Krag D, Weaver D, Ashikaga T, et al [ Univ of Vermont, Burlington; Sylvester Cancer Ctr, Miami, Fla; Arkansas Cancer Research Ctr, Little Rock, et al]
The Sentinel Node in Breast Cancer : A Multicenter Validation Study
N Engl J Med 339: 941-946, 1998
Sentinel node resection offers a possible alternative to axillary lymph node dissection in selected patients with breast cancer and the complications and psychologic distress associated with it.
Before surgery, technetium-99m sulfur colloid, 37 MBq, was injected into the breast around the tumor or biopsy cavity. A gamma probe was then used to identify hot spots corresponding to the sentinel node.
After radioactive sentinel nodes were removed, the patients underwent complete axillary lymphadenectomy. The investigators compared the pathologic findings of the sentinel nodes with those of the remaining axillary nodes.
Sentinel node evaluation was 97% accurate in predicting the positivity or negativity of the axillary nodes.
Study validates the use of sentinel node biopsy to predict the presence or absence of axillary lymph node metastases in patients with breast cancer.
Therefore, if the SLN is negative for tumor, no further axillary dissection may be necessary.