Department of General Surgery, Ankara Oncology Training and Research Hospital, Ankara, Turkey.
J Breast Cancer. 2012 Mar;15(1):87-90. doi: 10.4048/jbc.2012.15.1.87. Epub 2012 Mar 28.
Sentinel lymph node biopsy (SLNB) in breast cancer patients with clinically negative axilla will ensure axillary dissection only for cases with lymph node metastasis and provide information about pathologic staging as accurate as the axillary dissection. It was shown that SLNB could be successfully performed regardless of the type of biopsy. The aim of this study was to investigate the feasibility of SLNB after excisional biopsy.
One hundred patients diagnosed with excisional biopsy or guide wire-localization and operated on with SLNB between February 2007 and March 2009 were retrospectively analyzed. SLNB was performed with 10 cc of 1% methylene blue alone or both methylene blue and 1 mCi of Tc-99m nanocolloid combination. Age, tumor localization and size, length of the biopsy incision, size of the biopsy specimen, multifocality, lymphovascular invasion, tumor grade, staining with methylene blue, localization, number and metastatic status of the lymph nodes stained, and success rate with a gamma probe were evaluated.
Sentinel lymph node (SLN) could not be identified in 9 (16.9%) of patients in the methylene blue group (n=53). In the combination group (n=47), SLN could not be identified in one patient. Of 32 patients with negative SLNB, metastatic involvement was found to be present in 5 patients after axillary lymph node dissection (false negatives). The average numbers of SLNs found in the methylene blue group and combination group were 1.4 and 1.6, respectively. SLN detection and false negative rates in the methylene blue group were 83% and 15.7%, respectively. The rates for the combination group were 98% and 6.4%, respectively. None of the parameters related to patient, tumor or process were found to affect detection rates of SLN.
Only SLNB using a combination method is a safe and reliable technique for breast cancer patients diagnosed with excisional biopsy.
在临床腋窝阴性的乳腺癌患者中进行前哨淋巴结活检（SLNB），可以确保仅对淋巴结转移的病例进行腋窝清扫，并提供与腋窝清扫一样准确的病理分期信息。研究表明，无论采用哪种活检方式，SLNB 都可以成功进行。本研究旨在探讨在切除活检后进行 SLNB 的可行性。
回顾性分析了 2007 年 2 月至 2009 年 3 月间接受 SLNB 治疗的 100 例接受切除活检或导丝定位的患者。SLNB 采用 10cc1%亚甲蓝单独或亚甲蓝和 1mCiTc-99m 纳米胶体联合进行。评估的参数包括年龄、肿瘤定位和大小、活检切口长度、活检标本大小、多灶性、脉管侵犯、肿瘤分级、亚甲蓝染色、定位、染色的淋巴结数量和转移状态、伽马探针的成功率。
在亚甲蓝组（n=53）中，有 9 例（16.9%）患者无法识别前哨淋巴结（SLN）。在联合组（n=47）中，有 1 例患者无法识别 SLN。在 32 例 SLNB 阴性的患者中，5 例在腋窝淋巴结清扫后发现有转移浸润（假阴性）。亚甲蓝组和联合组平均检出的 SLN 数分别为 1.4 和 1.6 个。亚甲蓝组的 SLN 检出率和假阴性率分别为 83%和 15.7%，联合组分别为 98%和 6.4%。未发现与患者、肿瘤或过程相关的任何参数影响 SLN 的检出率。
仅使用联合方法的 SLNB 是一种安全可靠的技术，适用于接受切除活检诊断的乳腺癌患者。
