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Sentinel lymph node detection in breast cancer - first experience.

S Stojanoski1, N Ristevska1, D Pop Gjorceva1

  • 1Institute of Pathophysiology and Nuclear Medicine, Acad. "Isak S. Tadzer", Skopje, R. Macedonia.

Prilozi (Makedonska Akademija Na Naukite I Umetnostite. Oddelenie Za Medicinski Nauki)
|June 17, 2015
PubMed
Summary

Sentinel lymphnode (SLN) detection is a safe and reliable method for breast cancer staging. This technique accurately identifies metastatic involvement, guiding treatment decisions for early-stage breast cancer patients.

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Area of Science:

  • Oncology
  • Surgical Pathology
  • Nuclear Medicine

Background:

  • Breast cancer is a leading cause of cancer death in women, with axillary lymphnode (ALN) status being a critical predictor of metastasis.
  • Sentinel lymphnode (SLN) status is crucial for determining appropriate treatment strategies in breast cancer patients.

Purpose of the Study:

  • To evaluate the benefits and efficacy of sentinel lymphnode (SLN) detection in patients diagnosed with early-stage breast cancer.
  • To assess the reliability of ex tempore histopathology in SLN evaluation.

Main Methods:

  • The study included 38 female patients with T1-2 N0 M0 breast cancer and no enlarged ALN on ultrasound.
  • SLN detection was performed using a gamma camera and probe after injection of 99m-Technetium-SENTISCINT, with blue dye administered pre-operatively.
  • Ex tempore histopathology was conducted on the extirpated SLN.

Main Results:

  • Ex tempore SLN evaluation was negative in 74% of patients, indicating preserved lymphatic pathways.
  • In 26% of patients, SLN was positive, leading to radical surgery.
  • A false negative rate of 10.7% (3/28) was observed, with metastatic involvement detected on final histopathology.

Conclusions:

  • Sentinel lymphnode (SLN) detection is a non-invasive, safe, and reliable technique for breast cancer staging (T1-2 N0 M0).
  • Combined periareolar and peritumoral colloid injection offers the most reliable method for SLN detection.
  • Patients with drainage to the internal mammary artery require consideration for adjuvant therapy protocols.