How to reduce the false negative rate of sentinel lymph node biopsy on breast cancer / 肿瘤

ABSTRACT

Objective: To investigate the reasons for false negative test results of sentinel lymph node (SLN) biopsy using isotope for patients with breast cancer and discuss how to reduce the false negative rate. Methods: The SLNs were identified in 150 breast cancer patients between May 2000 and May 2007. 99mTc-labeled dextran (99mTc-DX) was injected pre-operatively, then the localization of SLN was identified by γ-detecting probe intraoperatively, finally the removed SLNs were confirmed by routine pathological examination. Results: The detection rate of SLN biopsy was 96%. The sensitivity, specificity, false negative rate, false positive rate, and accuracy of SLN detection were 93.4%, 100%, 6.6%, 0%, and 97.2%, respectively. The positive and negative predictive value were 100% and 95.4%, respectively. Youden's index was 0.934. The false negative rate was associated with the selection of indication, anatomic variation, preoperative biopsy and radiotherapy, appearance of internal mammary SLN, multifocality, incomplete pathological examination and inexperienced skills. Conclusion: The false negative rate could be reduced to an acceptable degree gradually by strictly selecting indications for SLN biopsy, probing SLN location according to standard operating procedure, keeping seriousness, performing post-operative pathological examination.