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No Axillary Disease Recurrences After Sentinel Lymph Node Biopsy.
SAN ANTONIO -- Intermediate-term follow-up of breast cancer patients managed via sentinel lymph node biopsy showed an encouraging absence of axillary disease recurrences in a large patient series.
This finding strongly suggests that breast cancer lymphatic mapping via the sentinel lymph node biopsy (SLNB) technique is a sensitive method for detecting nodal metastases. The 971 patients in the study, who were followed for a mean of 25 months, were spared complete axillary node dissection because of a negative sentinel node, Dr. Sophie Dessureault reported at a breast cancer symposium sponsored by the San Antonio Cancer Institute.
The advantage of this minimally invasive technique is that it identifies women who don't need complete axillary lymph node dissection for local control of their cancer. They can thus be spared a costly procedure involving substantial long-term morbidity, said Dr. Dessureault of the H. Lee Moffitt Cancer Center at the University of South Florida, Tampa.
In a separate presentation, Dr. Jose-Luis B. Bevilacqua reported that the SLNB experience at Memorial Sloan-Kettering Cancer Center, New York, suggests the technique offers an additional advantage: It finds an absolute 7% more metastases than with conventional axillary dissection. Dr. Bevilacqua reported on 596 patients who underwent SLNB and definitive surgical therapy at Sloan-Kettering for breast cancers 1 cm or smaller.
The incidence of axillary metastasis was 20.4% when the enhanced pathologic analysis with immunohistochemistry and serial sectioning that is routine with SLNB was used. In contrast, the incidence was only 13.2% in 258 women who underwent standard axillary dissection with a single hematoxylin-eosin--stained section per lymph node in the pre-SLNB era at Sloan-Kettering.
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