Application of sentinel lymph nodes biopsy by isotope in predicting status of axillary nodes of breast cancer patients

Objective To study the possibility of sentinel lymph nodes(SLN) accurately predicting the status of axillary nodes of breast cancer patients and the application of SLN biopsy in clinical practice. Methods In 150 breast cancer patients,the SLN identified by 99mTc-DX were excised for biopsy by using a hand-held-γ-detection probe in operation,after SLN biopsy,modified mastectomy or breast-conserving therapy was followed. The SLNs were examined separately and in detail by pathologist. Results SLNs were identified in 144 patients,the successful rate was 96.0%. The number of SLNs were 1～4 in every patient. All SLNs were located at level I of axillary. The sensitivity of SLN biopsy was 93.4%,the specificity was 100.0%,the false negative rate was 6.6%,the false positive rate was 0,the accuracy rate was 97.2%,the positive predictability was 100.0%,the negative predictability was 95.4%,Youden's index was 0.934. The SLNs of 59 cases were examined by immunohistochemical staining,14 cases were found micrometastases,but its were not found in their non-SLNs. Conclusions SLN can evaluate the status of axillary lymph nodes in breast cancer patients and determine whether the axillary dessection is done. The method of SLN identified by isotope has many advantages of simplicity,high accuracy,etc.