The mammographic features of the microcalcifications were not specific enough to distinguish recurrent malignancy from benign disease. Prior to surgery to remove part of or the entire breast, a tiny amount of radioactive particles are injected in the area of the breast where the tumor is or around the nipple. Three of the four patients with recurrent carcinoma had had calcifications in the original cancer. In a sentinel node biopsy, only the sentinel nodes are surgically removed, which results in fewer complications and side effects for the patient, including lymphedema. The morphologic appearance of the microcalcifications was similar in both malignant and benign disease, although the malignant calcifications tended to appear earlier than the benign ones. The sentinel lymph node is the first node breast cancer cells will reach if they spread beyond the breast. Of the ten patients who underwent reexcision, six had clusters of calcifications that were benign, and four had malignant calcifications. Seventeen other patients developed scattered, coarse, benign macrocalcifications that have remained stable as determined with mammographic follow-up.

The pathologic status of the axilla was independently determined by removal of the first or first and second SLN in 99% of patients removal of more than three SLNs did not increase the accuracy of finding a positive node.Ten of 152 (7%) consecutive breast cancer patients who underwent excisional biopsy and radiation therapy developed suspect microcalcifications at the biopsy site. Only one of 105 patients had metastasis in the third SLN removed. Of the 105 patients with a positive SLN, the first SLN independently predicted the pathologic status of the axilla in 96 patients (91.4% 95% CI 86.1-96.8), and the first and second SLN independently predicted the status in 104 patients (99% 95% CI 97.2-100). The number of SLNs removed was comparable between node-negative and node-positive patients, and none of the parameters analyzed was significantly related to the number of SLNs removed. The SLNs were negative in 158 patients and positive in 105. Positive SLNs were ranked in the order they were removed and examined for which node contained the metastasis.ĭuring biopsy, a mean of 1.8 (range, 1-5) SLNs were found. These factors were analyzed to determine whether they had any significant correlation to the number of removed lymph nodes. Research published in the World Journal of Surgical Oncology notes that putting steroids into the surgical wound after breast reconstruction or the first day after a mastectomy with sentinel lymph node biopsy has been shown to cut the risk of seroma development. In patients with positive SLNs, the nodes were then analyzed to determine which SLN contained metastasis.įor 263 patients with breast cancer who successfully underwent SLN biopsy, parameters such as tumor size, histologic characteristics, differentiation, and receptor status, patient age, breast quadrant, type of surgery, mapping with blue dye only or with radiocolloid, and whether biopsy was performed before or after tumorectomy were prospectively collected. This study investigated various factors to determine if they had any significant correlation with the number of SLNs found during biopsy. The number of sentinel lymph nodes (SLNs) removed during biopsy may have an impact on the accuracy of finding a positive SLN.

Breast ectomy with sentinel node biopsy