Minimal sentinel node procedure for staging early breast cancer

Area of Science:

• Oncology
• Surgical Oncology
• Breast Cancer Research

Background:

• Sentinel lymph node dissection (SLND) is an emerging staging technique for early breast cancer.
• Minimizing surgical extent is crucial for patient recovery and outcomes.
• Evaluating SLND under regional anesthesia addresses the need for less invasive surgical options.

Purpose of the Study:

• To assess the feasibility of performing sentinel lymph node dissection (SLND) under regional anesthesia for early breast cancer.
• To evaluate the efficacy of eradicating primary breast lesions and sentinel lymph nodes (SLN) in a single procedure.
• To determine the safety and patient compliance with regional anesthesia for SLND.

Main Methods:

• A cohort of 76 patients with operable breast cancer and no palpable lymph nodes was studied.
• Radiotracer administration and lymphoscintigraphy were used for SLN identification.
• Nervous block anesthesia preceded the surgical excision of the primary lesion, SLN, and non-SLNs (if invasive carcinoma was confirmed).

Main Results:

• The primary breast lesion was successfully excised in 100% of patients.
• Sentinel lymph nodes (SLNs) were identified in 89% of patients.
• Twenty-nine percent of patients had metastatic disease in examined lymph nodes, with 55% of these cases showing cancer exclusively in the SLN. No false negatives were observed, and no anesthesia-related complications occurred.

Conclusions:

• Single radiotracer administration is effective for localizing both occult lesions and SLNs.
• SLND under regional anesthesia is a feasible and effective method for staging early breast cancer.
• This approach offers improved patient management, compliance, and reduced recovery time without compromising surgical effectiveness.