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Indian Journal of Surgical Oncology logoLink to Indian Journal of Surgical Oncology
. 2010 Aug 7;1(1):52–58. doi: 10.1007/s13193-010-0012-z

Sentinel lymph node mapping in early breast cancer — Our experience

Vasu R Challa 1, V Seenu 1, Anurag Srivastava 1,✉, Rakesh Kumar 2, Anita Dhar 1, Sunil Chumber 1, Rajinder Parshad 1, Mahesh C Misra 1
PMCID: PMC3421000  PMID: 22930619

Abstract

Background

The axillary lymph node status is the most important determinant of prognosis in patients with breast cancer. Sentinel lymph node (SLN) biopsy is a safe alternative for axillary clearance with an equal efficacy limiting the morbidity caused by axillary clearance.

Patient and methods

From May 1996 till September 2009, 523 clinically node negative, early breast cancer patients attending our clinic at All India Institute of Medical Sciences were included in the study. They underwent sentinel lymph node biopsy by either combined technique or blue dye alone. All patients irrespective of the axillary status underwent axillary lymph node dissection (ALND).

Results

Of 523 patients, 267 underwent combined technique of sentinel node mapping and 256 underwent blue dye technique alone. The identification rate of sentinel lymph node was 94.3% (253/267) for combined technique and 87.8% (225/256) for blue dye alone. Of 523 patients SLN was identified in 478 patients. The identification rate was 91.3%. The sensitivity = 91.5% (141/154), false negative = 8.4% (13/154), negative predictive value = 96.14% (324/337), and accuracy being 97.2% (465/478).

Conclusion

Sentinel node mapping is a simple and safe technique of identifying the axillary node involvement. Sentinel lymph node biopsy is associated with less arm oedema and shoulder morbidity compared to ALND. However, the results of long term effects of sentinel node approach on tumor recurrence or patient survival are awaited.

Keywords: Sentinel lymph node biopsy, Axillary lymph node dissection, Axillary node sampling, Lymphatic mapping, Early breast cancer, Immuohistochemistry

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