[Sentinel-node biopsy in axillary lymph-node staging under local anaesthesia in breast cancer: technical aspect].
OBJECTIVE
To perform sentinel node with local anaesthesia in the breast carcinoma without frozen section. So we used definitive histological and immunohistochemical results of sentinel node the day of conserving surgery with complete axillary lymph node dissection under general anaesthesia in case of involved nodes.


METHODS
Patients with a stage TNM > T1 or N1, a multicentric breast cancer, a neoadjuvant chemotherapy, an allergy, an obesity or no detection of hot sentinel node were excluded. Patients in ambulatory surgery had scintigraphy 3 hours after injection of radiotracer. If we had a hot sentinel node, we applied Emla 5% cream on the areolar and axillary site and gave midazolam. We performed an intradermal injection of 2 ml of xylocaine with adrenaline above cancer and in the subareolar site in case of non-palpable cancer. With the same needle, we injected 2 ml of blue dye. We injected so 2 ml of xylocaine with adrenaline in the axillary hot spot. We completed local anaesthesia with 16 ml of xylocaine with adrenaline step by step on the route that intraoperative gamma probe showed us.


RESULTS
We performed 17 patients (52.6 years [38-62]; body mass index = 23.7 [20-34.1], size of tumour = 10.8 mm [1-25]). We detected 100% of sentinel node. We had a secondary haematoma which was evacuated.


CONCLUSIONS
Perform sentinel node under local anaesthesia is possible for patients with no obesity but radio tracer is absolutely necessary.
Narducci
Fabrice
F
Centre de lutte contre le cancer Oscar-Lambret, 3, rue Frédéric Combemale, BP307, 59020 Lille Cedex. f-narducci@o-lambret.fr
Creutz
Vinciane
V
Aubard
Yves
Y
Dugrain
Marie-Paule
MP
Carpentier
Philippe
P
Baranzelli
Marie-Christine
MC
Giard
Sylvie
S
D000328:Adult; D000779:Anesthetics, Local; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*
D000779:Anesthetics, Local