الفهرس 
title: Sentinal lymph node biopsy VS observation in clinically and ultrasound node negative early stage breast cancer
AbstractOnly 14 pages are availabe for public view
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Abstract
Background: Sentinel lymph node biopsy (SLNB) is the gold standard for axillary staging in node-negative early-stage breast cancer. However, axillary complications are reported with axillary lymph node dissection (ALND), SLNB, and axillary radiation, but to a lesser extent with SLNB alone compared to ALND. The Z0011 trial showed that there is no outcome advantage in dissecting the axilla in the presence of positive SLN, meaning not only that wider surgery in the axilla is not improving outcome but also that the information achieved by removing lymph nodes does not change the prognosis of the disease. Keeping in mind that preoperative axillary ultrasound (PAUS) is a first{u2010}line method to evaluate axillary nodal status based on morphologic features including size, shape, cortical thickness, and echogenicity so it can rule out cases indicated for ALND. Objective: to compare SLNB versus observation in patients with early stage clinically node negative breast cancer by palpation and preoperative ultrasound regarding locoregional recurrence, disease free survival and overall survival. Methods: Sixty patients with clinically and radiologically node negative early breast cancer who are candidates for Breast Conservative Surgery were randomized to one of two groups: Study group (group A): 30 patients underwent BCS with no further axillary surgery. Control group (group B): 30 patients underwent BCS and SLNB. Follow up was done to detect the two years locoregional recurrence, DFS and OS in addition to the axillary/nodal recurrence rate and the post-operative wound complication and arm edema. Results: The mean age was 53.13±6.9 years in arm A and 50.93±12 years in arm B. In arm A 28 patients had IDC while 26 patients were found to have IDC in arm B. All the 30 patients of arm A were found to be hormonal positive while in arm B 27 patients were hormonal positive. SLNB was done in all patients in arm B using 1% MB with identification rate 100%