Sentinel lymph node biopsy in breast cancer: day surgery and local anaesthetic approach
© BioMed Central Ltd. 2009
Published: 23 June 2009
Sentinel node biopsy (SNB) is widely used in the management of breast cancer patients without axillary metastases.
From 1 January 2006 through 31 December 2008 we performed 113 SNBs at St M. Goretti Hospital. Mammary carcinoma was diagnosed as malignant by aspiration cytology and/or biopsy. In all cases with positive cytology, we performed at the same time quadrantectomy and SNB. The patients underwent preoperative lymphoscintigraphy. We never used vital blue dye. All patients underwent surgical treatment 3 to 4 hours later. We performed SNB and quadrantectomy in day surgery (DS) and local anaesthesia (LA). Axillary incision was 2 to 3 cm. This approach was discussed with all patients and informed consent was obtained. The objective of the present study is to investigate the validity of this procedure.
Four patients underwent preoperative lymphoscintigraphy, the radiotracer did not show any sentinel lymph node (SLN), and we performed axillary dissection. One case showed a double SLN in the axilla and internal mammary chain. Only the internal mammary node was positive. After surgery we distributed a questionnaire to the patients about the acceptability of this approach. We identified the SLN in all patients (100%).
The results achieved are extremely accurate. This procedure is safe and well accepted by doctors and patients (98%). The oncological results are absolutely reliable. As regards hospital logistics, operations in DS and LA can be easily managed, leading to a significant cost reduction – 42.15% less expensive than the same operation performed under general anaesthesia.