title: Sentinel lymph node detection in breast cancer - first experience.
abstract: BACKGROUND
  Breast cancer accouns for 22.9% of all cancers in women and 13.7% of cancer deaths. Positive axillary lymphnodes (ALN) predict the development of distant metastases. The status of the sentinel lymphnode (SLN) is crutial for the treatment selection.
  
  
  OBJECTIVE
  To determine the benefits of SLN detection in patients with breast cancer.
  
  
  METHODS
  38 female patients (pts), age 44 ± 12 years, with T1-2 N0 M0 breast cancer, without enlarged ALN on ultrasound (US), were included. SLN detection was performed using gamma camera and gamma detection probe after periareolar subcutaneous and/or peritumoral injection of (99m-Technetium-SENTISCINT). Blue dye was administered 20 min before the operation. SLN was extirpated and ex tempore histopathology was performed.
  
  
  RESULTS
  Ex tempore SLN evaluation was negative and the lymphatic pathways preserved in 28/38 (74%) pts. In 10/38 (26%) pts SLN was positive, followed by radical surgery. In 3/28 ex tempore negative patients, histopathological analysis showed metastatic involvement (false negative). In 3/10 ex tempore positive patients micro metastases 0,2-2 mm were detected. 12 pts had 2 SLN, 8/12 (66%) had negative and 4/12 (34%) had positive SLN. 3 pts had a rare double drainage to axilla and a. mammaria int.
  
  
  CONCLUSIONS
  Our results confirm that SLN detection technique is non-invasive, safe and reliable and should be incorporated into the guidelines for breast cancer pts (T1-2 N0 M0). The most reliable option for colloid application is the combined technique of periareolar and peritumoral injection. Patients with drainage to a. mammaria interna should be selected for adjuvant protocols.
authors.affiliation: Institute of Pathophysiology and Nuclear Medicine, Acad. "Isak S. Tadzer", Skopje, R. Macedonia.
authors.forename: S
authors.initials: S
authors.lastname: Stojanoski
authors.affiliation: Institute of Pathophysiology and Nuclear Medicine, Acad. "Isak S. Tadzer", Skopje, R. Macedonia.
authors.forename: N
authors.initials: N
authors.lastname: Ristevska
authors.affiliation: Institute of Pathophysiology and Nuclear Medicine, Acad. "Isak S. Tadzer", Skopje, R. Macedonia.
authors.forename: D
authors.initials: D
authors.lastname: Pop Gjorceva
authors.affiliation: Clinic for Thoracovascular surgery, Skopje, R. Macedonia.
authors.forename: B
authors.initials: B
authors.lastname: Antevski
authors.affiliation: Institute of Pathology, Medical Faculty, Skopje, R. Macedonia.
authors.forename: G
authors.initials: G
authors.lastname: Petrusevska
mesh_terms: D000328:Adult; D001365:Axilla; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D004396:Coloring Agents; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D061206:Neoplasm Micrometastasis / Q000473:pathology*; D009367:Neoplasm Staging; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013667:Technetium
chemical_list: D004396:Coloring Agents; D019275:Radiopharmaceuticals; D013667:Technetium