Abstract
The purpose of this study was to present a novel surgical method for intraoperative precise sentinel lymph node biopsy (SLNB) and to determine its clinical efficacy and sensitivity in breast cancer patients. The sentinel lymph nodes (SLNs) were preoperatively evaluated by axillary ultrasound. The intraoperative detection of SLNs was guided by lymphatic drainage pathway. The lymphatic vessels and SLNs were visualized. During operation, we searched for all the true SLNs (trSLNs), para-SLNs (paSLNs) and post-SLNs (poSLNs) followed lymphatic drainage ducts. After precisely locating the lymphatic channels and lymph node, all the lymph nodes that firstly receive lymphatic drainage are designated as trSLNs. We precisely distinguished the trSLNs, paSLNs and poSLNs. We found the average number of trSLNs ranged from1 to 6. In addition, we assessed the novel technique in a total of 125 breast cancer patients. trSLNs were successfully identified in all patients (detection rate: 100 %). The accuracy of trSLNs is 99.2%. Data from our study strongly suggest that our method is a feasible and effective for the detection of precise trSLNs in breast cancer with real-time observations. (ClinicalTrials.gov number, NCT02651142).
Highlights
Sentinel lymph nodes (SLN) are the first lymph nodes that receive lymphatic drainage
After precisely locating the lymphatic channels and lymph node, all the lymph nodes that firstly receive lymphatic drainage are designated as true SLNs (trSLNs)
Our finding showed that different trSLNs had different number of input lymphatic ducts
Summary
Sentinel lymph nodes (SLN) are the first lymph nodes that receive lymphatic drainage. Cancer cells are mainly spread through the lymphatic system in early stage of breast cancer. Axillary lymph node dissection has been used to evaluate lymph node status. It appears correlated with higher morbidity of lymphedema, arm pain and stiffness, seroma formation. At present sentinel lymph nodes biopsy (SLNB) has been used successfully for axillary evaluation in breast cancer and it’s considered the standard method for early-stage breast cancer without clinically or radiologically axillary lymph node metastases [1, 2]. The American Society of Clinical Oncology recommend the minimum sentinel node identification rate is 85% and the false-negative rate is less than 5% before abandoning the axillary dissection [3]. Though many new techniques, such as Indocyanine green (ICG), have been employed for identifying SLN [5, 6], the specificity and risk of false-negative rate in mapping SLNs are still the main concern
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
