Dr.Tarek Said's Scientific Publications

Intraoperative Lymphatic Mapping & Sentinel Node Biopsy Predicts Axillary Nodal Involvement and Avoids Negative Axillary Dissections in (N0) Breast Cancer

Tarek Ahmed Said, M.D

The Department of Surgery, Cairo University

Kasr El Aini Journal of Surgery, Vol (1), No (1),July 2000: 103-114

The status of the axillary nodes is the strongest known prognostic factor variable in patients with breast cancer, and is routinely used in planning postoperative therapy. Conventional axillary dissection is limited by sampling error and potential morbidity. With new wide scale regimens of screening and growing consensus of early diagnosis of breast cancer, increasing numbers of negative axillary nodal dissections are encountered. Sentinel node biopsy techniques have revolutionized the management of axillary nodes. Accurate identification and focused histologic evaluation of the sentinel node allow accurate prediction of the status of the other axillary nodes, thereby avoiding the morbidity and expense of a complete axillary dissection in node negative patients. In 26 cases of breast cancer, SLN intraoperative mapping was done following preoperative subcutaneous dye injection over breast mass. SLN detection success rate was 76.92%. Pathological examination of detected SLN(s) and comparison with the rest of axillary nodes revealed an accuracy rate of 90% in detection of axillary status with a negative predictive value of 80%. With further evaluation and growing experience with the technique, it can be a useful  method to decide when to proceed with formal axillary dissection in cases with no clinically detected nodes.
 
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