ACS: False-Negative Rate >10% With SLN Surgery
(HealthDay News) – For women with clinically node-positive (cN1) breast cancer, the false-negative rate (FNR) for sentinel lymph node (SLN) surgery is >10%, according to a study published online Oct. 7 in the Journal of the American Medical Association to coincide with presentation at the annual meeting of the American College of Surgeons, held from Oct. 6–10 in Washington, DC.
Judy C. Boughey, MD, from the Mayo Clinic in Rochester, MN, and colleagues used data from the American College of Surgeons Oncology Group Z1071 trial to determine the FNR for SLN surgery in women initially presenting with cN1 breast cancer. A total of 649 women who underwent SLN surgery and axillary lymph node dissection (ALND) after chemotherapy were included.
The researchers found that of the 525 patients with at least two SLNs, in 215 patients, no cancer was identified in the axillary lymph nodes, for a pathological complete node response of 41%. Cancer was not seen in the SLNs, but was found in lymph nodes obtained by ALND of 39 patients, resulting in a FNR of 12.6%.
"Given this FNR threshold, changes in approach and patient selection that result in greater sensitivity would be necessary to support the use of SLN surgery as an alternative to ALND," the authors write.
Two authors disclosed financial ties to the biomedical industry.