Clinical application and significance of sentinel lymph node biopsy in breast cancer

Objective To discuss the feasibility, accuracy and clinical value of sentinel lymph node (SLN) biopsy (SLNB) in the management of breast cancer. Methods 99 Tc m labeled sulfur colloid was injected into the breast tissue adjacent to the primary tumor or resection cavity. After 2～4 h, the patients underwent intraoperative lymphatic mapping using a hand-held gamma detector. The SLN was identified and removed, followed by a definitive cancer operation, including an axillary lymph node (ALN) dissection (ALND). The predictive value of sentinel node for the axillary tumor status was evaluated with histopathology, immunohistochemistry (IHC) and RT-PCR. Results The SLN was identified in 48(91%) of patients using this method, altogether 91 SLNs were harvested, an average of 1.9 SLNs was examined and 14.2 ALNs was removed. SLNB was 100% predictive of axillary status in this 48 patients. Conclusion The study confirms that intraoperative lymphatic mapping using a hand-held gamma detector to identify SLN is technically feasible and the histologic characteristics of the SLN probably reflect the histologic characteristics of the rest of the ALNs and SLNB may become a substitute for ALND.