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Sentinel Lymph Node Biopsy in the Breast Carcinoma in Clinical Practice


Authors: J. Gatěk 1;  L. Hnátek 1;  B. Dudešek 1;  P. Vážan 3;  J. Bakala 2;  K. Hradská 1;  J. Kotoč 1;  T. Musil 1;  J. Duben 1
Authors‘ workplace: Chirurgické oddělení Nemocnice Atlas a. s. Zlín, Univerzita Tomáše Bati ve Zlíně, vedoucí: prim. MUDr. J. Gatěk Ph. D. 1;  Oddělení nukleární medicíny Krajská nemocnice Tomáše Bati a. s. Zlín, vedoucí: prim. MUDr. J. Bakala 2;  Bioptická a cytologická laboratoř Zlín, vedoucí: MUDr. J. Velecký 3
Published in: Rozhl. Chir., 2008, roč. 87, č. 4, s. 180-185.
Category: Monothematic special - Original

Overview

Aim:
In the management of early breast carcinoma, biopsy of sentinel lymph nodes has gradually replaced dissection of Level I and II axillary nodes. The aim of the study is to assess feasability and reliability of the method in our conditions.

Method:
From June 1998 to June 2007, a total of 458 sentinel node biopsies (SLNB) were performed. Originally, patent blue sentinel node mapping was used. Since 2000, a combination of radiocolloid application and a gamma- probe (detector), as well as the patent blue, has been used. Originally, SLNBs were followed by axillary dissections, however, in 2002, the procedure was waived in cases of negative sentinel nodes findings.

Results:
Out of the total of 458 SLNB patients, 382 female patients were included in the study. SLNB, without concomitant axillary dissection, was performed in 170 subjects. In 70 subjects, the sentinel node was positive and they were indicated for axillary dissections. Positive non-sentinel nodes were detected 17 times. In total, 899 sentinel nodes were examined in the study group of 382 biopsies. The mean was 2.35. False negative nodes were recorded in three cases in female patients with SLNB and axillary dissection (4.6%). No local relapses in the axilla were recorded in negative sentinel node findings without subsequent axillary dissections.

Conclusion:
Sentinel node biopsy is a safe alternative to axillary dissection in the surgical management of early breast carcinoma.

Key words:
breast carcinoma – sentinel lymph node – axillary dissection


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