Diagnostic biopsy of sentinel lymph nodes in mammary gland cancer

Abstract

Objective.To improve the diagnostic biopsy of sentinel lymph nodes in patients, suffering mammary gland cancer, using fluorescent lymphography, and to reduce the quantity of postoperative complications.
 Materials and methods. In 2016 – 2021yrs period on the base of Odessa Regional Clinical Hospital 400 patients, suffering mammary gland cancer Stages Т1–Т3N0М0, were operated on with application of fluorescent lymphography, using two dyers – the patent blue and indocyanine green. All the patients were distributed into two groups. In Group I (a control one) in 200 patients the sentinel lymph nodes biopsy was performed. The dyer patent blue was applied for the lymph nodes coloring.In Group II (the main) in 200 women–patients the sentinel lymph nodes biopsy, using the patent blue and fluorescent dyer indocyanine green, was performed. Both dyers were injected subdermally along the external areolar edge in the dose 2 ml of the dyer solution.
 Results. Total 5–year survival after axillary lymphodissection and after the sentinel lymph node biopsy have constituted 91and 92%, accordingly, while the recurrence–free 5–year survival – 82.2 and 83.9%, accordingly. Regional recurrence in sentinel lymph nodes on the affected mammary gland side was diagnosed in 1.1% of the women–patients. In 58% of the women–patients the sentinel lymph nodes were clear, and that’s why a subsequent lymphodissection was not indicated to perform. Metastatic lymph nodes were revealed in 42% of the women–patients.
 Conclusion. The method of diagnostic biopsy of sentinel lymph nodes in patients, suffering mammary gland cancer, using dyers, permits in majority of them to abandon traumatic operations in favor of organ–preserving interventions, thus reducing the postoperative complications rate significantly.