[Impact of the availability of an external nuclear medicine service in the application of sentinel lymph node biopsy in breast cancer surgery].
BACKGROUND
To perform sentinel lymph node biopsy (SLNB), nuclear medicine services that have previously undergone a validation phase are required. The aim of the present study was to analyze the possibility of performing this technique with a previously validated, external nuclear medicine service and to study its impact on the indication for radical axillary lymphadenectomy (RAL) and on length of postoperative hospital stay.


METHODS
We performed a prospective study in a cohort of patients with breast cancer starting from the introduction of SLNB in our center, which was made possible by collaboration with an external nuclear medicine service that performed lymphoscintigraphy and sentinel node detection. Intraoperative detection was performed through a portable probe. The feasibility of the project and its clinical impact were analyzed, taking a reduction in the number of lymphadenectomies and length of hospital stay as endpoints.


RESULTS
A total of 196 patients with 201 breast carcinomas were treated. The most frequent interventions were tumorectomy (TC) with SLNB in 124 patients (62%), and TC with SLNB and RAL in 62 patients (31%). Sentinel node visualization on lymphoscintigraphy was achieved in 187/201 carcinomas (93.1%) and sentinel nodes were detected during the intervention in 182/187 carcinomas (97.4%). Sentinel node detection in the internal mammary chain was achieved in 23/201 carcinomas (11.4%). RAL was avoided in 131 of the 201 carcinomas (65%). Days of postoperative hospital stay with or without RAL showed a mean difference of 1.8 days (3.1 vs. 1.3; P < .001).


CONCLUSIONS
SLNB is feasible with the collaboration of an external nuclear medicine service. This technique avoids 65% of RAL and reduces length of postoperative stay by 1.8 days.
Segura
Marcel
M
Unidad de Patología Mamaria, Servicio de Cirugía General y Servicio de Radiología (IDIMAS, CRC-MAR), Hospital Universitario del Mar, Barcelona, España. msegura@imas.imim.es
Juncà
Valentín
V
Solsona
Jordi
J
Piqueras
Arturo
A
Puig
Sonia
S
Jimeno
Jaime
J
Pereira
José Antonio
JA
Ortega
Marisa
M
Fernández
Alex
A
Fraile
Manuel
M
Vidal-Sicart
Sergi
S
Segura
Agia
A
Ferrer
Francisco
F
Grande
Luis
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D018567:Breast Neoplasms, Male / Q000473:pathology / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009684:Nuclear Medicine Department, Hospital; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000706:statistics & numerical data*