>Cirugía y Cirujanos
>Year 2004, Issue 5
Lymphatic mapping and biopsy of sentinel lymph node in patients with breast cancer.Results of the first phase of a study
Cir Cir 2004; 72 (5)
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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
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.
||Sentinel node, Lymphatic mapping, Breast cancer.
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>Cirugía y Cirujanos
>Year 2004, Issue 5