title: Axilloscopy and endoscopic sentinel node detection in breast cancer patients.
abstract: BACKGROUND
  Sentinel node biopsy is a promising technique that allows the axillary status of breast cancer patients to be predicted with high accuracy. Reducing false negative results remains a major challenge for the improvement of this procedure. Furthermore, new techniques are required to achieve axillary clearing with less morbidity in cases of unsuccessful mapping or multicentric carcinoma. We analyzed whether axilloscopy and endoscopic sentinel node biopsy is a feasible procedure for visualization of the axillary space and resection of the sentinel node using endoscopic techniques.
  
  
  METHODS
  Following blue dye-guided lymphography and liposuction of the axillary fat, endoscopic axillary sentinel node biopsy was performed in 35 breast cancer patients. We then assessed the exposure of anatomical landmarks, the detection rate of the sentinel node, the false negative rate, and the accuracy of consecutive axillary clearing.
  
  
  RESULTS
  In almost every case, an excellent anatomical orientation was achieved. The detection rate for the sentinel node was 83.3%. In one case, the sentinel node did not reflect the status of the residual axilla. A mean number of 17.1 lymph nodes was harvested at consecutive axillary clearing.
  
  
  CONCLUSIONS
  Axilloscopy and endoscopic sentinel node biopsy, following liposuction of the axillary fat, is a feasible procedure that allows identification and minimally invasive resection of the sentinel node with high accuracy. The endoscopic approach might help to minimize the pitfalls of sentinel node biopsy by visualizing the axillary space. In future, it may become a technique that enables minimally invasive axillary clearing when complete lymphadenectomy is required.
authors.affiliation: Department of Gynecology and Obstetrics, University of Ulm, Prittwitzstrasse 43, 89079 Ulm, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Kühn
authors.forename: C
authors.initials: C
authors.lastname: Santjohanser
authors.forename: K
authors.initials: K
authors.lastname: Koretz
authors.forename: W
authors.initials: W
authors.lastname: Böhm
authors.forename: R
authors.initials: R
authors.lastname: Kreienberg
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008220:Lymphography / Q000379:methods; D008875:Middle Aged; D010865:Pilot Projects; D012680:Sensitivity and Specificity