Background: Multicentric breast cancer is often considered a contra-indication for sentinel lymph node (SLN) biopsy due to concerns with sensitivity and false negative rate. To assess SLN feasibility and accuracy in multicentric breast cancer, the multi-institutional SMMaC trial was conducted. Methods: In this study 30 patients with multicentric breast cancer and a clinically negative axilla were prospectively included. Periareolar injection of radioisotope and blue dye was administered. In all patients SLN biopsy was validated by back-up completion axillary lymph node dissection. Results: the SLN was successfully identified in 30 of 30 patients (identification rate 100%). The incidence of axillary metastases was 66.7% (20/30). The false negative rate was 0% (0/20) and the sensitivity was 100% (20/20). The negative predictive value was 100% (10/10). Conclusion: SLN biopsy in multicentric breast cancer seems feasible and accurate and should therefore be considered in patients with multicentric breast cancer and clinically negative axilla.

Axillary lymph node dissection, False negative rate, Multicentric breast cancer, Sentinel lymph node biopsy
dx.doi.org/10.1016/j.ejso.2013.11.004, hdl.handle.net/1765/60719
European Journal of Surgical Oncology
Department of Surgery

van la Parra, R.F.D, de Roos, W.K, Contant, C.M.E, Bavelaar-Croon, C.D.L, Barneveld, P.C, & Bosscha, K. (2014). A prospective validation study of sentinel lymph node biopsy in multicentric breast cancer: SMMaC trial. European Journal of Surgical Oncology. doi:10.1016/j.ejso.2013.11.004