THE LONG-TERM OUTCOMES OF SENTINEL NODE NAVIGATION SURGERY FOR BREAST CANCER

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 68; no. 5; pp. 1051 - 1056
• Main Authors: FUJIWARA, Ikuya, KOBAYASHI, Aya, HACHIMINE, Yasushi, MIZUTA, Naruhiko, NAKATSUKASA, Katsuhiko, NAKAJIMA, Hiroo, SAKAGUCHI, Koichi
• Format: Journal Article
• Language: English; Japanese
• Published: Japan Surgical Association 25.05.2007
• ISSN: 1345-2843; 1882-5133; 1882-5133
• DOI: 10.3919/jjsa.68.1051

In the surgical treatment of breast cancer, it is believed that axillary lymph node dissection (ALND) can be avoided with no evidence of metastasis by sentinel lymph node biopsy (SLNB) that dose not lead to an increase in axillary lymph node metastasis, with a resultant decrease in complitcations. Since 2000, we have avoided unnecessary ALND based on SLNB, and here we report the outcome. Subjects were 403 patients with primary breast cancer treated until December 2005, from whom we could obtain informed consent about avoiding ALND according to SLNB. Of these 403 patients performed SLNB, SLNs were capable of being detected in 402 patients, the detecting rate being 99.8%. Sixty-one patients (15.2%) of them experienced metastasis. The SLN metastatic rates by tumor diameters measured preoperatively were 4.0% (2/50) in Tis, 12.3% (20/162) in T1, and 20.5% (39/190) in T2. ALND was avoided in 341 patients who showed no evidence of SLN metastasis. The median observation period was 33 months (12-79 months). Five (1.5%) patients experienced axillary lymph node metastasis, and the median time until metastasis was 15 months (9-31 months). Of the five patients, there were there T1 and two T2 patients as for preoperative tumor diameter. Six patients experienced distant organ metastasis. They are still alive after addition of ALND. No complications with SLNB have occurred. It is concluded that avoidance of unnecessary ALND according to SLNB is a safe and useful method.