P341 Use of fibrin glue in the prevention of seroma formation after axillary lymphadenectomy

Goals: The ACOSOG Z0011 trial showed that an axillary lymph node dissection (ALND) may be safely omitted in selected patients with a positive sentinel lymph node biopsy (SNB). One of these eligible criteria has non palpable lymphadenopathy. However, the eligibility for patients with a suspicious Ultrasonography (US) is controversial. The purpose of this study was to evaluate the validity of the SNB for patients with suspicious lymph node (sN+) compared to clinical node negative patients (cN0). Methods: Patients with suspicious axillary lymph node positive breast cancer by preoperative assessed US or CT were performed fine needle aspiration (FNA) cytology between 2004 and 2014. Patients with a negative axillary US (cN0 group) or negative FNAC (sN+ group) result underwent SNB. All SNB positive patients underwent completion ALND. The number of positive nodes after ALND was compared cN0 group with sLN group. Results: 530/2683 patients (19.7%) had positive SNB. Ultrasoundaxilla was 49% sensitive and 84% specific in predicting SNB metastases. The positive (PPV) and negative predictive value (NPV) was 53% and 81% respectively. For suspicious group, this was 68.4% sensitive and 99.7% specific in detecting SNB metastases. PPV and NPV were 99.6% and 74.2% respectively. The number of metastasis lymph nodes is 1 (48%), 2 (19%), 3 (9%), more than 4 (54%) and N1mic (17%) in the cN0 group, and 1 (37%), 2 (14%), 3 (7%), more than 4 (10%) and N1mic (28%) in the cN1 suspicious group. Conclusion: These results suggest that patients with suspicious axillary metastases on ultrasound-guided biopsy have less involved nodes than SNB-positive patients with clinical negative node. Therefore, we conclude that SNB can be safely performed in patients with clinically suspicious lymph node on ultrasonography. Disclosure of Interest: No significant relationships.