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The Clinical Value of Parasternal Sentinel Node Biopsy in Breast Cancer

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Abstract

Background

Lymphoscintigraphy (LS) with sentinel node (SN) biopsy is proposed to provide a feasible method to complete lymphatic staging in breast cancer. The aim of this study was to evaluate the clinical value of parasternal SN biopsy.

Methods

A total of 984 consecutive patients with clinical stage T1/2N0 invasive breast cancer who underwent LS and SN biopsy were included in the study. A prospectively collected database was used. An intratumoral injection of 50 to 145 MBq of 99mTc-labeled human albumin colloid (Nanocoll) was used for preoperative LS.

Results

LS showed the axillary SN in 844 (86%) cases and the parasternal SN in 138 (14%) cases. The median number of visualized parasternal SN was 2 (range, 1–6). Visualization of the parasternal SN was more common in patients with mediocentral tumors (81 of 399; 20%) and in patients with lateral tumors (56 of 585; 10%; P < .0001). Parasternal SNs were visualized more often, in 100 (17%) of 584 patients without axillary metastases compared with 38 (10%) of 400 patients with metastatic axillary nodes (P = .0006). Parasternal SNs were harvested successfully in 121 (88%) patients with visualization of those nodes. Parasternal SN metastases were detected in 18 patients, with a median of 1 metastasis (range, 1–4 metastases). Eight of these 18 patients were axillary node negative.

Conclusions

Parasternal SN biopsy results in upstaging in 2% of all breast cancer patients who undergo SN biopsy. The clinical value of the procedure seems insignificant, although it may influence the adjuvant treatment regimen in some patients.

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Acknowledgment

Supported by a grant from the Helsinki University Hospital Research Fund.

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Authors and Affiliations

  1. Breast Surgery Unit, Helsinki University Hospital, FIN-00029 HUS, Helsinki, P.O. Box 140, Finland

    Marjut Hannele Kristiina Leidenius MD, PhD & Karl Albert Johan von Smitten MD, PhD

  2. Department of Pathology, Helsinki University Hospital, Haartmaninkatu 3, FIN-00029 HUS, Helsinki, P.O. Box 400, Finland

    Leena Anneli Krogerus MD, PhD & Terttu Sinikka Toivonen MD

  3. Department of Nuclear Medicine, Helsinki University Hospital, Haartmaninkatu 4, FIN-00029 HUS, Helsinki, P.O. Box 340, 00210, Finland

    Esa Antero Leppänen MD, PhD

Authors
  1. Marjut Hannele Kristiina Leidenius MD, PhD
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  2. Leena Anneli Krogerus MD, PhD
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  3. Terttu Sinikka Toivonen MD
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  4. Esa Antero Leppänen MD, PhD
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  5. Karl Albert Johan von Smitten MD, PhD
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Corresponding author

Correspondence to Marjut Hannele Kristiina Leidenius MD, PhD.

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Leidenius, M.H.K., Krogerus, L.A., Toivonen, T.S. et al. The Clinical Value of Parasternal Sentinel Node Biopsy in Breast Cancer. Ann Surg Oncol 13, 321–326 (2006). https://doi.org/10.1245/ASO.2006.02.022

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  • DOI: https://doi.org/10.1245/ASO.2006.02.022

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