Abstract
Background: The sentinel node procedure for breast cancer allows for accurate staging of the
axilla while the axillary node dissection can be avoided in patients with no sentinel
node metastasis. This study describes those patients in whom an axillary dissection
is performed, depending on the outcome of the sentinel node procedure, with particular
emphasis on the use of strict criteria for the procedure and its practical limitations.
Methods: Preoperative lymphoscintigraphy was performed in 115 consecutive patients. The sentinel
nodes were located with the use of a gamma probe and blue dye. Axillary dissection
was performed at the same time when the sentinel node procedure was positive by frozen
section or not successful by the criteria used. Results: The sentinel node procedure was successful in 106 patients, with the sentinel node
being both radioactive and blue in 94% of these patients. The frozen section was positive
in 21 of 37 patients with sentinel node metastases. Axillary dissection could be avoided
in 69 patients. Conclusions: The triple technique (with the use of lymphoscintigraphy, the gamma probe, and the
blue dye) gives a high success rate of the sentinel node procedure, even when strict
criteria for a successful sentinel node procedure are used. Palpation of the open
axilla for metastatic nonsentinel nodes is advocated. (Surgery 2000;128:6-12.)
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Article info
Publication history
Accepted:
January 12,
2000
Footnotes
*Reprint requests: Sybren Meijer, MD, Professor of Surgery Department of Surgical Oncology, Academic Hospital Vrije Universiteit, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
Identification
Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
