Mehrabibahar M, Azizi S, Jangjoo A, Saremi E, Kakhki V R Dabbagh, Sadeghi R, Chicken D W, Keshtgar M
Acta Chir Belg. 2014 Jan-Feb;114(1):31-3.
We evaluated the concordance between peri-areolar blue dye and peri-incisional radiotracer injections for axillary sentinel node mapping of patients with the history of previous breast lesion excisional biopsy.
80 patients with the history of previous excisional biopsy of the breast lesions were included. All patients received two injections of 99mTc-antimony sulfide colloid in both ends of incision line in an intradermal fashion. 2 mL patient blue V dye was injection to all patients in the peri-areolar area of the index quadrant after induction of anesthesia. All blue or hot nodes were harvested as sentinel lymph nodes.
At least one sentinel node could be detected during surgery in 79 patients. In total 94 sentinel nodes were detected. All detected sentinel nodes were hot. In three patients sentinel nodes were detected by gamma probe but not blue dye. The tumor location in all of these patients was in the upper lateral quadrant and the incision line was extended into the axillary tail of the breast in all of them. 91 out of 94 sentinel nodes were stained blue, which amounts to 95.8% concordance between blue dye and radiotracer on a per node analysis.
Single peri-areolar injection in the index quadrant would suffice for sentinel node mapping of patients with history of excisional biopsy. Care should be taken in patients with large excisional biopsy in the extreme proximity to axilla.
我们评估了乳晕周围蓝色染料注射与切口周围放射性示踪剂注射在既往有乳腺病变切除活检史患者腋窝前哨淋巴结定位中的一致性。
纳入80例既往有乳腺病变切除活检史的患者。所有患者均在切口线两端皮内注射两次99mTc-硫化锑胶体。麻醉诱导后，向所有患者的索引象限乳晕周围区域注射2 mL患者蓝色V染料。所有蓝色或热结节均作为前哨淋巴结切除。
79例患者在手术中至少可检测到1个前哨淋巴结。共检测到94个前哨淋巴结。所有检测到的前哨淋巴结均为热结节。3例患者通过γ探测仪检测到前哨淋巴结，但未检测到蓝色染料。所有这些患者的肿瘤位置均在上外象限，且切口线均延伸至乳腺腋窝尾部。94个前哨淋巴结中有91个被染成蓝色，在单个淋巴结分析中，蓝色染料与放射性示踪剂的一致性达95.8%。
对于有切除活检史的患者，在索引象限进行单次乳晕周围注射足以进行前哨淋巴结定位。对于腋窝附近有大的切除活检的患者应谨慎操作。
