medigraphic.com
ISSN 0016-3813 (Print)

2003, Number 3

<< Back Next >>

Gac Med Mex 2003; 139 (3)

Lymphatic Mapping and Sentinel Lymph Node Biopsy in Patients with Breast Cancer.

Gallegos-Hernández JF, Chávez-García MA, Nájera I, Ramírez-Ramírez L, Durán-Martínez M

Language: Spanish
References: 18
Page: 205-208
PDF size: 43.08 Kb.


ABSTRACT

Axillary lymphadenectomy is the standard of care in breast cancer patients. Lymphatic mapping has arisen as an alternative offering less morbidity. Objective: To determine the success rate of subareolar blue dye injection (SM) in sentinel node (SN) biopsy and its value in axillary staging. Methods: 62 stages I and II breast cancer patients without palpable axillary nodes received subareolar injection of blue dye; an intraoperative study of the SN was carried out. Axillary lymphadenectomy was carried out in all patients. Sensitivity, specificity, positive predictive value, and negative predictive value were measured. Results: In 58/62 patients (93.5%), SN was identified; 19/58(32%) patients had nodal metastases, 18 were identified in intraoperative study, and only one false negative; 12/18 patients showed metastasis in other axillary nodes (66%), in 6 (27%) the only metastasis site was SN. Sensitivity/specificity of the SN was 92.8 and 88.6%, respectively. Positive predictive value is 72.2% and negative predictive value is 97.5% Conclusion: SAI of blue dye allows identification of SN in 93.5%; with high sensitivity. SN negative predictive value is 97.5% in this study.


REFERENCES

  1. Giuliano AE, Jones RC, Brennan M, et al. Sentinel lymphadenectomy in breast cancer. J Clin Oncol. 1997;15:345-350.

  2. Bass SS, Cox CE, Ku NN, Berman C, Reintgen D. The role of sentinel lymph node biopsy in breast cancer. 1999;189: 183-194.

  3. Siegel BM, Mayzel KA, Love SM. Level I and II axillary dissection in the treatment of early-stage breast cancer. An analysis of 259 consecutive patients. Arch Surg 1990; 125:1144-1147.

  4. Kissin MW, Quercy della Rovere G, Easton D, Westbury G. Risk of lymphoedema following the treatment of breast cancer. Br J Surg 1986;73:580-584.

  5. Kapteijn BAE, Nieweg OE, Peterse JL y cols. Identification and biopsy of the sentinel lymph node in breast cancer.Eur J Sur Oncol 1998,24:427-430.

  6. Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 1992;127:392-399.

  7. Tanis PJ, Nieweg OE, Valdés-Olmos RA, Rutgers Ejth, Kron BBR. History of sentinel node and validation of the technique. Br Can Res 2001;3:109-112.

  8. Keshtgar MRS, Waddington WA, Lakhani SR, Ell PJ. Injection techniques. In: The sentinel node in surgical oncology. Keshtgar MRS. Editor. Springer.Berlin.2000.pp193.

  9. Reutgers EJTh, Jansen L, Nieweg OE, de Vries J, Cshrafford Koops, Kroon BBR. Technique of sentinel node biopsy in breast cancer. Eur J Surg Oncol 1998;24:316-319.

  10. Tanis PJ, Nieweg OE, Valdes Olmos RA, Kroon BBR. Anatomy and physiology of lymphatic drainage of the breast from the perspective of sentinel node biopsy. J Am Coll Surg 2001;192:399-409

  11. Kern KA. Sentinel lymph node mapping in breast cancer using subareolar injection of blue dye. J Am Coll Surg.1999; 189:539-545.

  12. Cabańas RM. An approach for the treatment of penile carcinoma.Cancer 1977;39:456-466.

  13. Borgstein PJ, Meijer S, Pipjers R. Intraderma blue dye to identify sentinel lymph node in breast cancer. Lancet 1999;349:1668-1669.

  14. Kam PCA, Thompson JF y Uren RF. Microanatomy and physiology of the lymphatic system. In: Nieweg OE, Essner R, Reitgen DS and Thompson JF editors.Lymphatic mapping and probe applications in oncology.Marcel Dekker Inc. New York.2000. pp378.

  15. Nieweg OE, Jansen L, Valdés Olmos RA, Rutgens EJTh, peterse L, Hoefnagel KA, Kroon BBR. Lymphatic mapping and sentinel lymph node biopsy in breast cancer. Eur J Nucl Med 1999; 26(Suppl):S11-S16.

  16. van der Wall E. The sentinel node in breast cancer: implications for adjuvant treatment? Eur J Nucl Med 1999;26(Suppl): S17-S19.

  17. Early Breast Cancer Trialists’ Collaborative Group Polychemotherapy for early breast cancer: an overview of the randomized trials. Lancet 1998;352:93042.

  18. Kroon BBR, Jansen L, Rutgers EJTh, Nieweg O. The future of lymphatic mapping and sentinel node biopsy. In: Nieweg OE, Essner R, Reintgen DS, Thompson JF. Editors. Lymphatic mapping and probe applications in oncology. Marcel Dekker Inc. New York.2000.pp378.




2020     |     www.medigraphic.com