The effect of lymphatic tumor burden on sentinel lymph node biopsy results

Sandra L. Wong, Michael J. Edwards, Celia Chao, Diana Simpson, Kelly M. McMasters

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Increasing tumor burden in the axilla, as determined by the number of positive lymph nodes, adversely affects sentinel lymph node (SLN) identification and false-negative rates. The University of Louisville Breast Cancer Sentinel Lymph Node Study is a prospective, multi-institutional study. All enrolled patients underwent SLN biopsy, followed by complete level 1/11 axillary dissection. Participating surgeons represent a variety of practice settings, mostly community-based private practice. A total of 229 surgeons enrolled 2206 patients between August 1997 and November 2000. SLN biopsy was performed using blue dye injection alone, radioactive colloid alone, or a combination of the two agents. Two key parameters used to measure SLN biopsy success are the SLN identification rate and SLN false-negative rate. The overall SLN identification and false-negative rates were 92.5% and 8.0%, respectively. With increasing numbers of positive axillary nodes, there was a decreased sentinel node identification rate. There was no difference in the false-negative rate with increasing axillary tumor burden. Increased tumor burden in the axilla (as determined by the mean number of positive nodes) is associated with failure to identify a SLN in some cases, but is not an explanation for false-negative results. Standard axillary dissection should be performed when a SLN cannot be identified.

Original languageEnglish (US)
Pages (from-to)192-198
Number of pages7
JournalBreast Journal
Issue number4
StatePublished - 2002
Externally publishedYes


  • Axillary metastases
  • Breast cancer
  • Sentinel lymph node biopsy

ASJC Scopus subject areas

  • Internal Medicine
  • Surgery
  • Oncology


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