The sentinel node biopsy is not contraindicated in multifocal breast carcinoma

Abstract

Aim. Following the availability of the results ofvalidation studies, the sentinel lymph node biopsy(SLNB) has replaced routine axillary dissection(AD) as the new standard of care in early unifocal breast cancers.Multifocal (MF) and multicentric (MC) tumours have been considered as a contraindication for this technique due to the possible incidence of a higher false-negative rate. In this retrospective study we try to demonstrate the usefulness of SLNB in MF/MC breast carcinoma. Patients and Methods. Eight hundreds and fiftyeightpatients with breast carcinoma underwent a conservative surgery and sentinel node excision. Ninety-four out of 858 patients had histological diagnosis of multifocal breast carcinoma; out of these patients, 22 had SLN localization by both radio-colloid and blue dye, and 72 had localization by radio-colloid only. Results. Using radioisotope technique SLN was identified in 90/94 cases (95.7%). Using radioisotope technique and blue dye the SLN was identified in all 94 cases. SLNs were positive for metastases in 53 of the 94 cases (56.4%), in 39 cases (41%) were negative. The axillary dissection was performed in all 53 patients with positive SLNs: in 22 patients (41.5%) the SLN was the only site of axillary metastasis. None of the patients within this group experienced axillary recurrence at follow-up (median 54 months, ranging from 19 to 110 months). Conclusions. The high accuracy of SLNB in MF and MC breast cancer demonstrates,according to the results of other series published in the literature, that bothMF andMC tumours do not represent a contraindication for SLNB anymore. Eur. J. Oncol., 16 (2), 105-110,2011