Evaluation of New Tracers in the Identification of Sentinel Lymph Node in Patients with Early Breast Cancer.

PURPOSE

Sentinel node mapping is the standard of care for evaluation of axilla for women with early node negative breast cancer. Validation of a new tracer for sentinel node biopsy requires full axillary lymph node dissection to establish its performance indicators. This exposes about 70% of women to unnecessary axillary dissection with its attendant morbidity.

AIMS AND OBJECTIVE

To investigate the predictive value of identification of sentinel lymph nodes by a tracer for knowing its sensitivity and false-negative rates (FNR).

METHODS

A linear regression on data from a network meta-analysis was carried out, and the correlation between identification and sensitivity and its predictive value were ascertained.

RESULTS

A strong linear relationship was observed between identification and sensitivity of sentinel node biopsy (correlation coefficient = 0.97). The sensitivity and false negativity can be predicted by the identification rate. An identification rate of 93% corresponds to sensitivity = 90.51% and a FNR = 9.49%. The current literature on newer tracers has been succinctly reviewed.

CONCLUSION

The linear regression demonstrated a very high predictive value of identification rate for ascertaining the sensitivity and FNRs of sentinel node biopsy. A new tracer for sentinel node biopsy can be introduced in clinical practice, if it achieves an identification rate of 93% or more.