[Study of the sentinel node in breast cancer using lymphoscintigraphy and a fast method for cytokeratin].
BACKGROUND
Histopathological examination of the axillary sentinel node (SN) is becoming a routine procedure in the surgical phase of infiltrating ductal carcinoma of the breast (IDC). The SN exam may yield false negative cases mainly due to identification failure of the SN but some of the false negative cases may be the result of the pathological examination procedure applied.


METHODS
Sixty two (62) cases of clinically staged N0 IDC of the breast by TNM nomenclature were assigned to breast surgery along with conventional axillary node dissection. The identification technique included lymphoscintigraphy and intraoperative gamma-detecting probe after peritumoral injection of 99mTc-labeled colloids.The histological study of SN was performed with paired 4 microm slices and staining with hematoxylin-eosin and with a fast method of cytokeratins for freezing.


RESULTS
In only two of the 62 patients, it was not possible to identify the SN. Eighteen of the remaining 60 had SN involvement by metastasis, having no metastases in the other nodes of the axillary dissection in 6 of them. Ten of those were micrometastasis (size of metastasis= or <0.2 cm). In two out of these last 10 cases, diagnosis of the micrometastasis was only possible using slices stained with CK. There were no false negative results.


CONCLUSIONS
The lymphoscintigraphy, after peritumoral injection of small volumes and low dose of the tracer, makes it possible to obtain excellent results in the intraoperative detection of the SN in breast cancer. The study of this SN with a fast method for CK decreases the number of false negative results of the technique.
Cordero
J M
JM
Servicio de Medicina Nuclear, Hospital de La Ribera, Alcira, Valencia. jmcordero@hospital-ribera.com
Bernet
L
L
Cano
R
R
Bustamante
M
M
Vila
R
R
Ballester
B
B
González
P J
PJ
D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007633:Keratins; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy
D007633:Keratins