الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
Axillary lymph node dissection has long been the standard surgical procedure as part of treatment for invasive breast cancer. The presence or absence of axillary metastases is still the single most powerful predictor of outcome.
Axillary dissection, however, is accompanied by considerable morbidity and there is a definitive correlation between the number of nodes excised and the severity of postoperative discomfort.
Sentinel node biopsy has been developed during recent years to stage the axilla. The status of the sentinel node predicts the status of the rest of the nodes in the node basin. Three different methods have been used to identify the sentinel node in patients with breast cancer: blue dye, lymphoscintigraphy and intraoperative use of a probe and a combination of these three methods.
In our study, the three methods are combined for the localization of the sentinel lymph node and our aim is to test our ability to localize the sentinel lymph node.
The study was conducted on 20 female patients with early cancer breast with unpalpable axillary lymph nodes for whom sentinel lymph node biopsy was done by the combination of the three methods followed by modified radical mastectomy followed by axillary evacuation.
The detection rate of the sentinel lymph node is 95 % of the patients.
The blue dye successful localization rate is 50%, pre operative lymphoscintigraphy successful rate is, while intra operative use of gamma probe had a successful rate of 95%.
After pathological examination of sentinel lymph node and the rest of axillary nodes it appeared that:
-The sentinel lymph node was the only affected by metastases in 4 of 20 cases ie 20%.
-In 7 cases the sentinel lymph nodes were negative and all other axillary lymph nodes were also negative i.e specificity is 100%.
So it appears that sentinel lymph node biopsy is becoming a successful method for predicting the status of the axillary lymph nodes and avoid unnecessary axillary evacuation in cases with negative sentinel lymph node for metastases.