PREDICTION OF NON-SENTINEL LYMPH NODE METASTASES IN BREAST CANCER

Objective. To identify a subset of breast cancer patients in whom metastatic disease is confined only to the sentinel lymph node(SLN). Methods. Sentinel lymph node biopsy is performed with the injecetion of Tc99m-SC, and a gamma probe. Sentinel node biopsy was compared with standard axillary dissection for its ability to reflect the final pathological status of the axillary nodes. The factors associated with non-SLN metastases were assessed in the univariate and multivariate analysis. Result. We successfully identified 91 out of 95 patients for SLN(95.8%). The accuracy of sentinel lymph node to predict the axillary lymph node status was 93.4%. Clinical tumor size and tumor grade were proved to be the independent predictive factors for non-SLN metastases by logistic regression model. Conclusion. In most cases, the gamma probe guided method is technically feasible for detecting sentinel nodes, accurately predicting the axillary lymph node status. A subset of the patients identified who have a low risk of non-SLN metastases may not require axillary lymph node dissection.