AXILLARY STAGING UTILIZING SELECTIVE SENTINEL LYMPHADENECTOMY FOR PATIENTS WITH INVASIVE BREAST-CARCINOMA

The clinical staging of the regional lymphatics in patients with breas t carcinoma is currently receiving much attention in the medical liter ature. However, controversy still exists regarding surgical staging of the axilla. Most recently, the technique of selective sentinel lympha denectomy has been applied to staging of breast carcinoma. Our experie nce with this technique is presented. From July 1, 1995 through Decemb er 31, 1996, 20 patients underwent 21 selective sentinel lymphadenecto mies prior to level I, level II, and partial level III axillary dissec tions. There were 13 modified radical mastectomies and 8 segmental mas tectomies. The median number of lymph nodes per specimen was 9 (range, 1-31). The sentinel node was identified in 14 patients (66%). Dual se ntinel nodes were identified during 3 procedures. The sentinel nodes w ere negative in 9 procedures, of which all axillary nodes dissected we re negative. The sentinel node was positive in 5 procedures for a 100 per cent predictive value. The sentinel node was the only positive nod e in 3 of the 5 patients, and 2 of these were microscopic (less than 2 mm). There were no associated complications due to the sentinel node biopsy. These results add to the growing literature supporting the fea sibility of the sentinel node technique for accurately staging breast carcinoma. This technique is sensitive and specific and can be perform ed with minimal morbidity.