False negative rate of sentinel lymph node biopsy in patient with early breast cancer in Udonthani hospital
Keywords:
Breast cancer, sentinel lymph node biopsy, axillary lymph node dissection, False negative rateAbstract
Background: In early stage breast cancer, sentinel lymph node biopsy is promising the standard method for the diagnosis of axillary lymph node status. That was determined by removal of the sentinel lymph nodes. Identifcation technique is performed by injection of radioactive tracer followed by lymphoscintigraphy, injection of blue dye or both. The detection rate and false negative rate were varies in multiple previous reviews. The purpose of this study was determining false negative rate of sentinel lymph node biopsy in patient with early breast cancer in Udonthani hospital.
Methods: Between August 2015 and July 2017, all patients with early stage breast cancer underwent sentinel lymph node biopsy with blue dye injection technique in Udonthani hospital. All sentinel lymph nodes were harvested and all patients were conducted to level I, II axillary lymph node dissection. Statistical analysis was performed and data expressed as false negative rate, sensitivity, specifcity and overall accuracy.
Results: A total of 104 patients were enrolled in this study. The average age was 52 + 11 years. Average tumor size was 2.7 + 1.2 centimeter and invasive ductal carcinoma was common histological subtype. Sentinel lymph node biopsy was performed in all patients with 100% identification rate. Median of 2 (range 1-9) sentinel lymph nodes were found. The sentinel lymph node was positive in 38 patients (36.5%). However, 3 of 66 patients with negative sentinel lymph node had evidence of metastasis in axillary lymph node. False negative rate of sentinel lymph node biopsy was 4.5%. Sensitivity and specifcity of sentinel lymph node biopsy in this study were 90.9% and 88.7%, respectively. The overall accuracy was 89.4%.
Conclusion: Sentinel lymph node biopsy in patient with early breast cancer in Udonthani hospital shows it to be reliable and accurate for prediction the axillary lymph node metastatic status with false negative rate of 4.5%.
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