Holl G, Stöcklein R, Dorn R, Vogt H, Wischnik A, Sciuk J
Klinik für Nuklearmedizin, Klinikum Augsburg, Augsburg.
Nuklearmedizin. 2008;47(5):216-9.
We investigated the influence of the injection technique on the false negative rate in identifying the sentinel lymph node in multifocal breast cancer.
PATIENTS, METHODS: 958 consecutive patients were divided into unifocal and multifocal breast cancer patients. The scintigrafic and intraoperative detection rate as well as the false negatives were calculated in relation to peritumoral or subareolar injection.
In all patients the scintigrafic and intraoperative detection rate exceeded 99%, except in patients with multifocal cancer, who were injected peritumorally. In this group the intraoperative detection rate declined to 96%. In patients with unifocal breast cancer the false negative rate was below 5%, independent of the injection technique. Multifocal breast cancer patients showed a significant dependence on the injection technique. The false negative rate was 26.3% in patients with peritumoral injection and 5.6% in those with subareolar injection.
The results clearly demonstrate that in multifocal breast cancer a reliable detection of a SLN is impossible with the peritumoral injection technique. Subareolar injection seems to be a way to operate on multifocal breast cancer with SLNE, but the number of investigated patients is too low for statistic approval. So, prospective studies should be performed to validate these preliminary results before SLNE becomes routine in multifocal breast cancer.
我们研究了注射技术对多灶性乳腺癌前哨淋巴结识别假阴性率的影响。
患者、方法：958例连续患者被分为单灶性和多灶性乳腺癌患者。计算了相对于瘤周或乳晕下注射的闪烁扫描和术中检测率以及假阴性率。
在所有患者中，闪烁扫描和术中检测率均超过99%，但瘤周注射的多灶性癌症患者除外。在该组中，术中检测率降至96%。在单灶性乳腺癌患者中，假阴性率低于5%，与注射技术无关。多灶性乳腺癌患者对注射技术有显著依赖性。瘤周注射患者的假阴性率为26.3%，乳晕下注射患者的假阴性率为5.6%。
结果清楚地表明，在多灶性乳腺癌中，瘤周注射技术无法可靠地检测前哨淋巴结。乳晕下注射似乎是一种对多灶性乳腺癌进行前哨淋巴结活检手术的方法，但所研究的患者数量太少，无法进行统计学验证。因此，在多灶性乳腺癌前哨淋巴结活检成为常规操作之前，应进行前瞻性研究以验证这些初步结果。
