Extra-axillary sentinel node biopsy in XXXX staging--is it necessary?

@entity1 @entity0
AIMS: The aim of this study was to assess the value of lymphoscintigraphy in general and extra-axillary lymph node biopsy in particular, based on our experience with sentinel biopsy in 128 consecutive @entity1 undergoing surgery for @entity0 . METHODS: Sentinel node biopsy was performed with the aid of isotope, hand held gamma probe, blue dye and lymphoscintigraphy in 83 @entity1 . Injection technique was peritumoral or intratumoral. Lymphoscintigraphy was performed 2-4 h following isotope injection. RESULTS: Eighteen lymposcintigraphies were negative (21.7%). The sentinel node was found in 14 of these cases. We were unable to identify the sentinel node(s) in four @entity1 (4/83; 4.8%). All in all 20/25 (80%) extra-axillary nodes were located and taken out. Only two of these (2/20, 10%) were positive for metastatic disease on histological examination. The adjuvant treatment plans for these @entity1 were not altered in response to these findings. No positive extra-axillary node(s) with simultaneous normal axillary sentinel node was found. CONCLUSIONS: In this serie, lymphoscintigraphy and biopsy of extra-axillary sentinel nodes added nothing but time, risk and cost to the procedure.
