Sentinel Node in Breast Cancer

Authors

  • Areewan Somwangprasert Department of Surgery, Maharaj Nakorn Chiangmai Hospital, Chiangmai University, Thailand.
  • Göran Lijegren Örebro Medical Center, Örebro, Sweden

Abstract

                 Aims of the study: To investigate the sensitivity and negative predictive value of sentinel node biopsy in breast cancer in a Swedish hospital.

                 Materials and methods: Sixty-One patients with invasive breast cancer who were scheduled for breast conserving therapy or modified radical mastectomy in Orebro Medical Center, Sweden, were asked to participate and gave their informed concent. A peritumoral injection of 40 mBq of Tc- 99-nanocolloid was given the day before operation or on the morning of the same day. A lymphoscintigraphy was performed to localise the sentinel node. At the operation, after general asesthesia, I milliliter of Patent Blue Dye® was injected subcutaneously just above the tumor. A handheld gamma probe was used to localise a hot spot in axilla, indicating the position of the sentinel node.

                A small incision was made in the lower part of axilla in the area where sentinel node was found with the probe and blue coloured lymphatics were soughted for. If a blue node was found the probe was used to confirm that it also contained the isotope. And if the blue node could not be found, the probe was used to identify the hot spot. The sentinel nodes that could be identified were removed and separately sent for pathological examination. Thereafter the tumor was removed by partial mastectomy or total mastectomy followed by a dissection of the nodes in the axilla.

               Results: The sentinel node could not be identified in 6 out of 61 patients. 'Two of these partients had positive axillary node involvement. Out of 55 identified, 18 were positive for metastasis. In 7 cases the sentinel nodes were the only positive nodes. Among the 37 negative sentinel node cases, 3 cases were found to have metastasis in other lymph nodes in the axilla. This gives a sensitivity of 85.7 per cent and a negative predictive value of 91.9 per cent.

               Conclusion: The results of this pilot study concur with other reports in the literature. Probably the sensitivity and negative predictive value will improve as we go along the learning curve. A national multicenter study is underway in Sweden aiming at including 500 patients to confirm that the method can safely be used in all surgical hands.

 

References

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Published

1999-09-30

How to Cite

1.
Somwangprasert A, Lijegren G. Sentinel Node in Breast Cancer. Thai J Surg [Internet]. 1999 Sep. 30 [cited 2024 Nov. 23];20(3):89-92. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/247886

Issue

Vol. 20 No. 3 (1999): July - September

Section

Original Articles

License

Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.