Vol. 9, No 3, 2002 pp. 223 - 226
UC 618.19-006:616-076
THE ROLE OF SENTINEL LYMPH NODE BIOPSY
IN BREAST CANCER DIAGNOSIS
Nebojša Đorđević1, Slađana Filipović2,
Miomir Pešić1, Mihajlo Đorđević1,
Aleksandar Karanikolić1, Toplica Bojić1
1University of Niš, Surgical Clinic,
2University
of Niš, Clinic of Oncology, Niš, Serbia
Summary. Sentinel lymph node biopsy (SLNB) is a relatively new method
of evaluation of breast cancer spread. The procedure is a specific test
able to demonstrate whether the breast cancer has spread and invaded axillary
lymph glands. Axillary dissection is still being performed in over 50%
of breast cancer patients with histologically negative disease, in spite
of the significant associated postoperative morbidity (prolonged axillary
pain, lymphedema, arm numbness, wound seroma formation). Axillary lymph
node status is also an important prognostic factor in breast can-cer patients
and a primary factor for systemic adjuvant therapy institution. Aim of
this work is to stress the importance of this surgical method in diagnosis
and treatment of breast cancer and to demonstrate technical performance
details (technique of SLN marking, technique of SLN dissection, pathologic
evaluation etc.). The method has been utilized in many European surgical
centres for more than a decade, and the acceptable standard of 95% of successful
SLN dissections further affirmates the method, so it is expected that the
method should become a routine procedure in surgical breast cancer management.
Key words: Breast cancer, sentinel lymph node biopsy,
dissection of axillary lymph nodes, staging
ULOGA BIOPSIJE "STRAŽAR"
LIMFNOG NODUSA
U DIJAGNOZI KARCINOMA DOJKE
Kratak sadržaj: Biopsija "stražar" limfnog nodusa (SLNB) je relativno
novija metoda za procenu rasprostranjenosti kancerskog procesa kod karcinoma
dojke. Ovaj postupak predstavlja svojevrstan test kojim može da se utvrdi
da li se karcinom dojke proširio limfnim putem i zahvatio limfne žlezde
aksile. Danas se disekcija aksilarnih limfnih nodusa još uvek izvodi u
više od polovine pacijenkinja sa karcinomom dojke koje imaju histološki
negativne noduse, uprkos značajnom postoperativnom morbiditetu (prolongirani
aksilarni bol, limfedem, ukočenost ruke, stvaranje seroma u rani). Status
aksilarnih limfnih nodusa je takođe važan prognostički faktor kod
bolesnica sa karcinomom dojke i primarni faktor za korišćenje sistemske
adjuvantne terapije. Cilj ovog rada je da se ukaže na značaj ove
hirurške metode u dijagnostici i terapiji karcinoma dojke i da se prikažu
tehnički detalji izvođenja metode (tehnika obeležavanja SLN, tehnika disekcije
SLN, patološka procena i drugo). Metoda se u mnogim evropskim hirurškim
centrima primenjuje više od jedne decenije, a prihvatljiv standard od 95%
uspešnih disekcija SLN afirmiše metodu, te treba očekivati da ona postane
rutinska procedura u hirurškom lečenju karcinoma dojke.
Ključne reči: Karcinom dojke, biopsija ťstražarŤ limfnog nodusa,
disekcija aksilarnih limfnih nodusa
