Intraoperative morphology of lymph nodes in breast cancer

Authors

Keywords:

breast cancer, sentinel lymph node, ICG.

Abstract

Introduction. In 2020, more than 2.2 million cases of breast cancer were registered, and these figures indicate that this disease is very common. Lymphogenic metastasis is one of the most important causes of local recurrence of breast cancer and an unfavorable factor of prognosis. The aim of the work is to improve the algorithm of intraoperative diagnosis of the sentinel lymph node in patients with breast cancer. Methods. Between 2009 and 2016, 400 patients with T1-T3N0M0 breast cancer were operated on at the Odesa Regional Clinical Hospital and two types dyes Patent Blue and ICG were used. Patients who underwent mastectomy with sentinel lymph node biopsy more often had a clinical diagnosis of T2-T3N0M0 breast cancer. In group I, 100 patients underwent sentinel lymph node biopsy. Staining of lymph nodes was performed using Patent Blue dye. In group II, sentinel lymph node biopsy was performed using Patent Blue dye and the second fluorescent dye ICG, which was also administered subdermally. Results. The overall five-year survival after axillary lymph node dissection and sentinel lymph node biopsy was 91% and 92%, respectively. Five-year recurrence-free survival after axillary lymph node dissection was approximately 82.2%, and after sentinel lymph node biopsy was 83.9%. Regional recurrences in the sentinel lymph nodes on the affected side were found in only 1.1% of cases. In 58% of the patients, the sentinel lymph nodes were clean, therefore, the subsequent lymphodissection was not performed, and the detection of the number of metastatic affected lymph nodes was 42%. The time of observation of the patients ranged from 60 to 180 months. Recurrence was registered in 0.2%. As a result of the study, there was no difference in overall and recurrence-free survival between the groups. Conclusion. When MTS lesions of the axillary (sentinel) lymph nodes are detected, the operation should be continued with the obligatory selection of the second and third order lymph nodes. The extent of surgical intervention is determined on the operating table based on the results of an intraoperative histological examination. The fluorescent lymphography method has a high accuracy of 99%, which makes it possible to recommend it for implementation in clinical practice.

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Published

2022-10-20

How to Cite

Nikitenko , R. ., Kosovan, . V., Vorotyntseva , K. ., & Degtyarenko , S. . (2022). Intraoperative morphology of lymph nodes in breast cancer. Морфологія / Morphologia / Morfologìâ, 16(3), 83–90. Retrieved from https://morphology.dma.edu.ua/article/view/281916

Issue

Vol. 16 No. 3 (2022)

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