2008, Number 2
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Rev Mex Mastol 2008; 3 (2)
Validation and learning curve in the lymphatic mapping (LM) and sentinel lymph node biopsies (SLNB) in women with early breast cancer
Barroso-Bravo S, Zarco G, Alvarado-Cabrero I, Valenzuela-Flores AG, Pichardo-Romero P, Rodríguez-Cuevas SA
Language: Spanish
References: 40
Page: 49-56
PDF size: 115.17 Kb.
ABSTRACT
The lymphatic mapping (LM) and sentinel lymph node biopsy (SLNB) can predict the absence of axillary-node metastases and avoid the axillary lymph node dissection (ALND). To ensure the method the validation consists in identified the node sentinel (SN) in more of 90% and a false-negative rate of 10% or minor. The main of the paper was the evaluation of validation and learning curve of LM and SLNB. We studied 77 Mexican women with early breast cancer without palpable lymph nodes, staging I and II, during March 2002 from December 2004. The patients underwent to LM and SLNB with blue patent alone or blue patent plus gamma probe. All patients underwent a complete axillary lymphadenectomy. The overall rate of identification of SL was 92% (72 of 77), 80% (4 of 5) the fall cases were identified with colorant alone and 100% (5 of 5) during the first year of investigation. In 72 patients with successful identify the mean age were 56.2 year (28-82), the mean size tumor 26 mm (8-45), staging I 12% (9 of 72), IIA 78% (56 of 72), IIB 10% (7 of 72). The cases with blue patent alone were 54% (39 of 72), and blue patent plus gamma-probe 46% (33 of 72), in 44% (32 of 72) find lymph nodes positive and in 59.3% (19 of 32) the sentinel lymph node was only lymph node-positive. There were false negative rate of 9.7% (7 of 72), five of seven with colorant alone and results during the first year of investigation. For to know the trained required for surgeons we evaluated the validation individual, identified to surgeons with experience how A, B, C, D and inexpert with E. The surgeons with experience proper identification successful, but surgeons A and B with 16 cases by one the false-negative rate were more of 10% and required five cases for ensure accurate staging of SN. In the surgeons C and D with 28 cases and 8 cases respective the false-negative rate was minor of 10%, the late surgeon with trained since residence. The surgeons E inexpert were not accuracy in find to SN and the unacceptable 22% of false-negative rate. The conclusions is that the validation of LM and SLNB is mandatory before to avoid ALND, the combinative technique, the time, the surgeon’s experience and performed more the 20 cases are important.
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