Sentinel lymph node detection in breast cancer - first experience.

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.