Abstract
Sentinel node detection localizes the first node that drains a malignant lesion aiming to detect tumor dissemination. To assess the yield of sentinel node detection in breast cancer, using pre or intraoperative scintigraphy. Review of medical records of patients with breast cancer who had a scintigraphic detection of sentinel nodes. Lymph node scintigraphy and surgery were performed in the same day. We studied 174 women aged 53 ± 13 years, operated with a diagnosis of breast cancer, including six highly suspicious lesions in the contralateral breast (totaling 180 studied breasts). Preoperative scintigraphy showed a sentinel node in 174 of 180 breasts (97%). Intraoperative gamma probe confirmed the presence of the sentinel node in the same 174 breasts and detected an additional one reaching a detection yield of 97%. Four patients in whom a sentinel node was not detected in the preoperative scintigraphy, had macrometastases. Frozen section biopsies were available in 177 of 180 breasts. Metastases were informed in 45 patients who underwent axillary lymph node dissection, plus one additional patient with a suspicious lesion. A high rate of sentinel node detection in the preoperative scintigraphy was observed. Most sentinel nodes not detected with nuclear medicine had macrometastases. In 71% of patients, the detection of sentinel node avoided axillary lymph node dissection.
Highlights
Pre and intraoperative scintigraphic detection of sentinel nodes in breast cancer Background: Sentinel node detection localizes the first node that drains a malignant lesion aiming to detect tumor dissemination
Material and Methods: Review of medical records of patients with breast cancer who had a scintigraphic detection of sentinel nodes
We studied 174 women aged 53 ± 13 years, operated with a diagnosis of breast cancer, including six highly suspicious lesions in the contralateral breast
Summary
Aim: To assess the yield of sentinel node detection in breast cancer, using pre or intraoperative scintigraphy. En el estudio de las lesiones malignas de mama, con axila clínicamente negativa, el estado histológico de los linfonodos axilares es reconocidamente uno de los factores más importantes para el pronóstico y tratamiento de la enfermedad. Uno de los primeros estudios multicéntricos en cáncer de mama con detección de LC con radioisótopos y sonda o gamma intraoperatorio fue publicado por Krag[16] y evaluó a 11 distintos cirujanos. En nuestro estudio hemos querido realizar una revisión retrospectiva del rendimiento del LC usando radiocoloide y su posterior correlación con la detección quirúrgica mediante gamma probe intraoperatorio, en pacientes con cáncer de mama, en quienes el cirujano solicitó el estudio de LC, realizados en Clínica Santa María entre marzo de 2006 y agosto de 2011
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