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Sentinel Node Biopsy False Negative Rate

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Kevin R. Fox, MD
Last Modified: August 18, 2002

Dear OncoLink "Ask The Experts,"
My wife was recently diagnosed with breast cancer after having an excisional biopsy performed. We are now facing additional surgery to determine whether the lymph nodes are involved. One option proposed by the surgeon was a sentinel node biopsy - however she pointed out that there is no long-term history with this regarding the frequency of false negatives. My wife would like to avoid the prospect of additional surgeries, but would also like to avoid the potential complications of a full axillary dissection. Would a sentinel node biopsy be appropriate? 

Kevin R. Fox, MD, Assistant Director, Clinical Affairs and Associate Professor of Hematology/Oncology at the Abramson Cancer Center of the University of Pennsylvania, responds:

This patient is an ideal candidate for a sentinel node biopsy. The false negative rate, in experienced hands is felt to be 5% or less when the surgeon has performed enough of these procedures to become competent in the surgery. You should ask your surgeon how many of these procedures they have performed. There is no absolute number of procedures to become an expert, but the literature suggests those that have performed the procedure numerous times (at least 30 times) have a lower false negative rate.