Objective: To evaluate feasibility and accuracy of intraoperative lymphatic mapping with sentinel lymphadenectomy (SLND) for predicting axillary status in patients with breast cancer.
Methods: Our study enrolled 52 patients with primary breast cancer, clinically and ultrasonographically negative axillae. Mapping procedures and SLND were performed using methylene blue injected at the primary breast cancer site followed by axillary lymph node dissection (ALND). Sentinel node (SN) was examined by using frozen sections intraoperatively and all of the axillary lymph nodes were evaluated pathologically (HE) after operation.
Results: Sentinel nodes were identified in 46 (88.5%) of 52 procedures and nodal status accurately predicted axillary in 44 (95.7%) of 46 cases. In 2 (4.3%) of 46 cases, the SN was false-negative. The overall sensitivity of the SN technique was 90.9%, with a specificity of 100%. The overall positive and negative predictive values were 100% and 92.3%, respectively. In 15 (75%) of 20 cases of clinically negatively and pathologically positive axillary, the SN was the only tumor-involved lymph node identified.
Conclusion: Our study indicates that intraoperative lymphatic mapping using a vital dye and SLND can accurately predict the axillary status of primary breast cancer patients with clinically and ultrasonographically negative axillae.