Radiology 1999 Nov;213(2):526-9
Sentinel lymph node mapping for breast cancer: analysis in a diverse patient
group.
Eary JF, Mankoff DA, Dunnwald LK, Byrd DR, Anderson BO, Yeung RS, Moe RE.
PURPOSE: To evaluate sentinel lymph node mapping in patients with breast cancer.
MATERIALS AND METHODS: Sixty-two patients with breast cancer scheduled to
undergo axillary nodal dissection underwent scintigraphic localization of
sentinel lymph nodes with filtered technetium 99m sulfur colloid. At surgery,
isosulfan blue was injected. Sentinel nodes were identifiable by blue color and
by radioactivity with hand-held gamma probe. Results were analyzed
statistically. RESULTS: A sentinel lymph node was identified in 49 patients
(79%). Lymph nodes were positive for metastatic disease in 26 patients (42%).
The mapping success rate was 78% (n = 21) in the 27 patients with no prior
surgery, 78% (n = 18) in the 23 patients with prior surgery, and 86% (n = 12) in
the 14 patients with prior chemotherapy. Axillary nodes were positive in 11
(41%) of the 27 patients with no prior intervention, six (26%) of the 23
patients with prior surgery, and 10 (71%) of the 14 patients with prior
chemotherapy. There were no false-negative findings in patients without prior
intervention. Four patients with positive nodes had false-negative sentinel
nodes. CONCLUSION: Sentinel lymph node mapping and biopsy without axillary
dissection is appropriate in patients with breast cancer who have not undergone
prior intervention. Further study is necessary to ascertain the accuracy of the
procedure for patients who have undergone presurgical chemotherapy or previous
excisional biopsy.
