Precise intraoperative sentinel lymph node biopsies guided by lymphatic drainage in breast cancer
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Xiaoyan Li1, Sisi Chen1, Liyu Jiang1, Xiaoli Kong1, Tingting Ma1, Hong Xu2 and Qifeng Yang1,3
1Department of Breast Surgery, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
2Department of Breast Surgery, General Hospital of Chinese Armed Police Force, Beijing 100039, P.R. China
3Department of Pathology Tissue Bank, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
Qifeng Yang, email: [email protected]
Hong Xu, email: [email protected]
Keywords: precise sentinel lymph node biopsy, trSLNs, breast cancer
Received: February 13, 2017 Accepted: May 29, 2017 Published: June 27, 2017
The purpose of this study was to present a novel surgical method for intraoperative precise sentinel lymph node biopsy (SLNB) and to determine its clinical efficacy and sensitivity in breast cancer patients. The sentinel lymph nodes (SLNs) were preoperatively evaluated by axillary ultrasound. The intraoperative detection of SLNs was guided by lymphatic drainage pathway. The lymphatic vessels and SLNs were visualized. During operation, we searched for all the true SLNs (trSLNs), para-SLNs (paSLNs) and post-SLNs (poSLNs) followed lymphatic drainage ducts. After precisely locating the lymphatic channels and lymph node, all the lymph nodes that firstly receive lymphatic drainage are designated as trSLNs. We precisely distinguished the trSLNs, paSLNs and poSLNs. We found the average number of trSLNs ranged from1 to 6. In addition, we assessed the novel technique in a total of 125 breast cancer patients. trSLNs were successfully identified in all patients (detection rate: 100 %). The accuracy of trSLNs is 99.2%. Data from our study strongly suggest that our method is a feasible and effective for the detection of precise trSLNs in breast cancer with real-time observations. (ClinicalTrials.gov number, NCT02651142).
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