SLNB Comparison with Routine Axillary LN Dissection in Breast Cancer

DR. M.Dorchin

Seham Soleiman,Moha Manashi , Zahere Fahad

The 8th International Breast Cancer Congress

Tehran ,20-22 Feb, 2013

Contraindication

1-Node +

2-Previous Surgery?

3-Pregnancy

4-Skin Disease

Indications

1-Any T Base on

Breast Size

2- Node Negative

3-Stage I-II-III(No)

Methods:

From July 2007 to November 2009,

we randomly assigned 423 patients with PBC .

PBC: T< 2 cm (T1) in two groups.

1 - Sentinel-Lymph Node Biopsy group(SLNB)

2 - Axillary-Dissection group( AXD)

Al-Bairouni University Hospital

Study of the SLNB in Breast Cancer Al-Bairouni university Hospital in Damascus city,

and Comparison with Routine Axillary LN Dissection .

Statistical AnalysesTable 1 shows total new cancer cases referred to the

Al-bairouni hospital from 2007-2009:

Year New cases

Breast cancer

Pt,s in my study

Percentage

2007 8943 675 118 1.31%

2008 9058 689 109 1.21%

2009 9774 807 196 2.00%

Total 27775 2171 423 1.5%

Treatment & follow up

The patients were followed up 4 times, every 3

months for one year

39 patients didn’t followed and therefore

cancelled from the study. Only 384 patients

ended the treatment and the follow up

The median follow up was 12 months.

Geographic Distribution

The most patients that referred to

the Al-Bairouni Hospital were

from Damascus and Aleppo

provinces, and seaboard patients

were the less.

Smokers = 24% Alcoholic =11%

The median age was 43 years(24-73)

Positive Familial History = 19%

Axillary -dissection group

. A sentinel node was positive in 69 of the 208

patients in the Axillary -dissection group (33.17

percent)

Patients

AXD

SLN

positive

percentage

208 69 33.17

sentinel-node group

A sentinel node was positive in 74 of the 186

patients in the sentinel-node group (39.78

percent).

Patients

SLN

SLN

positive

percentage

176 74 42.04%

The Axillary dissection group

In the Axillary dissection group, the overall

accuracy of the sentinel-node status was 96.9

percent, the Sensitivity 91.2 percent and the

specificity 100 percent.

Accuracy Sensitivity Specificity

96.9% 91.2% 100%

Complications

There was less pain and better arm mobility

in the patients who underwent sentinel-node

biopsy only than in those who also underwent

Axillary dissection.

Complications Ax – Diss Group SN Group

Less Pain &

Better Arm

mobility

16 6

Among the 112 patients who did

not undergo Axillary dissection,

there were no cases of overt

axillary metastasis during follow-

up.

Conclusions:

Sentinel-node biopsy is a safe

and accurate method of

screening the axillary nodes for

metastasis in women with a

small breast cancer.

Thanks for Your Kindness Attention