Clinical impact of false-negative sentinel node biopsy in primary breast cancer

Abstract

Background: The aim was to assess the false-negative sentinel node biopsy rate in women with early breast cancer and its implications in patient treatment. Methods: Between January 1995 and March 2001, 328 consecutive patients with clinically lymph node-negative primary operable breast cancer underwent lymphatic mapping and sentinel node biopsy using a combination of preoperative lymphoscintigraphy and/or blue dye. All underwent immediate axillary dissection. The intraoperative success rate in sentinel node identification, false-negative rate, predictive value of negative sentinel node status and overall accuracy were assessed. The clinical features and primary tumour characteristics for each false-negative case were reviewed. Results: The sentinel node was identified in 285 (86·9 per cent) of 328 women. The false-negative rate was 7·9 per cent (eight of 101). Most members of the breast multidisciplinary team would have instituted adjuvant systemic therapy for six false-negative cases based on clinical features and primary tumour histology. In all, only two (0·7 per cent) of 285 women who had sentinel node biopsy may have had their management and survival prospects potentially jeopardized owing to a false-negative sentinel node. Conclusion: The results of this study suggest that the clinical impact of a false-negative sentinel node is low.