Clinical significance of sentinel lymph node biopsy in breast cancer

Objective To study whether the characteristics of the sentinel lymph node(SLN) accurately predict the status of axillary nodes and the application of SLN biopsy in clinical practice. Methods Between May, 1999 and Febrary, 2004, in 116 breast cancer patients, the sentinel lymph nodes 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 111 patients, the successful rate was 96%. The number of SLNs in every patient ranged from 1 to 4, and the average number was 2. 4. All SLNs were located at level I of axillary. The sensitivity of SLN biopsy was 92%, the specificity was 100%,the false negative rate was 8%, the false positive rate was 0, the accuracy rate was 97. 2% , the positive predictability was 100%, the negative predictability was 95% , Youden's index was 0. 92. In 2 of 26 cases examined by immunohistochemical staining, micrometastases were found, but were not found in their non-SLNs. Conclusion SLN can evaluate the status of axillary lymph nodes in breast cancer patients and determine whether the axillary dissection is done. The method of SLN identified by isotope has many advantages of simplicity, high accuracy and so on.