Document Detail


Follow-up of cases with false-negative pathologic sentinel nodes in breast cancer.
MedLine Citation:
PMID:  15550864     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The clinical practice of sentinel lymph node biopsy for breast cancer patients started in 1999 in our hospital, to obviate unnecessary axillary lymph node dissection. The present study examines the pathological false-negative cases on intraoperative sentinel lymph node investigations and evaluates their outcomes. METHODS: The subjects consisted of 183 cases with clinically node-negative breast cancer who had undergone sentinel node biopsy. When the sentinel node was noted to contain malignant cells intraoperatively, a complete axillary lymph node dissection was performed subsequently. The patients with tumor free sentinel nodes underwent no further axillary surgery. The pathological false-negative cases in this series were defined as patients with lymph node involvement which was revealed postoperatively, despite negative intraoperative sentinel node examinations. After these surgeries and/or adjuvant therapies, interval clinical evaluations were performed for all patients. RESULTS: Intraoperative diagnosis of the sentinel node was 96.2% accurate compared with the results of permanent sections. There were six pathological false-negative cases, a false-negative rate of 4.1%, all of which had only micrometastasis. Five cases received systemic adjuvant therapy and have been disease-free, however, one patient who refused further therapy developed infraclavicular lymph node metastasis two years after surgery. CONCLUSIONS: In the management of the patients with postoperatively revealed sentinel node micrometastasis, systemic adjuvant therapies might reduce local relapse without secondary lymph node dissection.
Authors:
Takeshi Nagashima; Hiroshi Yagata; Takashi Nikaido; Fumio Horiuchi; Keiji Koda; Masaru Miyazaki
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Breast cancer (Tokyo, Japan)     Volume:  11     ISSN:  1340-6868     ISO Abbreviation:  Breast Cancer     Publication Date:  2004  
Date Detail:
Created Date:  2004-11-19     Completed Date:  2004-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888201     Medline TA:  Breast Cancer     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  175-9     Citation Subset:  IM    
Affiliation:
Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Axilla
Breast Neoplasms / pathology*,  surgery
Chemotherapy, Adjuvant
False Negative Reactions
Female
Follow-Up Studies
Humans
Intraoperative Period
Lymph Node Excision
Lymphatic Metastasis / diagnosis*,  pathology*
Middle Aged
Prognosis
Radiotherapy, Adjuvant
Sentinel Lymph Node Biopsy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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