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>Revistas >Cirugía y Cirujanos >Año 2004, No. 5

Gallegos-Hernández JF
Mapeo linfático y biopsia del ganglio centinela en pacientes con cáncer de mama.Resultados de la primera fase del estudio
Cir Cir 2004; 72 (5)

Idioma: Español
Referencias bibliográficas: 18
Paginas: 357-360
Archivo PDF: 71.28 Kb.

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Background: The standard surgical treatment in breast cancer patient is resection of the primary tumor and axillary lymphadenectomy; nevertheless almost 50% of patients without axillary palpable nodes do not have axillary metastasis in the axillary dissection specimen. In theory the sentinel node identification (lymphatic mapping) selects patients with high risk of hidden metastasis and avoids unnecessary axillary dissections, the technique is performed with blue dye, radio colloid or both. Objective: To know the sentinel node value in axillary staging in patients with invasive breast cancer without palpable nodes. Material and methods: Prospective study including 87 breast cancer patients stage I-II without palpable nodes. In 65 we use blue dye only and in 22 blue dye and Tc99 nanocoloid, all patients were submitted to axillary dissection; the sentinel node was study by imprint cytology, frozen sections and H/E stains. Sensibility, success index, negative predictive value, positive predictive value and false negative rate were calculated. Results: Sentinel node was identified in 57/65 patients (87%) in blue dye group and in all the patients in combined technique group. There were sentinel node metastasis in 19/79 (24%), 4/19 patients had metastatic non-sentinel nodes without sentinel node metastasis (false negative rate = 17%), all the false negative sentinel nodes in the blue dye only group. Conclusions: Lymphatic mapping and sentinel node biopsy could avoid unnecessary axillary dissections in early stages of breast cancer; the combined technique reduces the false negative rate and increases the index of success.

Palabras clave: ganglio centinela, mapeo linfático, cáncer de mama.


  1. Giuliano AE, Jones RC, Brennan M, et al. Sentinel lymphadenectomy in breast cancer. J Clin Oncol 1997;15:345-350.

  2. Bass SS, Cox CE, Ku NN, Berman C, Reintgen D. The role of sentinel lymph node biopsy in breast cancer. J Am Coll Surg 1999;189:183-194.

  3. Siegel BM, Mayzel KA, Love SM. Level I and II axillary dissection in the treatment of early-stage breast cancer. An analysis of 259 consecutive patients. Arch Surg 1990;125:1144-1147.

  4. Kissin MW, Quercy della Rovere G, Easton D, Westbury G. Risk of lymphoedema following the treatment of breast cancer. Br J Surg 1986;73:580-584.

  5. Kapteijn BAE, Nieweg OE, Peterse JL, et al. Identification and biopsy of the sentinel lymph node in breast cancer. Eur J Surg Oncol 1998,24:427-430.

  6. Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 1992;127:392-399.

  7. Tanis PJ, Nieweg OE, Valdés-Olmos RA, Rutgers E, Kron BBR. History of sentinel node and validation of the technique. Br Can Res 2001;3:109-112.

  8. Keshtgar MRS, Waddington WA, Lakhani SR, Ell PJ. Injection techniques. In: Keshtgar MRS, editor. The sentinel node in surgical oncology. Berlin: Springer; 2000. pp. 193.

  9. Reutgers E, Jansen L, Nieweg OE, de Vries J, Cshrafford K, Kroon BBR. Technique of sentinel node biopsy in breast cancer. Eur J Surg Oncol 1998;24:316-319.

  10. Tanis PJ, Nieweg OE, Valdés-Olmos RA, Kroon BBR. Anatomy and physiology of lymphatic drainage of the breast from the perspective of sentinel node biopsy. J Am Coll Surg 2001;192:399-409.

  11. Kern KA. Sentinel lymph node mapping in breast cancer using subareolar injection of blue dye. J Am Coll Surg 1999;189:539-545.

  12. Cabañas RM. An approach for the treatment of penile carcinoma. Cancer 1977;39:456-466.

  13. Borgstein PJ, Meijer S, Pipjers R. Intraderma blue dye to identify sentinel lymph node in breast cancer. Lancet 1999;349:1668-1669.

  14. Kam PCA, Thompson JF, Uren RF. Microanatomy and physiology of the lymphatic system. In: Nieweg OE, Essner R, Reintgen DS, Thompson JF, editors. Lymphatic mapping and probe applications in oncology. New York: Marcel Dekker; 2000. pp. 1-22.

  15. Nieweg OE, Jansen L, Valdés-Olmos RA, Rutgens EJTh, Peterse L, Hoefnagel KA, Kroon BBR. Lymphatic mapping and sentinel lymph node biopsy in breast cancer. Eur J Nucl Med 1999;26(Suppl):S11-S16.

  16. Van der Wall E. The sentinel node in breast cancer: implications for adjuvant treatment? Eur J Nucl Med 1999;26(Suppl):S17-S19.

  17. Early Breast Cancer Trialists’ Collaborative Group. Polychemotherapy for early breast cancer: an overview of the randomized trials. Lancet 1998;352:930-942.

  18. Kroon BBR, Jansen L, Rutgers E, Nieweg O. The future of lymphatic mapping and sentinel node biopsy. In: Nieweg OE, Essner R, Reintgen DS, Thompson JF, editors. Lymphatic mapping and probe applications in oncology. New York: Marcel Dekker; 2000. pp. 359-369.

>Revistas >Cirugía y Cirujanos >Año2004, No. 5

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