[Staging surgery with minimal axillary invasion in breast cancer. Value of the sentinel lymph node].
Traditionally, axillary dissection has been the best way to staging patients with breast cancer, nevertheless in the early stages (I and II), without palpable axillary nodes (NO) half will not have nodal metastasis and will have been unnecessarily exposed to the morbidity of the procedure. The sentinel node (SN) has showed to be a predictor of the histologic state of the other axillary nodes, its identification allows to adequate staging of NO breast cancer patients avoiding the axillary dissection.


OBJECTIVE
To get to know the SN value as predictor of axillary nodal metastasis.


METHODS
From 2000 to 2001, 62 patients in stages I and II of breast infiltrating ductal carcinoma NO, have been subject to lymphatic mapping and biopsy of the sentinel node with blue dye, the sentinel node was studied intraoperatively and, independently from the result, axillary dissection was practiced to all the patients. A sensitivity and specificity test of the SN as predictor of the histologic state of the other nodes was carried out.


RESULTS
In 58/62 (93.5%) the SN was identified, 18/58 patients (31%) had nodal metastasis, only one patient showed false negative SN (92% sensitivity). With the procedure, 98% of the patients were appropriately typified by stages, the specificity of the intraoperatively study is 100%. None of the patients with SN negative had metastasis in other axillary nodes.


CONCLUSIONS
The SN predicts, with high sensitivity, the histologic state of the other nodes, appropriately staging the NO breast cancer patients and can prevent more than half of axillary dissections.
Gallegos Hernández
José Francisco
JF
Departamento de Tumores de Mama Hospital de Oncología CMN SXXI, IMSS.
D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy