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KMID : 0371320020620020119
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Journal of the Korean Surgical Society
2002 Volume.62 No. 2 p.119 ~ p.126
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Expriences with Sentinel Lymphadenectomy in 157 Cases of Breast Carcinoma
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Choi Jin-Wook
Lee Hy-De
Park Byeong-Woo
Jung Woo-Hee
Oh Ki-Keun
Ryu Yong-Hoon
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Abstract
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Purpose: The status of the axillary nodes in breast carcinoma
patients is one of the most significant prognostic factors. Although many
trials in order to gain information concerning axillary status, to date
there is no satisfactory procedures other than axillary lymph node
dissection (ALND) which has many complications. Recently sentinel
lymphadenectomy has become accepted as an alternative to ALND.
Methods: Sentinel lymphadenectomy followed by ALND was performed in
157 patients with invasive breast carcinoma between Nov. 1998 and Dec. 2000.
The period from Nov. 1998 to May. 1999, which included the first 54 patients
was set as a learning period. 99m Tc antimony trisulfide colloid was used in
the detection of the sentinel node, with a gamma camera preoperatively and
then a gamma probe in the operating room. The dissected sentinel nodes were
examined by both frozen section and serial section (SS) with
immunohistochemical stains (IHC). Results: The detection rate was
96.8%. The false negative rate was 22.6% for the frozen sections and 4.8%
for the permanent sections. The detection rate and the false negative rate
had improved after the learning period with statistic significance
(P-value<0.05). The false negative rate for tumors less than 2 ㎝ was
significantly lower than that for tumors greater than 2 ㎝ (P-value=0.000).
Conclusion: Sentinel lymphadenectomy using 99m Tc antinomy trisulfide
colloid showed high detection rate and low false negative rate. The learning
period is thought to be necessary for its clinical application. In the
future, sentinel lymphadenectomy may replace axillary lymph node dissection
in certain subgroups of breast carcinoma patients.
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KEYWORD
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