Clinical relevance of sentinel lymph nodes outside the axilla in patients with breast cancer
L Jansen, MHE Doting, EJT Rutgers… - British journal of …, 2000 - Wiley Online Library
L Jansen, MHE Doting, EJT Rutgers, J De Vries, RAV Olmos, OE Nieweg
British journal of surgery, 2000•Wiley Online LibraryBackground Lymphatic mapping in patients with breast cancer can reveal sentinel lymph
nodes that are not located at level I–II of the axilla. Little is known about the clinical
relevance of these nodes. Methods Some 113 consecutive patients with clinical stage T1—3
N0 M0 breast cancer were studied. Based on preoperative lymphoscintigraphy, sentinel
node biopsy was performed guided by a γ probe and patent blue dye. All sentinel nodes that
were visible on lymphoscintigraphy were sought. Pathological examination of the sentinel …
nodes that are not located at level I–II of the axilla. Little is known about the clinical
relevance of these nodes. Methods Some 113 consecutive patients with clinical stage T1—3
N0 M0 breast cancer were studied. Based on preoperative lymphoscintigraphy, sentinel
node biopsy was performed guided by a γ probe and patent blue dye. All sentinel nodes that
were visible on lymphoscintigraphy were sought. Pathological examination of the sentinel …
Background
Lymphatic mapping in patients with breast cancer can reveal sentinel lymph nodes that are not located at level I–II of the axilla. Little is known about the clinical relevance of these nodes.
Methods
Some 113 consecutive patients with clinical stage T1—3 N0 M0 breast cancer were studied. Based on preoperative lymphoscintigraphy, sentinel node biopsy was performed guided by a γ probe and patent blue dye. All sentinel nodes that were visible on lymphoscintigraphy were sought. Pathological examination of the sentinel nodes included step‐sections and staining with CAM 5·2. Axillary node dissection was performed regardless of sentinel lymph node status.
Results
Twenty‐one (19 per cent) of 113 patients had sentinel lymph nodes outside level I–II of the axilla, mostly in the internal mammary chain. Twenty‐two of the 30 sentinel nodes at these sites were harvested. Three patients had sentinel nodes only outside the axilla. Four other patients had metastases outside the axilla. This changed postoperative treatment in three patients. No postoperative complication occurred.
Conclusion
Sentinel lymph nodes outside level I–II of the axilla were present in 19 per cent of patients with breast cancer in this series. Biopsy of these nodes was technically demanding but was performed without additional morbidity. The clinical impact was limited; treatment changed in only 3 per cent. © 2000 British Journal of Surgery Society Ltd
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