Sentinel lymph nodes lymphoscintigraphy and biopsy in breast cancer

Full text: The objective of this study was to determine the clinical value of SLN detection by lymphoscintigraphy and gamma ray detecting probe (GDP) and assess the value of H and E staining combined with immunohistochemistry analysis for detecting micro metastasis in lymph nodes. 42 patients with breast cancer were included in this study. All the patients had no palpable axillary lymph node. The mean tumor size was 23.8 millimeter. 21 patients had T1 tumors, and others had T2 tumors. Pathologically, 34 tumors were invasive ductal carcinoma, 3 were medullary carcinoma, 2 were adenocarcinoma, 1 was intraductal carcinoma, and 2 were mixed carcinoma. Technetium-99m dextran was injected peritumorally. Lymphoscintigraphy images were obtained in anterior and lateral projections. SLNs were identified and removed with the aid of gamma ray detecting probe during operation. In 41 of 42 patients, drainage was to the ipsilateral axilla and was revealed by lymphoscintigraphy. Only 1 drainage was to internal mammary lymph node. The SLN was successfully detected and removed in 39 patients. The numbers of SLNs revealed was 1-5. Mean number was 1.9. The sensitivity was 92.9%. We conclude that lymphoscintigraphy and GDP are very useful to detect SLN. Additional H and E staining combined with IHC analysis of the SLNs helps to predict micro metastasis. The biopsy of the SLN can be an accurate method for staging breast cancer. (author)