Our Experience with the Sentinel Lympho
Node Detection
Červinka V.1, Šťastný K.2, Havlíček K.1, Vyhnánková I.3, Vaňásek J.4, Pavlíková E.4, Rothröckel P.5, Hácová M.5, Nechvátal L.4
Ústav zdravotnických studií, přednosta prof. MUDr. A. Pellant, DrSc. Chirurgická klinika nemocnice Pardubice, přednosta doc. MUDr. K. Havlíček, CSc. 2 Mamologie s.r.o., Pardubice, vedoucí lékař MUDr. K. Šťastný Oddělení nukleární medicíny nemocnice Chrudim, přednostka MUDr. I. Vyhnánková 4 Onkologické oddělení nemocnice Pardubice, přednosta doc. MUDr. J. Vaňásek, CSc. 5 Patologické oddělení nemocnice Pardubice, přednosta MUDr. P. Rothröckel |
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Summary:
Background: Axillary lymph node staging is the most powerful predictor of survival in breast cancer women.
Sentinel lymph node biopsy (SLNB) is more accurate method in evaluation of axillary lymph node staging than
complete axillary lymph node dissection (CALND) because of more precious histological and imunohistochemical
assessment of the first draining lymph nodes. Furthermore, SLNB eliminates complications resulting from
CALND.
Material and methods: SLNB is either performed using blue dye technique or using of combination of blue
dye and radioguided technique.We prefer two days protocol in application of Tc 99 radiocolloid. There were used
both techniques for detection sentinel lymph nodes and results were compared.
Results: There were performed 21 SLNBs using blue dye technique, Group A, and 20 SLNBs using
combination of blue dye and radioguided technique, Group B, from October 2001 to November 2003. Sentinel
lymph nodes were not detected in Group A in two cases, false negativity occurred two times in this group. Sentinel
lymph nodes were detected in all cases in Group B and there was no false negativity present in this group.
Conclusion: Combination of blue dye and radioguided technique is more precious in detection of sentinel
lymph node than blue dye technique itself. Two days protocol of application of Tc 99 radiocolloid enables
performing this method even in hospitals, where the Department of Nuclear Medicine is not available.
Key words:
axillary lymph node staging – sentinel lymph node – blue dye method – radioguided method
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