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Effectiveness of axillar sentinel lymph node detection


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


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Nuclear medicine Radiodiagnostics Radiotherapy
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