Lymphatic Mapping and Sentinel Lymph Node Biopsy in the Patients with Breast Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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Department of Breast Surgery, The Poeple’s Hospital of Sichuan Province, Chengdu 610072;

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Keywords：

Breast cancer Sentinel lymph node Sentinel lymph node biopsy

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Objective To identify the feasibility of the lymphatic mapping and sentinel node biopsy (SLNB) in patients with breast cancer and to examine whether the characteristics of the sentinel lymph node (SLN) accurately predict the status of axillary lymph node.MethodsFrom March to October 2000, 32 patients with breast cancer were evaluated at the Sichuan Provincial People’s Hospital. Lymphatic mapping was performed using Methlene Blue. A SLN was defined as any blue node. Thirtytwo patients, with breast cancer underwent a complete axillary lymph node resection (ALNR) following SLN biopsy. Subsequently, all SLNs and ALNs were examined by both H amp;E staining as well as immunohistochemical staining for cytokeratin. ResultsLymphatic mapping was successful in identifying the SLN in 26/32(81.25%) cases of nodes at level Ⅰ. Of the 26 patients mapped successfully, 10 had metastasis to the SLNs.In 3 cases that SLNs were positive, but other axillary lymph nodes were negative. In 2 cases that the SLNs were negative, but other axillary lymph nodes were positive. The sensitivity of SLNB using Methlene Blue in this study was 77.78%(7/9), accuracy 80.77%(21/26), specificity 82.35%(14/17), and false negative rate 22.22%(2/9). ConclusionSLN can predict the status of the axillary lymph nodes reliably. However, the efficacy of SLNB in the setting of randomized, prospective trials must be tested first before abandoning axillary lymph node resection as the standard of care.

Citation： LIU Jinping,ZHOU Yi,ZHOU Leilei,et al.. Lymphatic Mapping and Sentinel Lymph Node Biopsy in the Patients with Breast Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2002, 9(5): 319-321. doi: Copy

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1. Giuliano AE, Kirgan DM, Guenther JM, et al. Lymphatic mapping and sentinel lymphadenectomy for breast cancer [J]. Ann Surg, 1994; 220(3)∶ 391.
2. Guenther JM, Krishnamoorthy M, Tan LR. Sentinel lymphadenectomy for breast cancer in a community managed care setting [J]. Cancer J Sci Am, 1997; 3（6）∶336.
3. 黄广健综述. 乳腺癌中淋巴结定位图和哨兵淋巴结活检 [J]. 国外医学外科学分册，1999； 26（2）∶100.
4. 李志宇综述.腋窝前哨淋巴结活检在早期乳腺癌中的应用 [J]. 中国普外基础与临床杂志, 1999; 6(5)∶317.
5. Veronesi U, Paganelli G, Galimberti V, et al. Sentinelnode biopsy to avoid axillary dissection in breast cancer with clinically negative lymphnodes [J]. Lancet, 1997; 349(9069)∶1864.
6. Chu KU, Turner RR, Hansen NM, et al . Do all patients with sentinel node metastasis from breast carcinoma need complete axillary node dissection? [J]. Ann Surg，1999； 229(4)∶536.
7. Veronesi U, Rilke F, Luini A, et al. Distribution of axillary node metastases by level of invasion. An analysis of 538 cases [J]. Cancer, 1987; 59 (4)∶682.
8. Chilosi M, Lestani M, Pedron S,et al. A rapid immunostaining method for frozen sections [J]. Biotech Histochem, 1994; 69(4)∶235.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Lymphatic Mapping and Sentinel Lymph Node Biopsy in the Patients with Breast Cancer

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