Hemosiderin: a new marker for sentinel lymph node identification

Luiz Gonzaga Porto Pinheiro,Raissa Vasconcelos Cavalcante,Paulo Henrique Diógenes Vasques,Pedro Henrique De Oliveira Filgueira,Douglas Henning Pinheiro Aragão,Pedro Macedo Esmeraldo Barbosa,Renato Santos De Oliveira Filho,Hugo Enrique Orsini Beserra

doi:10.1590/s0102-86502009000600002

Abstract

To evaluate and present our initial results of a new marker (hemosiderin) for mammary sentinel lymph node identification in an experimental model. Skins mapped like a lymphatic duct draining to the axilla in patients submitted to breast biopsy, in our mastology service, stimulated us to try it in an animal model (female dogs). Our theory was that some blood derivate (hemosiderin) was captured by macrophages and accessed the lymphatic ducts in direction to the axilla. Six female dogs of no defined race were studied. We injected 0,2 ml of technetium on both superior mammary glands. After ten minutes, a 2,5 ml solution of hemolized blood (hemosiderin) from the own animal was injected in the subareolar lymphatic plexus on the left superior mammary gland and 2,5 ml of patent blue concomitantly and equally on the contralateral gland. Ten minutes after, incisions on both axillae were made to search, through the lymphatic mapping and a gamma probe, the sentinel lymph nodes. Seven brown sentinel lymph nodes were identified and also radiomarked on the left axilla. Six blue sentinel lymph nodes were identified and also radiomarked on the right axilla. Preliminary studies of a potential new dye for sentinel lymph node identification are presented. It may be the change of the current use of the blue dyes and their severe side-effects on patients submitted to sentinel lymph node biopsies.

Highlights

The incidence of female breast cancer has increased 0.5% since the year 2000, as reported by the International Agency Research on Cancer
Late stages (III and IV) of breast cancer are seen in 60% of women
Our theory was that some blood derivate was captured by macrophages and accessed the lymphatic duct in direction to the axilla (Figure 1)

Summary

Introduction

The incidence of female breast cancer has increased 0.5% since the year 2000, as reported by the International Agency Research on Cancer. This number is greater in developing countries due to the increase in life expectancy and change in behavior resulting in increased exposure to risk factors. Some 20% to 30% of all cases are diagnosed quite early (in situ lesions) with negative axillary nodes in 79% of the patients at this stage[1]. These values are somewhat different in developing countries where more than 50% of the cases are diagnosed at advanced stages of the disease. Late stages (III and IV) of breast cancer are seen in 60% of women

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Conclusion