breast cancer.

Methods: We conducted a retrospective review of a prospective database of SLNBs performed at Memorial Sloan-Kettering Cancer Center from 1996 to 2003 to determine the incidence of lymph node metastases by histological subtype. For the favorable subtypes, the patients age, tumor size, estrogen receptor status, lymphovascular invasion, nuclear grade, and histological grade were compared by nodal status to determine their predictive value.

Results: A total of 196 cases with favorable breast cancer subtypes were identified with a 4.1% (8 of 196) sentinel lymph node (SLN) positivity rate. Each of the histological subtypes included patients with positive SLNs, with the exception of adenoid cystic (n = 4) and secretory (n = 1) breast carcinoma, which were quite rare in our series. When compared by nodal status, the patients age, tumor size, estrogen receptor status, lymphovascular invasion, nuclear grade, and histological grade failed to predict those with positive SLNs.

Conclusions: Patients with favorable breast cancer histology have a small risk of axillary SLN metastases. The use of SLNB in these patients should be individualized, taking into consideration the small incidence of axillary metastases and the risks and benefits associated with the SLN procedure.

Key Words: Sentinel lymph node biopsy • Axillary node dissection • Favorable breast cancer subtypes • Breast cancer • Favorable histology

This article has been cited by other articles:

				B. Cady Regional Lymph Node Metastases; a Singular Manifestation of the Process of Clinical Metastases in Cancer: Contemporary Animal Research and Clinical Reports Suggest Unifying Concepts Ann. Surg. Oncol., June 1, 2007; 14(6): 1790 - 1800. [Abstract] [Full Text] [PDF]

				S. D. Nathanson, R. Slater, D. DeBruyn, A. Kapke, and M. Linden HER-2/neu Expression in Primary Breast Cancer With Sentinel Lymph Node Metastasis Ann. Surg. Oncol., February 1, 2006; 13(2): 205 - 213. [Abstract] [Full Text] [PDF]