Sentinel lymph node biopsy in patients with multicentric/multifocal breast cancer: low false-negative rate and lack of axillary recurrence

BACKGROUND: Accuracy of sentinel lymph node biopsy (SLNB) and rate of axillary recurrence in multicentric/multifocal (MC/MF) breast cancer are reported. METHODS: From 1999 to 2006, 93 patients with MC/MF breast cancer underwent SLNB; 41 underwent axillary lymph node dissection regardless of SLN pathology (group 1), and 5:1 underwent axillary lymph node dissection only if an SLN was positive (group 2). Patient demographics, SLN techniques, and pathology were recorded. RESULTS: There were no differences between the 2 groups with respect to patient aged tumor size, grade, stage, and histology; or method of SLN detection. The incidence of axillary metastasis was greater in group 1 patients (68%) compared with group 2 patients (12%) (P < .01). In group 1, the sensitivity and specificity of SLNB were 93% and 100%, respectively, with a false-negative rate of 7%. None of the 52 patients in group 2 experienced axillary recurrence (median follow-up 4.8 years). CONCLUSIONS: The accuracy of SLNB in MC/MF breast cancer is comparable with that observed in unifocal breast cancer. Despite a lower rate of SLN positivity in patients undergoing SLNB only, axillary recurrence was not observed. (C) 2008 Elsevier Inc. All rights reserved.