Estourgie S H, Valdés Olmos R A, Nieweg O E, Hoefnagel C A, Rutgers E J T, Kroon B B R
Department of Surgery, Academic Medical Centre, Meibergdreef 9, Amsterdam, The Netherlands.
Br J Surg. 2007 Sep;94(9):1088-91. doi: 10.1002/bjs.5763.
The aim was to validate the sentinel node biopsy procedure in women who had previous breast excision biopsy by means of determining the reproducibility of lymphoscintigraphy after surgery.
Twenty-five women scheduled for excision biopsy of a breast lesion were investigated. The day before surgery, (99m)Tc-labelled nanocolloid was injected into the tumour. Lymphoscintigraphy was repeated a minimum of 2 weeks after surgery.
Preoperative lymphoscintigraphy visualized at least one sentinel node in all 25 women. Discrepancy in the drainage patterns after surgery was noted in 17 of 25 patients. A change in the drainage pattern in the axilla after excision biopsy was seen in 11 women. Drainage to the internal mammary chain was noted before surgery in 13 women, but only three had the same drainage pathways after excision biopsy.
After breast excision biopsy lymphoscintigraphy usually showed a different drainage pattern. This implies that sentinel node biopsy should be performed before excision biopsy to ensure optimal sensitivity.
目的是通过确定手术后淋巴闪烁造影的可重复性，验证前哨淋巴结活检程序在曾接受过乳腺切除活检的女性中的应用。
对25例计划进行乳腺病变切除活检的女性进行了研究。手术前一天，将（99m）Tc标记的纳米胶体注入肿瘤。手术后至少2周重复进行淋巴闪烁造影。
术前淋巴闪烁造影在所有25例女性中均显示至少一个前哨淋巴结。25例患者中有17例术后引流模式存在差异。11例女性在切除活检后腋窝引流模式发生改变。术前13例女性显示引流至内乳链，但切除活检后只有3例具有相同的引流途径。
乳腺切除活检后淋巴闪烁造影通常显示不同的引流模式。这意味着前哨淋巴结活检应在切除活检前进行，以确保最佳敏感性。
