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Cancer Resources > Cancer News > Cancer News from Reuters > Reuters Cancer News > 2007 > May
In breast cancer, removing three sentinel lymph nodes isn't enough
Will Boggs, MD
Last Updated: 2007-05-30 15:07:23 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Despite recent suggestions that removing three sentinel lymph nodes from women with breast cancer is enough for a biopsy, all sentinel lymph nodes (SLNs) should be removed to reduce the risk of false-negative results, according to a report in the May Archives of Surgery.
"If you find more than 3 SLNs, you should remove them, because you add little morbidity, and you may find cancer in a higher echelon node," Dr. Anees B. Chagpar from University of Louisville, Kentucky told Reuters Health. "That way, you minimize your risk of a false-negative result."
Dr. Chagpar and colleagues determined that among 1358 node-positive patients, 105 (7.7%) had a negative SLN biopsy result, the authors report.
Removing only 3 SLNs would have increased the false-negative rate from 7.7% to 10.3%, the results indicate, whereas all metastases were identified when 11 SLNs were removed.
"Therefore, 2.6% of the SLN-positive patients had their first sign of metastasis in their fourth or higher SLN," the investigators note.
"Given our findings, I don't think there really is an 'optimal' number," Dr. Chagpar said. "Ideally, patients should have as few lymph nodes removed as possible, but not fewer. But the idea is that we don't want to miss disease, and at the same time we don't want to increase morbidity."
"There are newer radioactive tracers currently under investigation that might result in fewer nodes being removed," Dr. Chagpar added.
Arch Surg 2007;142:456-460.
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