Twenty-six studies with a total of 24,248 sentinel lymph node biopsies (SLNB) were included in the review. Studies included 1,604 cases of multifocal/multicentric tumours and 1,912 larger tumours.
Multifocal tumours:
Six studies describing 314 cases reported separate data on the performance of SLNB in multifocal breast cancer. SLNB success rates ranged from 86% to 94%. Sentinel lymph node positivity rates were 42% to 59%. For the five studies that performed routine axillary lymph node dissection, sensitivity ranged from 67% to 100%, false negative rate ranged from 0 to 33% and overall accuracy ranged from 78% to 100%. The non-sentinel lymph node positive rate (following axillary dissection for positive SLNB) ranged from 16% to 50%; four studies.
Multicentric tumours:
Five studies describing 262 cases reported separate data on the performance of SLNB in multicentric breast cancer. SLNB success rates ranged from 92% to 100%. Sentinel lymph node positivity rates were 25% to 61%. For the three studies that performed routine axillary lymph node dissection, sensitivity ranged from 92% to 100%, false negative rate ranged from 4 to 8% and overall accuracy ranged from 96% to 100%. The non-sentinel lymph node positive rate (following axillary dissection for positive SLNB) ranged from 37% to 82%; five studies.
Multiple breast cancer (multicentric and multifocal combined):
Ten studies describing 996 cases reported data on the performance of SLNB for multicentric and multifocal breast cancer treated as one category. SLNB success rates ranged from 92% to 100%. Sentinel lymph node positivity rates were 12% to 63%. Sensitivity ranged from 86% to 100%, false negative rate ranged from 0 to 25% and overall accuracy ranged from 82% to 100%. The non-sentinel lymph node positive rate (following axillary dissection for positive SLNB) ranged from 32% to 51%; three studies.
Larger tumours:
Eleven studies describing 1,912 cases reported separate data on the performance of SLNB in larger tumours. SLNB success rates ranged from 86% to 100%. Sentinel lymph node positivity rates were 49% to 72%. Sensitivity ranged from 82% to 97%, false negative rate ranged from 3 to 18% and overall accuracy ranged from 85% to 98%. The non-sentinel lymph node positive rate (following axillary dissection for positive SLNB) ranged from 40% to 80%; three studies.