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Sentinel lymph node biopsies in breast cancer


Lymph node biopsy is not only important as a prognostic factor, but also influences therapy. However, axillary lymphadenectomy is often accompanied by high morbidity. The sentinel lymph node biopsy (SLN) should reduce the morbidity, but give the same prognostic value. In 97.5% cases metastasis occurs in lymph nodes (LN) of levelI first, and only less than 3% directly in LN level II. The first draining LN can be identified either by radioactive material or colouring technique.


Patients with primary breast cancer (41 cases, age 30-80 years), 1 day before surgery, received peritumoral 1-3 ml nanocolloid containing 99m-technetium, with scintigraphy performed 30-120 min later. Alternatively 2 ml Patentblau (2.5% Byk Gulden) was applied during the surgery 15 min before the axillary lymphadenectomy. The marked LN was separated and sent to pathology together with the other LN.


Seventeen patients received Tc-nanocolloid, 21 Patent-blue. Three patients were treated with both identification methods. Out of 41 patients, 14 had an axillary metastasis. Comparison of radioactive labelling showed no false-negative results, but 7.3% false negativity was obtained with the colour method.

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Hess, A., Flüβ, M., Nestle-Krämling, C. et al. Sentinel lymph node biopsies in breast cancer. Breast Cancer Res 3 (Suppl 1), A31 (2001).

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