The impact of method of biopsy on the incidence of breast cancer sentinel lymph node metastases

• Published in: European journal of surgical oncology 2014-03, Vol.40 (3), p.277-281
• Main Authors: Meattini, I, Giannotti, E, Abdulcadir, D, Saieva, C, Guerrieri, A.M, Vanzi, E, Scartoni, D, Cecchini, S, Sanchez, L.J, Orzalesi, L, Casella, D, Bianchi, S, Livi, L, Nori, J
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Analysis of Variance; Biopsy, Fine-Needle - adverse effects; Biopsy, Fine-Needle - methods; Breast cancer; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Carcinoma, Intraductal, Noninfiltrating - mortality; Carcinoma, Intraductal, Noninfiltrating - secondary; Carcinoma, Intraductal, Noninfiltrating - surgery; Chi-Square Distribution; Cohort Studies; Databases, Factual; Disposable Equipment; Female; Hematology, Oncology and Palliative Medicine; Humans; Immunohistochemistry; Incidence; Lymph Nodes - pathology; Lymphatic Metastasis; Macrometastases; Micrometastases; Middle Aged; Multivariate Analysis; Neoplasm Invasiveness; Neoplasm Micrometastasis - pathology; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - pathology; Neoplasm Seeding; Neoplasm Staging; Neoplastic Cells, Circulating - pathology; Percutaneous bioptic technique; Prognosis; Proportional Hazards Models; Radiotherapy; Retrospective Studies; Risk Assessment; Sentinel Lymph Node Biopsy - adverse effects; Sentinel Lymph Node Biopsy - methods; Sentinel node; Surgery; Survival Analysis
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2013.12.011

Abstract Background The dislocation of the malignant cells along the needle tract during breast cancer (BC) diagnosis has been demonstrated by several studies. However, the published experiences that relate the diagnostic technique with sentinel node (SN) involvement are few and controversial. The aim of our analysis was to evaluate the impact of different techniques for preoperative BC biopsy among prognostic factors of metastases occurrence in SN. Materials and methods We reviewed the institutional clinical database of our Center. A total of 674 patients were diagnosed between February 1999 and December 2006 with invasive BC. SN metastases classification followed the 2002 American Joint Committee on Cancer (AJCC) TNM pathological staging: macrometastases, micrometastases, isolated tumor cells or negative. Only macrometastases and micrometastases were considered positive. Concerning fine-needle aspiration cytology, we used disposable needles of the size of 21–27 G. For percutaneous biopsy we used cutting needle type “tru-cut”; the Gauge needle ranged between 14 and 20. Results At univariate analysis of specific parameters using positive SN as outcome, percutaneous diagnostic technique did not affect significantly the SN positivity ( p  = 0.60). At multivariate models only central quadrant lesion ( p  = 0.005) and lymph vascular invasion (LVI) presence ( p