Aksiller Sentinel Lenf Nodu Biyopsisinde KombineYöntem (Mavi Boya ve Lenfosintigrafi) Sonuçlarının Değerlendirilmesi

Amaç: Meme Kanserinin en önemli prognostik faktörü aksillanın tümör metastazı açısından durumudur. Son zamanlarda, erken evre meme kanserin-de sentinel lenf nodu biyopsisi aksiller lenf nodu diseksiyonunun yerini almıştır. Bu çalışmada aksiller sentinel lenf nodu biyopsisi tekniğinde kombi-ne yöntemin sonuçlarının değerlendirilmesi amaçlandı. Gereç ve Yöntem: Temmuz 2015- Nisan 2017 tarihleri arasında ameliyat edilen klinik olarak erken evre (T1-T2, N0) meme kanserli 52 hastanın verileri retrospektif olarak incelendi. Tüm ameliyatlar aynı cerrah tarafından gerçekleştirildi. Hastalara meme koruyucu cerrahi ve kombine yöntem ile sentinel lenf nodu biyopsisi yapıldı. Hastaların demografik verileri, preoperatif evreleri, sentinel lenf nodu sayısı, postoperatif komplikasyonları kaydedildi. İşlemlerin ayrı ayrı sentinel lenf nodu saptama oranları hesaplandı. Bulgular: Hastaların hepsi kadındı ve yaş ortalaması 48.2 (33-78 yıl) idi. Mavi boya ile çıkarılan ortalama sentinel lenf nodu sayısı 1,5 (1-4) idi. 21 hastada 1, 22 hastada 2, 4 hastada 3, 1 hastada 4 sentinel lenf nodu bulundu. Lenfosintigrafi ile tespit edilen ortalama sentinel lenf nodu sayısı 2,1 idi (1-5). Beş hastada 1, 32 hastada 2, 10 hastada 3, 2 hastada 4 ve 1 hastada 5 sentinel lenf nodu bulundu. Üç hastada metilen mavisi ile hiç boyanma olmayıp lenfosintigrafi ile sentinel lenf nodu bulunurken, lenfosintigrafi ile tespit edilemeyen bir hastada sentinel lenf nodu mavi boya ile tespit edildi. Metilen mavisi ile lenf nodu bulma oranı %92,3, lenfosintigrafi ile %96,1, kombine teknik ile bu oran %98,0 olarak tespit edildi. Sonuç: Klinik erken evre meme kanseri tedavisinde sentinel lenf nodunu tespit etmede kombine yöntem yüksek doğruluk oranı ile güvenli ve uygula-nabilir bir yöntemdir.

Evaluation of Axillary Sentinel Lymph Node Biopsy By Combined Blue Dye and Lymphoscintigraphy Method

Objective: The most important prognostic factor of breast cancer is the status of the axillary lymph nodes regarding tumor metastasis. Recently, sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection in early-stage breast cancer. In this study, it was aimed to assess the results of axillary sentinel lymph node biopsy by combined method. Material and Method: The data of 52 patients with early-stage (T1-T2, N0) breast cancer undergoing surgery between July 2015 and April 2017 were reviewed retrospectively. All of the surgical operations were performed by the same surgeon. Breast-conserving surgery and sentinel lymph node biopsy with the combined technique was performed in all patients. Demographic data, preoperative stages, number of sentinel lymph nodes, postoperative complications were recorded. Sentinel lymph node detection rates of procedures were calculated individually. Results: All of the patients were females and the mean age was 48.2 (33-78) years. Average number of sentinel lymph nodes removed by blue dye was 1.5 (1-4). One sentinel lymph node was detected in 21 patients, 2 in 22 patients, 3 in 4 patients and 4 in 1 patient. Average number of sentinel lymph nodes detected with lymphoscintigraphy was 2.1 (1-5). One sentinel lymph node was detected in 5 patients, 2 in 32 patients, 3 in 10 patients, 4 in 2 patients and, 5 in 1 patient. While sentinel lymph node was detected with lym-phoscintigraphy in 3 patients despite no staining occurred with methylene blue, sentinel lymph node which could not be detected with lymphoscintig-raphy was detected with blue dye in one patient. Sentinel lymph node detection rates of methylene blue, lymphoscintigraphy and combined technique were determined to be 92.3%, 96.1% and 98%; respectively. Conclusion: Combined method is a safe and applicable method with high accuracy rate in sentinel lymph node detection for the management of patients with early-stage breast cancer.

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Fırat Tıp Dergisi-Cover
  • ISSN: 1300-9818
  • Başlangıç: 2015
  • Yayıncı: Fırat Üniversitesi Tıp Fakültesi