Sentinel lymph nodes lymphoscintigraphy and biopsy in breast cancer
- Author:
- No author available
- Journal Title:
- CHINESE MEDICAL JOURNAL
- Issue:
- 8
- DOI:
- 10.3760/cma.j.issn.0366-6999.2002.08.104
- Key Word:
- 核素淋巴显像;前哨淋巴结;免疫组织化学;腋窝淋巴结;乳腺癌;lymphoscintigraphy;sentinel lymph node;immunohistochemistry;axillary lymph node;breast cancer
Abstract： Objectives To determine the clinical value of sentinel lymph node (SLN) detection by lymphoscintigraphy and gamma ray detecting probe (GDP) and to assess the value of hematoxylin and eosin (H&E) staining combined with immunohistochemistry (IHC) analysis for detecting micrometastasis in lymph nodes (LNs).Methods Forty-two patients with breast cancer were included in this study. 99 Tcm-dextran was injected peritumourally. Lymphoscintigraphy images were obtained in anterior and lateral views. SLNs were removed with the aid of GDP during surgery. A standard axillary lymph nodes (ALNs) dissection was performed. All lymph nodes were first analyzed by HE staining. When all of the SLNs in a patient were negative, the ALNs were subjected to additional HE staining combined with IHC analysis.Results SLNs were successfully detected and removed in 39 (92.9%) of the 42 patients. The sensitivity, specificity and accuracy of SLN biopsy were 92.9% (13 in 14), 100% (25 in 25) and 97.4% (38 in 39) respectively. Additional HE staining combined with IHC analysis of the ALNs detected micrometastasis in 3 SLNs (2 cases), but there were no positives in the non-sentinal lymph nodes (NSLNs).Conclusions This study suggests that lymphoscintigraphy and GDP may be used to detect SLN. Additional HE staining combined with IHC analysis of the ALNs may help predict micrometastasis. Biopsy of SLN may be an accurate method for staging breast cancer.
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