Experience of breast sentinel ln biopsy in QEH

Background: Routine axillary dissection in breast cancer carries morbidity. Sentinel lymph node biopsy has been shown to predict axillary status. The experience of SLN biopsy in QEH is reviewed. Materials and methods: We included all patients with unifocal, palpable T1 or T2 tumour without palpable axillary LN from January 2001 to January 2004. Those who had previous excisional biopsy were also included. We excluded patients who had previous neoadjuvant chemotherapy or previous axillary surgery. Same-day subdermal injection of C1Tc99m sulphur colloid and peritumoral patent blue injection technique was employed. SLN detected were removed, followed by formal axillary clearance. Outcome: The endpoint is to evaluate pathological result of SLN and remaining axillary content. Results: Forty-three patients had SLN biopsy. Mean age was 51.2. Mean tumour size was 2.2 cm. Dye identification rate was 86%. Isotope identification rate was 97.7%. Mean no. of SLN harvested was 1.3. Sensitivity of SLN biopsy is 95.2%. Specificity is 100%. False negative rate is 4.76%. Negative predictive value is 95.7%. Accuracy is 97.7%. 57% of axilla-involved patients had SLN as the only LN involved. Five out of 21 SLN metastasis were micrometastasis. 60% of micrometastasis were diagnosed by immunohistochemistry. Conclusion: Results of breast SLN biopsy in QEH is comparable to other centres and is feasible.