Annals of Surgical Oncology

, 18:2879 | Cite as

Sentinel Lymph Node Biopsy in Multicentric Breast Cancer: Five-Year Results in a Large Series from a Single Institution

  • Oreste Gentilini
  • Paolo Veronesi
  • Edoardo Botteri
  • Fiammetta Soggiu
  • Giuseppe Trifirò
  • Germana Lissidini
  • Viviana Galimberti
  • Simona Musmeci
  • Paola Rafaniello Raviele
  • Antonio Toesca
  • Silvia Ratini
  • Andres Del Castillo
  • Marco Colleoni
  • Nina Talakhadze
  • Nicole Rotmensz
  • Giuseppe Viale
  • Umberto Veronesi
  • Alberto Luini
Breast Oncology

Abstract

Purpose

This study was designed to present the 5-year results of patients with multicentric breast cancer who underwent sentinel lymph node biopsy (SLNB) in a single institution.

Methods

Between June 1999 and December 2007, 337 patients with multicentric breast cancer and a clinically negative axilla underwent lymphatic mapping by a single periareolar/peritumoral (n = 306) or a double peritumoral or subdermal injection (n = 31) of 99mTc-HSA nanocolloids. The sentinel lymph node (SLN) was evaluated by intraoperative frozen section and axillary dissection was performed only in cases of positive SLNB.

Results

The median age of the patients was 48 (range, 22–81) years. The mean number of hot spots identified was 1.4 in the whole series, 1.3 in patients who received a single injection, and 1.7 in those who received a double injection (P < 0.001). The mean number of removed SLNs was 1.7 (median, 1; range, 1–7) with an identification rate of 100%. A total of 138 patients with negative SLNB (n = 134) or isolated tumor cells in the SLN (n = 4) did not receive completion axillary lymph node dissection (CALND). In these latter patients, a total of 27 events (19.5%) occurred with 3 patients (2.2%) developing axillary recurrences after a median follow-up of 5 years (range, 17–134 months).

Conclusions

Axillary lymph node reappearance was infrequent among patients with multicentric breast cancer, having negative SLNB and no CALND. We recommend SLNB as the standard procedure for nodal staging in patients with multicentric breast cancer and a clinically negative axilla.

Keywords

Sentinel Lymph Node Sentinel Lymph Node Biopsy Axillary Dissection Isolate Tumor Cell Axillary Recurrence 

Notes

Acknowledgment

The authors are greatly thankful to A.I.R.C. (Associazione Italiana per la Ricerca contro il Cancro), which supported clinical research on sentinel lymph node biopsy. We also thank William Russell-Edu, Librarian, European Institute of Oncology, for revising the English text and the Umberto Veronesi Foundation for supporting this research.

Disclosure

None.

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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Oreste Gentilini
    • 1
  • Paolo Veronesi
    • 1
    • 2
  • Edoardo Botteri
    • 3
  • Fiammetta Soggiu
    • 1
  • Giuseppe Trifirò
    • 4
  • Germana Lissidini
    • 1
  • Viviana Galimberti
    • 1
  • Simona Musmeci
    • 1
  • Paola Rafaniello Raviele
    • 5
  • Antonio Toesca
    • 1
  • Silvia Ratini
    • 1
  • Andres Del Castillo
    • 1
  • Marco Colleoni
    • 6
  • Nina Talakhadze
    • 1
  • Nicole Rotmensz
    • 3
  • Giuseppe Viale
    • 2
    • 5
  • Umberto Veronesi
    • 1
  • Alberto Luini
    • 1
  1. 1.Division of SenologyEuropean Institute of OncologyMilanoItaly
  2. 2.University of Milan School of Medicine, European Institute of OncologyMilanoItaly
  3. 3.Division of Epidemiology and BiostatisticsEuropean Institute of OncologyMilanoItaly
  4. 4.Nuclear Medicine DepartmentEuropean Institute of OncologyMilanoItaly
  5. 5.Department of Pathology and Laboratory MedicineEuropean Institute of OncologyMilanoItaly
  6. 6.Department of Medical OncologyEuropean Institute of OncologyMilanoItaly

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