Sentinel lymph node identification in breast cancer patients

Area of Science:

• Oncology
• Surgical Pathology
• Radiology

Background:

• Accurate staging of breast cancer is crucial for treatment planning.
• Sentinel lymph node biopsy (SLNB) is a minimally invasive technique to assess axillary lymph node involvement.
• Evaluating the predictive accuracy of SLNB compared to traditional axillary lymph node dissection (ALND) is essential for optimizing patient care.

Purpose of the Study:

• To assess the predictive value of sentinel lymph node biopsy (SLNB) versus axillary node dissection (ALND) for lymph node status.
• To determine the reliability of SLNB in identifying metastasis in early-stage breast cancer (T1-T2).

Main Methods:

• Lymphoscintigraphy using 99mTc-human albumin nanocolloids was performed in 41 patients with T1-T2 breast cancer and clinically negative axillary nodes.
• Sentinel lymph nodes were identified via gamma probe during surgery, followed by complete axillary dissection.
• Histological examination and immunohistochemistry (cytokeratin, EMA) were used to detect micrometastases in sentinel nodes.

Main Results:

• Sentinel lymph node identification was successful in most cases (37/41), with variations based on injection technique.
• Of 38 identified sentinel nodes, 6 were metastatic.
• In patients with non-metastatic sentinel nodes (32 cases), the remaining axillary nodes were also negative. In metastatic cases (6), SLNB accurately reflected axillary involvement.

Conclusions:

• Sentinel lymph node biopsy is a reliable and straightforward method for predicting axillary lymph node status in early breast cancer.
• SLNB can effectively help avoid complete axillary dissection in patients with negative sentinel nodes, reducing morbidity.