Sampol C, Giménez M, Torrecabota J, Serra C, Canet R, Daumal J, Peña C, Gonzalez L, Hernandez E, Graner A, Pozo A, Vega F
Servicio de Medicina Nuclear, Hospital Universitario Son Dureta, Palma de Mallorca, España.
Rev Esp Med Nucl. 2010 Sep-Oct;29(5):241-5. doi: 10.1016/j.remn.2010.02.007. Epub 2010 May 13.
The aim of our study was to analyze the application of the Selective Sentinel Lymph Node Biopsy (SLNB) in early Breast Cancer of our population, through the analysis of axillary recurrences in patients with false negative sentinel node procedures without complete axillary lymphadenectomy, after a subsequent clinical follow-up.
A total of 218 early Breast Cancer patients who underwent SLNB after being diagnosed of early breast cancer (T1-2N0) with complete axillary dissection only when the SLNB was positive in the histopathological analysis. In every case, a 2-day protocol was used to localize the sentinel node after injection of (⁹⁹m)Tc-Nanocolloid.
The mean subsequent clinical follow-up was 27 months. A total of 413 sentinel nodes were removed with a median of 1.89/p (range 1-5). Infiltration was detected in 33.9% of patients (59.45% macrometastasis, 22.97% micrometastasis and 17.5% Isolated Tumor Cells (ITC)) and negative for the other nodes excised after conventional lymphadenectomy in 60% of cases. In our population, there was only one case of false negative (FN) SLN due to massive lymphatic blockage, and an abnormal lymph node without uptake adjacent to the SLN was identified intraoperatively. No case of axillary recurrence was detected during an average follow-up of 27 months.
The absence of axillary recurrences in our population with negative SLNB without complete axillary dissection demonstrates the appropriate local control offered by this procedure in early Breast Cancer.
我们研究的目的是通过分析前哨淋巴结手术假阴性且未行完整腋窝淋巴结清扫患者后续临床随访中的腋窝复发情况,来分析选择性前哨淋巴结活检(SLNB)在我国早期乳腺癌患者中的应用。
共有218例早期乳腺癌患者,在被诊断为早期乳腺癌(T1-2N0)后接受了SLNB,仅在组织病理学分析中SLNB为阳性时才进行完整腋窝清扫。在每种情况下,注射(⁹⁹m)Tc-纳米胶体后,采用为期2天的方案来定位前哨淋巴结。
后续平均临床随访时间为27个月。共切除413个前哨淋巴结,中位数为1.89个/人(范围1-5个)。33.9%的患者检测到浸润(59.45%为宏转移,22.97%为微转移,17.5%为孤立肿瘤细胞(ITC)),60%的病例中常规淋巴结清扫术后切除的其他淋巴结为阴性。在我们的研究人群中,仅1例因大量淋巴管阻塞导致前哨淋巴结假阴性(FN),术中发现前哨淋巴结旁有一个无摄取的异常淋巴结。在平均27个月的随访期间未检测到腋窝复发病例。
在我国未行完整腋窝清扫且前哨淋巴结阴性的患者中未出现腋窝复发,这表明该手术在早期乳腺癌中能提供适当的局部控制。