Sentinel-Node Biopsy Seen As Feasible for Multicentric Breast Cancer
Sentinel-lymph-node biopsy may be helpful in staging multicentric breast cancer after all. Though identification of lymph-node involvement through a sentinel node has seemed inapplicable to patients with tumors in different quadrants, which might drain to different nodes, a surgical team here says that use of the subareolar injection site may obviate that barrier.
In a preliminary study of 19 multicentric breast cancer patients, who underwent lymph-node mapping along with axillary dissection, the concept was that a "network of lymphatic connecting different breast quadrants with the subareolar site might cause multicentric cancers to drain from the tumor site, into the subareolar area, and then to a lymph node in the axilla."
And, indeed, the sentinel-node biopsy accurately predicted the axillary node status of all 19, Drs. Peter Schrenk and Wolfgang Wayand of the Ludwig Boltzmann Institute for Surgical Laparoscopy reported in the Jan. 13 Lancet. Sixteen of the patients had tumors in two quadrants, and the other three had tumors in three quadrants. The sentinel node of nine patients was clear, and 10 had evidence of metastatic tumor involvement. In two of these 10 patients the sentinel node was the only node involved; three patients had two positive nodes, and the other five had more than two.
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