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Solitary positive sentinel lymph node accompanied by negative sentinel lymph node(s) is predictive of a negative completion axillary lymph node dissection.

Alkhatib W, Connor C, Fang F

Department of Surgery, University of Kansas Medical Center, 4960 Murphy Administration Building, Mail Stop 2005, 3901 Rainbow Blvd, Kansas City, KS 66160, USA. walkhatib@kumc.edu <walkhatib@kumc.edu>

BACKGROUND: Many patients with a positive sentinel lymph node (SLN) have a negative axillary lymph node dissection (ALND). We hypothesized that a solitary positive SLN associated with at least 1 negative SLN is predictive of a negative completion ALND. Omission of ALND may be possible in these patients. METHODS: A retrospective review of 392 consecutive patients who underwent SLNB was performed. The 78 (20%) SLN-positive patients were divided into 4 groups: group 1: solitary positive SLN associated with at least 1 negative SLN; group 2: more than 1 positive SLN with at least 1 negative SLN; group 3: solitary positive SLN with no additional SLNs; and group 4: more than 1 positive SLN and all SLNs positive. RESULTS: Excluding extracapsular extension, only 3% of group 1 patients had a positive ALND. Positive ALND was found in 15% of group 2, 29% of group 3, and 77% of group 4. CONCLUSIONS: A solitary positive SLN accompanied by additional negative SLN(s) is predictive of a negative completion ALND.

Published 16 November 2007 in Am J Surg, 194(6): 856-8; discussion 858-9.
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