ročník 11,2003 č.4

Sentinel Node Biopsy in the Breast Cancer, Short Term Results

Fait, V., Chrenko, V., Coufal, O., Jandáková, E., Staníček, J.

Masaryk Memorial Cancer Institute, Brno, Czech Republic

Sentinel node biopsy has been accepted as a standard treatment procedure in the year 2001 in our institute.
Indications are: histologically proven solitary breast cancer T1-T2, without palpable axillary nodes, with negative axillary sonography, without evidence of distant metastases
The procedure involves preoperative lymphoscintigraphy, in the surgery day. 2 hours before operation Tc 99 Nanocoll in the dose 15-20mBq peritumorally is applied.
Surgery is performed approximately 2 hours after radionuclide application and after gamma scan with showing the localisation of the sentinel node The surgery is provided with help of a hand held gamma probe (SURPRO DeLong Instruments) in combination with blue dye lymphatic mapping with patent blue.
225 breasts in 223 patients were operated.
Sentinel node was found in 221 cases, not found in 4 cases.
- 299 sentinel nodes were totally removed
- 292 z axillary nodes
- 1 intramammary node
- 2 supraclavicular nodes
- 4 parasternal nodes

The nodes were positive in 66 cases (29,3%) axillary clearance allways followed.
After axillar dissection in the positive cases 26 (39,4%) times further metastases in nonsentinel nodes were found.
The probability of involvement of the sentinel node correlates with the size of the tumour and with tumour grade.
The sentinel node was not found in 4 (1,8%) cases, twice in extemely obese patients.