Gallegos-Hernández José Francisco, Chávez-García Martha
Rev Invest Clin. 2003 Jul-Aug;55(4):407-11.
Although the axillary radical dissection continues being the standard treatment for patient with breast cancer, the lymphatic mapping with biopsy of the sentinel node has arisen as a possibility to appropriately staging patients without palpable axillary nodes (NO) and to prevent axillary lymphadenectomy. The best method to perform it is with the association of radiocolloid and dye, nevertheless for this purpose an intraoperatively gamma-probe is needed, when is not possible to get it, the procedure must be done only with dye, therefore is important to select the most successful administration way for the sentinel node (SN) identification.
To show that the lymphatic mapping with subareolar injection of blue dye has a high success rate for lymphatic mapping in breast cancer patients.
Lymphatic mapping was practiced to 62 breast cancer patients with subareolar injection of blue dye. All the patients were subject to axillary dissection, the index of false negatives, sensitivity and negative predictive values were estimated. The need to perform the mapping with association of radiocolloid--dye was assessed according to the literature.
The SN was identified in 58 patients (93.5% success rate), the index of false negatives was of 5.2% with sensitivity of 93% and the negative predictive value was of 97.5%.
The SN is a predictor of the axillary node state, the subareolar dye injection technique has a high success rate in the identification of the sentinel node.
尽管腋窝根治性清扫术仍然是乳腺癌患者的标准治疗方法,但前哨淋巴结活检的淋巴绘图已成为一种对腋窝无肿大淋巴结(NO)的患者进行准确分期并避免腋窝淋巴结清扫的方法。进行该操作的最佳方法是联合使用放射性胶体和染料,不过为此需要术中γ探测仪,若无法获得该仪器,则必须仅使用染料进行操作,因此选择最成功的前哨淋巴结(SN)识别给药方式很重要。
证明乳晕下注射蓝色染料进行淋巴绘图在乳腺癌患者中具有较高的成功率。
对62例乳腺癌患者进行乳晕下注射蓝色染料的淋巴绘图。所有患者均接受腋窝清扫,评估假阴性指数、敏感性和阴性预测值。根据文献评估联合使用放射性胶体 - 染料进行绘图的必要性。
58例患者识别出前哨淋巴结(成功率93.5%),假阴性指数为5.2%,敏感性为93%,阴性预测值为97.5%。
前哨淋巴结是腋窝淋巴结状态的预测指标,乳晕下染料注射技术在前哨淋巴结识别方面具有较高的成功率。