Nagao Tomoya, Hojo Takashi, Kurihara Hiroaki, Tsuda Hitoshi, Tanaka-Akashi Sadako, Kinoshita Takayuki
Department of Breast Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Breast Cancer. 2014 Sep;21(5):624-8. doi: 10.1007/s12282-011-0280-7. Epub 2011 Jun 14.
The number of breast augmentation surgeries (BAS) has increased. Therefore, the number of breast cancer patients with history of BAS has also increased. In this paper, we present two cases of sentinel lymph node biopsy (SLNB) in patients with previous BAS who were diagnosed with breast cancer. The patients were augmented using different approach; the first case was augmented through transaxillary incision, whereas the second case was augmented through periareolar incision. Lymphoscintigraphy (LPG) was performed on the patients 1 day prior to operation, enabling confirmation of lymphatic flow and SLN in both patients. SLNB was successfully performed in both cases. In one patient, SLNB was performed using indocyanine green (ICG) fluorescence and the Photodynamic Eye (PDE) system. Regardless of history of BAS, ICG and PDE system showed lymphatic flow and SLN in real time. LPG and ICG fluorescence were useful methods for SLN detection in patients with previous BAS, being able to confirm lymph flow before operation. Biopsy methods using LPG and PDE system were considered useful for difficult confirmation of lymph flow after breast augmentation. This is the first report of SLNB using ICG and PDE system for patients with previous BAS.
隆胸手术（BAS）的数量有所增加。因此，有隆胸手术史的乳腺癌患者数量也有所增加。在本文中，我们介绍了两例曾接受过隆胸手术且被诊断为乳腺癌的患者的前哨淋巴结活检（SLNB）情况。这两名患者采用了不同的隆胸方法；第一例通过腋窝切口进行隆胸，而第二例通过乳晕周围切口进行隆胸。在手术前1天对患者进行了淋巴闪烁造影（LPG），从而确认了两名患者的淋巴引流和前哨淋巴结。两例均成功进行了前哨淋巴结活检。在一名患者中，使用吲哚菁绿（ICG）荧光和光动力眼（PDE）系统进行了前哨淋巴结活检。无论有无隆胸手术史，ICG和PDE系统均能实时显示淋巴引流和前哨淋巴结。LPG和ICG荧光是检测有隆胸手术史患者前哨淋巴结的有用方法，能够在手术前确认淋巴引流情况。使用LPG和PDE系统的活检方法被认为对隆胸后难以确认淋巴引流的情况很有用。这是首例针对有隆胸手术史患者使用ICG和PDE系统进行前哨淋巴结活检的报告。
