[Quadrantectomy and removal of the sentinel lymph node under local anaesthesia in the day hospital setting].
In recent years, breast carcinoma diagnostics and therapy have evolved very considerably, allowing conservative surgery in most cases. These kinds of major operations have been greatly simplified since the introduction of the sentinel lymph node approach, with the possibility of a day surgery operation under local anaesthesia. The aim of this study, after thorough analysis of the axillary lymph nodes with ultrasound and cytological examinations, was to assess whether it would be possible to distinguish between negative and metastatic lymph nodes and whether the operation could be performed under local anaesthesia without hospitalisation. From January 2005 to January 2007, 54 breast carcinoma patients with negative axillary lymph nodes (after ultrasound examination) had a quadrantectomy and sentinel lymph node removal under local anaesthesia together with sedation where appropriate. Eight patients who presented micrometastases or isolated tumour cells in the sentinel lymph node underwent a subsequent lymphadenectomy. Our data show that, thanks to thorough analysis of the axillary cavity, it may be possible to use the sentinel lymph node approach with a good chance of the patient remaining free of distant metastases and of operating under local anaesthesia.
Ranieri
Ersilia
E
Medicina Territoriale e Prevenzione Oncologica, Dipartimento di Chirurgia Pietro Valdoni, Università degli Studi La Sapienza di Roma, Roma.
Larcinese
Antonella
A
Barberi
Simona
S
Caprio
Giuliana
G
Naticchioni
Enzo
E
Civitelli
Liana
L
Paglicci
Carlo
C
Pagni
Paola
P
Zancla
Serena
S
Rengo
Mario
M
Di Giorgio
Angelo
A
D000556:Ambulatory Surgical Procedures; D000772:Anesthesia, Local; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008408:Mastectomy / Q000379:methods*; D021701:Sentinel Lymph Node Biopsy