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[Axillary lymph node excision in breast cancer].

E Kubista

    Gynakologische Rundschau
    |January 1, 1989
    PubMed
    Summary

    Marking axillary lymph nodes with technetium-99 antimonsulfide in breast cancer surgery increased lymph node removal and detection rates. However, this did not impact long-term survival, suggesting potential benefits from adjuvant therapies in detected cases.

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    Area of Science:

    • Oncology
    • Surgical Oncology
    • Nuclear Medicine

    Background:

    • Accurate lymph node staging is crucial for breast cancer treatment planning.
    • Modified radical mastectomy is a standard surgical approach.
    • The utility of intraoperative lymph node imaging requires further investigation.

    Purpose of the Study:

    • To evaluate the impact of technetium-99 antimonsulfide marking on lymph node removal and patient outcomes in operable breast cancer.
    • To assess if enhanced lymph node detection influences prognostic parameters and survival rates.

    Main Methods:

    • A randomized study of 264 patients with operable breast cancer undergoing modified radical mastectomy.
    • One group (140 patients) had axillary lymph nodes marked with technetium-99 antimonsulfide and imaged with a gammacamera.
    • The control group (124 patients) did not have lymph node marking.

    Main Results:

    • The marked group showed a 25% increase in the average number of removed lymph nodes.
    • Lymph node-positive cases were higher in the marked group (50.7%) compared to the unmarked group (37.4%).
    • No significant differences were observed in survival rate, disease-free interval, local/regional recurrence, or distant metastases after 5 years.

    Conclusions:

    • Technetium-99 antimonsulfide marking enhances lymph node retrieval in breast cancer surgery.
    • Despite increased detection of positive lymph nodes, long-term survival outcomes were not significantly affected.
    • The findings suggest that improved lymph node staging may facilitate better adjuvant therapy selection, potentially offsetting the negative prognostic implication of more detected metastases.

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