Linfogammagrafía y biopsia del ganglio centinela en el carcinoma no palpable de mama
LINFOSCINTIGRAPHY and SENTINEL NODE BIOPSY IN NONPALPABLE BREAST CANCER. OBJECTIVE: The aim of the study was to evaluate the efficay of lymphatic mapping and sentinel node biopsy in nonpalpable breast cancer (NPBC) patients in comparison with palpable breast cancer patients (PBC). MATERIAL and METHODS: 199 breast cancer patients were studied. Patients were classified into two groups: nonpalpable breast cancer and palpable breast cancer. Following tomorectomy and sentinel node biopsy all patients underwent axillary lymphadenectomy. Lymphoscintigraphy was performed 90-120 minutes after peritumoral injection of 111MBq 99mTc nanocolloid in 1 ml in PBC (under US guidance in NPBC). Surgery was performed at 18-24 h after lymphoscintigraphy in PBC patients and at 4 h after lymphoscintigraphy in NPBC patients; a gammaprobe was used to localise sentinel node. Hystopathological sentinel node analysis was performed as follows: intrasurgical stydy (citologycal impront) and delayed study (Haematoxylin-eosin, immunohistochemistry of cytokeratin and mecular study). The following parameters were analysed in both groups: scintigraphic and surgical detection rates, true positives, true negatives, sensitivity, predictive negative value, false negative rate and global precision of the technique. RESULTS: The age of the patients was similar in both groups. Non significant difference was observed (p > 0,05) in lymphoscintigraphy or surgical sentinel node detection. Drainage to internal mamarian chain (p = 0,211) was more frequently seen in NPBC group (11,7%) versus (6,4%) PBC group, but differences were not significant. Metastasic axillary prevalence was lower in NPBC group (p = 0,019). Similar sensityvity, negative predictive value and global precision values (>90%) and false negative rate (< 3%) were found in both groups. CONCLUSIONS: Technique fiability and was skip metastases rate were similar in both groups. Independly of quadrant location all tumors drained primarly to axillary region. Drainage to internal mamarian chain was more frecuently seen in internal as well as in nonpalpable tumor. Chemotherapy seems to be related with higher non sentinel node detection.
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Advisor:Martín-Comín, Josep; Pujol Farriols, Ramon
School:Universitat de Barcelona
Source Type:Master's Thesis
Date of Publication:12/16/2004