Sentinel lymph node biopsy in patients with breast cancer: the authors’ own experience

Objective. To investigate whether 99mTc-technephyte can be used as a radiopharmaceutical agent (RPA) in the intraoperative scintigraphic search for sentinel lymph nodes (SI. N) in breast cancer (BC). Subjects and methods. Examinations were made in 90 patients aged 31 to 82 years with BC, who were treated at the Academician V.l. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology. RPA was injected intradermaily paraareolarly from 4 time points (at 12-15-18-21 hours) 2-24 hours prior to surgery. Thirty minutes after RPA injection, some [36 (40%)] patients underwent scintigraphy, the results of which were used to determine the number and localization of RPA-accumulating lymph nodes. SLNs were intraoperatively sought using a Gamma Finder II handheld gamma probe. When detected, SIN was removed and sent for urgent histological examination. Results. SLNs were visualized in 31 (86.1%) of the 36 patients undergoing scintigraphy and successfully intra-operatively identified in 86 (95.6%) patients. Regardless of scintigraphy results, all the patients underwent SLN biopsy. SLNs could not be visualized in 4 patients, which was the reason to perform axillary lymph node dissection. Urgent histological examination diagnosed SLN métastasés in 24 (27.9%) patients. Axillary lymph node dissection was performed in 17.patients. The mean follow-up period was 18 months. No regional recurrences were reported during this period. Conclusion. SLN biopsy is an effective procedure that can reduce the scope of regional lymph node surgery in patients with early breast cancer and can accordingly improve substantially quality of life in these patients under high locoregional control.

breast cancer, sentinel lymph node biopsy, radiopharmaceutical agent, scintigraphy