Sentinel lymph nodes lymphoscintigraphy and biopsy in breast cancer.
OBJECTIVE
To determine the clinical value of sentinel lymph node (SLN) detection by lympho- scintigraphy and gamma ray detecting probe (GDP) and to assess the value of hematoxylin and eosin (H&E) staining combined with immunohistochemistry (IHC) analys is for detecting micrometastasis in lymph nodes (LNs).


METHODS
Forty-two patients with breast cancer were included in this study. (99)Tc(m)-dextran was injected peritumourally. Lymphoscintigraphy images were obtained in anterior and lateral views. SLNs were removed with the aid of GDP during surgery. A standard axillary lymph nodes (ALNs) dissection was performed. All lymph nodes were first analyzed by HE staining. When all of the SLNs in a patient were negative, the ALNs were subjected to additional HE staining combined with IHC analysis.


RESULTS
SLNs were successfully detected and removed in 39 (92.9%) of the 42 patients. The sensitivity, specificity and accuracy of SLN biopsy were 92.9% (13 in 14), 100% (25 in 25) and 97.4% (38 in 39) respectively.   Additional HE staining combined with IHC analysis of the ALNs detected micrometastasis in 3 SLNs (2 cases), but there were no positives in the non-sentinal lymph nodes (NSLNs).


CONCLUSIONS
This study suggests that lymphoscintigraphy and GDP may be used to detect SLN. Additional HE staining combined with IHC analysis of the ALNs may help predict micrometastasis. Biopsy of SLN may be an accurate method for staging breast cancer.
Xu
Min
M
Department of Nuclear Medicine, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100021, China. nacya@sohu.com
Liu
Lin
L
Sun
Yuntian
Y
Chen
Shengzu
S
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003911:Dextrans; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy
D003911:Dextrans; D015609:Organotechnetium Compounds; C034146:technetium Tc 99m dextran