Effectiveness of axillar sentinel lymph node detection

Czech version

Authors: Ivana Bradáčková ¹; Věra Benešová ²; Lubomír Slavíček ²; Zdeněk Eibel ³; František Molva ³; Vladimír Šuťak ³; Michal Kheck ⁴
Authors‘ workplace: Oddělení zobrazovacích metod ¹; Onkologické oddělení ²; Chirurgické oddělení ³; Patologicko-anatomické oddělení, Nemocnice Jihlava p. o., ČR ⁴
Published in: NuklMed 2016;5:27-32
Category: Original Article

Overview

Introduction:
Sentinel Lymph Node Biopsy (SLNB) is a standard method in the early stage of breast cancer in axillar surgery. It presumes a team cooperation.

Goal:
To assess the effectiveness of location and detection of Sentinel Lymph Node (SLN) after their labeling with a radiopharmaceutical in further context.

Methods:
We retrospectively evaluated a group of 172 patients with the early stage of breast cancer (average age 63 (32–87) y) in whom the SLNB concept was used during surgery from 1/2010 to 12/2015. Two-day protocol for labeling and detection was used at the department of nuclear medicine.

Results:
Labeling of SLN succeeded in 99.4 %, only in one case SLN was not labeled neither with radiopharmaceutical nor with color. 1 to 3 SLN were detected in 92 %, 4 and more in 8 %. Suspected Non-Sentinel Lymph Nodes (NSLN) except of SLN were removed in 25 % during surgery. Primary axillar disection or sampling was done in 10 %. SLN were negative in 72 %, with macrometastases in 17 %, with micrometastases in 8 % and with isolated malignant cells in 3 %. False negative SLN were in 3/172 pts. Axillar disection was indicated in 17/29 pts with macrometastases, in 12/29 such pts radiotherapy and systemic treatment were prefered. Remote metastases were detected in 4/172 pts, upper extremity lymphedema was present in 8/172 pts.

Conclusion:
Our data support effectivity of labeling and detection of SLN as well as necessity of team cooperation.

Key Words:
early breast cancer, sentinel lymph node, metastases

Sources

1. Neoral Č, Bohanes T et al. Biopsie sentinelové uzliny. Praha, Galén, 2012, 141 p

2. Giammarile F, Alazraki N, Aarsvold JN et al. The EANM and SNMMI practice guideline for lymphoscintigraphy and sentinel node localization in breast cancer [online]. 2013. [cit. 2016-01-26]. Dostupné na: http://snmmi.files.cms-plus.com/docs/Final%20Breast%20Sentinel%20Node%20Guideline.pdf

3. Detekce sentinelových uzlin [online]. 2015. [cit. 2016-01-21]. Dostupné na: http://www.mou.cz/tz_detekce_sentinelovych_uzlin.pdf

4. Chakera AH, Friis E, Hesse U et al. Factors of importance for scintigraphic non- visualisation of sentinel nodes in breast cancer. Eur J Nucl Med Mol Imaging 2005;32:286-293

5. Pavlišta D, Eliška O. Mapa povrchových lymfatik prsu a jejich vztah k sentinelové uzlině. Čes Gynek 2005;70:192-197

6. Strnad P. Radionavigované chirurgické výkony u karcinomu prsu [online]. 2011. [cit. 2016-01-18].Dostupné na: http://zdravi.e15.cz/clanek/postgradualni_medicina/radionavigovane_chirurgicke_vykony_u_karcinomu_prsu_462099

7. Šimánek M, Abrahám V, Kořínek J. Dlouhodobá kontrola efektivity biopsie sentinelové uzliny sledováním výsledků komplexní terapie. NuklMed 2013;2:13-17

8. Coufal O, Vrtělová P, Krsička P. Operace mízních uzlin u karcinomů prsu – současný pohled [online]. 2012. [cit. 2015-05-22]. Dostupné na: http://zdravi.e15.cz/clanek/postgradualni_medicina/operace_miznich_uzlin_u_karcinomu_prsu_soucasny_pohled_464239

9. Zapletal O, Coufal O, Selingerová I et al. Počet odebíraných axilárních sentinelových uzlin a jeho vliv na diagnostickou přesnost sentinelové biopsie u karcinomu prsu. Rozhl Chir 2013;92:21-26

10. Pecha V, Kolařík D, Menzlová E et al. Biopsie sentinelové uzliny u žen s časným karcinomem prsu. Onkologie 2011;5:16-22

11. AGO DGS SGS ÖGS Panelists Executive Board Members German, Austrian and Swiss consensus konference on the diagnosis and local treatment of the axilla in breast cancer. Eur J Cancer 2013;49:2277-2283

12. Šimánek M, Abrahám V, Hruška J. Indikace axilární disekce uzlin při nálezu mikrometastatického postižení sentinelové uzliny u karcinomu prsu. NuklMed 2015;4:4-7

13. McLaughlin SA, Wright MJ, Morris KT et al. Prevalence of Lymphedema in Women With Breast Cancer 5 Years After Sentinel Lymph Node Biopsy or Axillary Dissection: Objective Measurements. J Clin Oncol 2008;26:5213-5219

14. Sener SF, Winchester DJ, Martz CH et al. Lymphedema after Sentinel Lymphadenectomy for Breast Carcinoma. Cancer 2001;92:748-752

15. Schrenk P, Rieger R, Shamiyeh A et al. Morbidity following Sentinel Lymph Node Biopsy versus Axillary Lymph Node Dissection for Patients with Breast Carcinoma. Cancer 2000;88:608-614

Labels

Nuclear medicine Radiodiagnostics Radiotherapy

Quality control of 223Ra eluate

18F-FDG PET/CT pitfalls in the diagnostic work-up of inflammation of unknown origin

Match V/Q defect in pulmonary embolism

Article was published in

Nuclear Medicine

2016 Issue 2