Tagging sentinel lymph nodes: a study of 100 patients with breast cancer

The aim of this study was to evaluate in breast cancer patients the feasibi lity of sentinel lymph node (SLN) identification and the sensitivity of thi s technique to detect node metastases. Between January and July 1997, SLNs were tracked with Evans Blue dye in 100 patients with breast cancer who the n underwent complete level I/II axillary lymph node dissection (ALND). All SLNs were examined by haematoxylin-phloxin-saffron (HPS) staining and immun ohistochemistry (IHC) of multiple sections. The findings for the SLNs were compared with results on ANLD, Axillary SLNs were identified in 83 patients (detection rate = 83%; 95% confidence interval (CI) 74-90%), Axillary SLNs were detected in 58/83 cases (70%) at level I only, and in 69/83 (83%) at levels including level I. Histologically positive axillary SLNs were found in 45% (37/83) of patients, including 2 patients with malignancy (micrometa stases) detected by IHC only. The sensitivity of axillary SLN to detect axi llary lymph nodes metastases was 37/39 = 95% (95% CI 83-99%), SLNs of the i nternal mammary chain (IMC) were dissected for 33 tumours of the median or inner quadrants and detected in 26/33 = 79% of cases (95% CT 61-91%). In ou r experience, the overall sensitivity of SLN identification as a predictor of node (axillary or IMC) metastases was 41/43 = 95% (95% CI 84-99%), confi rming the usefulness of the procedure. (C) 1999 Elsevier Science Ltd. All r ights reserved.