SLNB Comparison with Routine Axillary LN Dissection in Breast Cancer Damascus University. Syria

1. DR. M.Dorchin
Seham Soleiman,Moha Manashi , Zahere Fahad
The 8th International Breast Cancer Congress
Tehran ,20-22 Feb, 2013

2. Contraindication
1-Node +
2-Previous Surgery?
3-Pregnancy
4-Skin Disease
Indications
1-Any T Base on
Breast Size
2- Node Negative
3-Stage I-II-III(No)

3. Methods:
From July 2007 to November 2009,
 we randomly assigned 423 patients with PBC .
PBC: T< 2 cm (T1) in two groups.
1 - Sentinel-Lymph Node Biopsy group(SLNB)
2 - Axillary-Dissection group( AXD)
Al-Bairouni University Hospital
Study of the SLNB in Breast Cancer
 Al-Bairouni university Hospital in Damascus city,
and Comparison with Routine Axillary LN Dissection .

4. Statistical Analyses
Table 1 shows total new cancer cases referred to the
Al-bairouni hospital from 2007-2009:
Year New
cases
Breast
cancer
Pt,s in my
study
Percentage
2007 8943 675 118 1.31%
2008 9058 689 109 1.21%
2009 9774 807 196 2.00%
Total 27775 2171 423 1.5%

5. Treatment & follow up
The patients were followed up 4 times, every 3
months for one year
39 patients didn’t followed and therefore
cancelled from the study. Only 384 patients
ended the treatment and the follow up
The median follow up was 12 months.

6. Geographic Distribution
The most patients that referred to
the Al-Bairouni Hospital were
from Damascus and Aleppo
provinces, and seaboard patients
were the less.
Smokers = 24% Alcoholic =11%
The median age was 43 years(24-73)
Positive Familial History = 19%

7. Axillary -dissection group
. A sentinel node was positive in 69 of the 208
patients in the Axillary -dissection group (33.17
percent)
Patients
AXD
SLN
positive
percentage
208 69 33.17

8. sentinel-node group
A sentinel node was positive in 74 of the 186
patients in the sentinel-node group (39.78
percent).
Patients
SLN
SLN
positive
percentage
176 74 42.04%

9. The Axillary dissection group
In the Axillary dissection group, the overall
accuracy of the sentinel-node status was 96.9
percent, the Sensitivity 91.2 percent and the
specificity 100 percent.
Accuracy Sensitivity Specificity
96.9% 91.2% 100%

10. Complications
There was less pain and better arm mobility
in the patients who underwent sentinel-node
biopsy only than in those who also underwent
Axillary dissection.
Complications Ax – Diss Group SN Group
Less Pain &
Better Arm
mobility
16 6

11. Among the 112 patients who did
not undergo Axillary dissection,
there were no cases of overt
axillary metastasis during follow-
up.

12. Conclusions:
Sentinel-node biopsy is a safe
and accurate method of
screening the axillary nodes for
metastasis in women with a
small breast cancer.
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