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Staging efficacy of breast cancer with sentinel lymphadenectomy

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Abstract

Seventy‐two patients underwent dye‐guided or dye‐ and gamma probe‐guided sentinel lymphadenectomy (SLND) followed by complete axillary lymph node dissection (ALND). The results of imprint cytology, frozen sections, and permanent sections of the sentinel lymph node (SLN) were compared to each other and to the histologic findings in the nonsentinel nodes. The SLN was identified in 62 (88%) of 72 patients. Evaluation of the SLN on the permanent sections yielded a diagnostic accuracy of 95%, a sensitivity of 89%, and a specificity of 100, although the reliability of SLN diagnosis using frozen sections or imprint cytology is limited. Therefore, it may be concluded that SLND with multiple sectioning and histopathologic examination of the SLNs can predict the presence or absence of axillary‐node metastases in patients with breast cancer. However, further studies will be needed to investigate the value of SLND in respect to the long‐term regional control and any possible detriment or benefit to survival, before it can replace routine ALND as the preferred staging operation for operable breast cancer.

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References

  1. Fisher B, Redmond C, Fisher ER, et al.: Ten-year results of a randomized clinical trial comparing radical mastectomy and total mastectomy with or without radiation. N Engl J Med 312: 674–681, 1985

    Google Scholar 

  2. Lythgoe JP, Palmer MK: Manchester regional breast study - 5 and 10 years results. Br J Surg 69: 693–696, 1982

    Google Scholar 

  3. Cancer Research Campaign Work Party: Cancer Research Campaign (King's Cambridge) trial for early breast cancer. Lancet 2: 55–60, 1980

    Google Scholar 

  4. Senofsky GM, Moffat FL Jr, Davis K, et al.: Total axillary lymphadenectomy in the management of breast cancer. Arch Surg 126: 1336–1342, 1991

    Google Scholar 

  5. Donegan WL: Surgical clinical trials. Cancer 53: 691–699, 1984

    Google Scholar 

  6. Fentiman IS, Mansel RE: The axilla: not a no-go zone. Lancet 337: 221–223, 1991

    Google Scholar 

  7. Noguchi M, Miwa K, Michigishi T, et al.: The role of axillary lymph node dissection in breast cancer management. Breast Cancer 4: 143–153, 1997

    Google Scholar 

  8. Kissin MW, Querci della Rovere G, Easton D, et al.: Risk of lymphedema following the treatment of breast cancer. Br J Surg 73: 580–584, 1986

    Google Scholar 

  9. Wazer DE, Erban JK, Robert NJ, et al.: Breast conservation in early women for clinically negative axillary lymph nodes without axillary dissection. Cancer 74: 878–883, 1994

    Google Scholar 

  10. Feigelson BJ, Acosta JA, Feigelson HS, et al.: T1 breast carcinoma in women 70 years of agc and older may not require axillary lymph node dissecton. Am J Surg 172: 487–490, 1996

    Google Scholar 

  11. Silverstein MJ, Gierson ED, Waisman JR, et al.: Axillary lymph node dissection for T1a breast carcinoma: Is it indicated? Cancer 73: 664–667, 1994

    Google Scholar 

  12. Cady B: The need to reexamine axillary lymph node dissection in invasive breast cancer. Cancer 73: 505–508, 1994

    Google Scholar 

  13. Chadha M, Chabon AB, Friedmann P, et al.: Predictors of axillary lymph node metastases in patients with T1 breast cancer. Cancer 73: 350–353, 1994

    Google Scholar 

  14. Greco M, Agresti R, Raselli R, et al.: Axillary dissection can be avoided in selected breast cancer patients: Analysis of 401 cases. Anticancer Res 16: 3913–3918, 1996

    Google Scholar 

  15. Noguchi M, Katev N, Miyazaki I: Diagnosis of axillary lymph node metastases in patients with breast cancer. Breast Cancer Res Treat 40: 283–293, 1996

    Google Scholar 

  16. Giuliano AE, Kirgan DM, Guenther JM, Morton DL: Lymphatic mapping and sentinel lyinphadenectomy for breast cancer. Ann Surg 220: 391–401, 1994

    Google Scholar 

  17. Krag DN, Weaver DL, Alex C, Fairbank JT: Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe. Surg Oncol 2: 335–340, 1993

    Google Scholar 

  18. Albertini JA, Lyman GH, Cox C, et al.: Lymphatic mapping and sentinel node biopsy in the patient with breast cancer. JAMA 276: 1818–1822, 1996

    Google Scholar 

  19. Pijpers R, Meijer S, Hoekstra OS, et al.: Impact of lymphoscintigraphy on sentinel node identification with technetium-99m-colloidal albumin in breast cancer. J Nucl Med 38: 366–368, 1997

    Google Scholar 

  20. Veronesi U, Pagnelli G, Galimberti V, et al.: Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymphnode. Lancet 349: 1864–1867, 1997

    Google Scholar 

  21. Noguchi M, Kawahara F, Tsugawa K, et al.: Sentinel lymphadenectomy in breast cancer: alternative to routine axillary dissection. Breast Cancer 5: 1–7, 1998

    Google Scholar 

  22. Cox CE, Pendas S, Joseph E, et al.: Guidelines for sentinel node biopsy and lymphatic mapping of patients with breast cancer. Ann Surg 5: 645–653, 1998

    Google Scholar 

  23. Giuliano AE, Dale PS, Turner RR, et al.: Improved axillary staging of breast cancer with sentinel lymphadenectomy. Ann Surg 222: 394–401, 1995

    Google Scholar 

  24. International Union Against Cancer (UICC): Breast tumors (ICD-0 C-50). In: Sobin LH, Wittekind Ch (eds) TNM Classi-fication of Malignant Tumours. 5th edition. Wiley, New York, 1997, pp 123–130

    Google Scholar 

  25. Noguchi M, Tsugawa K, Kawahara F, et al.: Dye-guided sentinel lymphadenectomy in clinically node-negative or nodepositive breast cancer patients. Breast Cancer 5: 381–387, 1998

    Google Scholar 

  26. 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 186: 423–427, 1998

    Google Scholar 

  27. Japan Breast Cancer Society: General rules for clinical and pathological recording of breast cancer. 12th edition. Kanehara, Tokyo, 1996: pp 19–34

    Google Scholar 

  28. The World Health Organization: The World Health Organization histological typing of breast tumors. Am J Clin Pathol 78: 806–816, 1982

    Google Scholar 

  29. Giuliano AE: Sentinel lymphadenectomy in primary breast carcinoma: an alternative to routine axillary dissection. J Surg Oncol 62(2): 75–77, 1996

    Google Scholar 

  30. Borgstein PJ, Pijpers R, Comans EF, et al.: Sentinel lymph node biopsy in breast cancer: guidelines and pitfalls of lymphoscintigraphy and gamma probe detection. J Am Coll Surg 186: 275–283, 1998

    Google Scholar 

  31. Gulec SA, Moffat FL, Carrol RG, Krag DN: Gamma probe guided sentinel node biopsy in breast cancer. GJ Nucl Med 41: 251–261, 1997

    Google Scholar 

  32. Kramer EL: Lymphoscintigraphy: radiopharmaceutical selection and methods. Nucl Med Biol 17: 57–63, 1990

    Google Scholar 

  33. Turner RR, Ollila DW, Krasne DL, Giuliano AG: Histopathologic validation of the sentinel lymph node hypothesis for breast carcinoma. Ann Surg 226: 271–278, 1997

    Google Scholar 

  34. Offodile R, Hoh C, Barsky SH, et al.: Minimally invasive breast carcinoma staging using lymphatic mapping with radiolabelled dextran. Cancer 82: 1704–1708, 1998

    Google Scholar 

  35. Giuliano AE: Sentinel lymphadenectomy: a new axillary staging procedure for primary breast carcinoma. Breast Dis 7: 16–17, 1996

    Google Scholar 

  36. Hadjiminas DJ, Burke M: Intraoperative assessment of nodal status in the selection of patients with breast cancer for axillary clearance. Br J Surg 81: 1615–1616, 1994

    Google Scholar 

  37. Fisher CJ, Boyle S, Burke M, Price AB: Intraoperative assessment of nodal status in the selection of patients with breast cancer for axillary clearance. Br J Surg 80: 457–458, 1993

    Google Scholar 

  38. McGuire WL: Adjuvant therapy of node-negative breast cancer. N Engl J Med 320: 525–527, 1989

    Google Scholar 

  39. Mansour EG, Gray R, Shatila AH, et al.: Efficacy of adjuvant chemotherapy in high-risk node-negative breast cancer. N Engl J Med 320: 485–490, 1989

    Google Scholar 

  40. Fisher ER, Swamidoss S, Lee CH, et al.: Detection and significance of occult axillary node metastases in patients with invasive breast cancer. Cancer 42: 2025–2031, 1978

    Google Scholar 

  41. Kingsley WB, Peters GN, Check JH: What constitutes adequate study of axillary lymph nodes in breast cancer? Ann Surg 201: 311–314, 1985

    Google Scholar 

  42. Ilainsworth PJ, Tjandra JJ, Stillwell RG, et al.: Detection and significance of occult metastasis in node-negative breast cancer. Br J Surg 80: 459–463, 1993

    Google Scholar 

  43. Noguchi M, Tsugawa K, Taniya T, Miwa K: The role of internal mammary lymph node metastases in the management of breast cancer. Breast Cancer 5: 117–125, 1998

    Google Scholar 

  44. Krag D, Weaver D, Ashikaga T, et al.: The sentinel node in breast cancer. A multicenter validation study. New Engl J Med 339: 941–946, 1998

    Google Scholar 

  45. Noguchi M: Comment on "Improved axillary staging of breast cancer with sentinel lymphadenectomy". Ann Surg 225: 126–127, 1997

    Google Scholar 

  46. Veronesi U, Cascinelli N, Greco M, et al.: Prognosis of breast cancer patients after mastectomy and dissection of internal mammary nodes. Ann Surg 202: 702–707, 1985

    Google Scholar 

  47. Cody HS, Urban JA: Internal mammary node status: A major prognosticator in axillary node-negative breast cancer. Ann Surg Oncol 2: 32–37, 1995

    Google Scholar 

  48. Cote RJ, Rosen PP, Old LJ, Osborne MP: Detection of bone marrow micrometastases in patients with early-stage breast cancer. Diag Oncol 1: 37–42, 1991

    Google Scholar 

  49. Dearnaley DP, Ormerod MG, Sloane JP: Micrometastases in breast cancer: Long-term follow-up of the first patient cohort. Eur J Cancer 27(12): 236–239, 1991

    Google Scholar 

  50. Mansi JL, Easton D, Berger U, et al.: Bone marrow micrometastases in primary breast cancer: Prognostic significance after 6 years' follow-up. Eur J Cancer 27(12): 1552–1555, 1991

    Google Scholar 

  51. Diel IJ, Kaufmann M, Goerner R, et al.: Detection of tumor cells in bone marrow of patients primary breat cancer: a prognostic factor for distant metastasis. J Clin Oncol 10(10): 1534–1539, 1992

    Google Scholar 

  52. Harbeck N, Untch M, Pache L, Eiermann W: Tumor cell detection in the bone marrow of breast cancer patients at primary therapy: results of a 3-year median follow-up. Br J Cancer 69: 566–571, 1994

    Google Scholar 

  53. Molino A, Pelosi G, Turazza M, et al.: Bone marrow micrometastases in 109 breast cancer patients: correlations with clinical and pathological features and prognosis. Breast Cancer Res Treat 42: 23–30, 1997

    Google Scholar 

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Authors and Affiliations

  1. Operation Center, Kanazawa University Hospital, School of Medicine, Kanazawa University, Kanazawa, Japan

    Masakuni Noguchi

  2. Department of Surgery II, Kanazawa University Hospital, School of Medicine, Kanazawa University, Kanazawa, Japan

    Etsuro Bando, Koichiro Tsugawa, Koichi Miwa & Kunihiko Yokoyama

  3. Department of Nuclear Medicine, Kanazawa University Hospital, School of Medicine, Kanazawa University, Kanazawa, Japan

    Ken‐ichi Nakajima, Takatoshi Michigishi & Norihisa Tonami

  4. Division of Pathology, Kanazawa University Hospital, School of Medicine, Kanazawa University, Kanazawa, Japan

    Hiroshi Minato & Akitaka Nonomura

Authors
  1. Masakuni Noguchi
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  2. Etsuro Bando
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  3. Koichiro Tsugawa
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  4. Koichi Miwa
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  5. Kunihiko Yokoyama
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  6. Ken‐ichi Nakajima
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  7. Takatoshi Michigishi
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  9. Hiroshi Minato
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  10. Akitaka Nonomura
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Noguchi, M., Bando, E., Tsugawa, K. et al. Staging efficacy of breast cancer with sentinel lymphadenectomy. Breast Cancer Res Treat 57, 221–229 (1999). https://doi.org/10.1023/A:1006268426526

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