TY - JOUR

T1 - СОБСТВЕННЫЙ ОПЫТ ПРИМЕНЕНИЯ ФЛЮОРЕСЦЕНТНОЙ ЛИМФОГРАФИИ ДЛЯ БИОПСИИ СИГНАЛЬНЫХ ЛИМФОУЗЛОВ ПРИ РАКЕ МОЛОЧНОЙ ЖЕЛЕЗЫ

AU - Божок , Алла Александровна

AU - Кащенко, В.А.

AU - Ратников, Вячеслав Альбертович

AU - Горнов, С.В.

AU - Суворов, Ю.В.

AU - Манелов, А.Е.

PY - 2024

Y1 - 2024

N2 - Objective. To study diagnostic value of fluorescence lymphography for sentinel lymph node biopsy in breast cancer. Material and methods. The study enrolled 25 patients with breast cancer T1-2N0-1M0 between March 2023 and July 2023. Eight ones underwent neoadjuvant chemotherapy. In 3 patients, morphologically verified metastases cN1 in axillary lymph nodes regressed after treatment. After sentinel lymph node biopsy, all patients underwent standard axillary lymphadenectomy. Subareolar injection of indocyanine green 1 ml (5 mg/ml) was performed immediately before surgery. Fluorescence imaging was performed using the MARS system. Results. Detection rate was 100%. Mean number of sentinel lymph nodes was 2. Metastatic lesions of sentinel lymph nodes were observed in 6 patients (24%) with micro-metastases in 2 cases. In 50% of cases, metastatic lesion did not extend beyond sentinel lymph nodes. False negative result was obtained in 1 (4%) patient. Mean number of metastases was 1.8 (max 3 in one patient). Conclusion. Sentinel lymph node biopsy with fluorescence lymphography is a sensitive method. The advantages of this technique are visualization of subcutaneous lymphatic vessels and skin incision for access to sentinel lymph nodes, as well as visualization of sentinel lymph nodes after skin incision.

AB - Objective. To study diagnostic value of fluorescence lymphography for sentinel lymph node biopsy in breast cancer. Material and methods. The study enrolled 25 patients with breast cancer T1-2N0-1M0 between March 2023 and July 2023. Eight ones underwent neoadjuvant chemotherapy. In 3 patients, morphologically verified metastases cN1 in axillary lymph nodes regressed after treatment. After sentinel lymph node biopsy, all patients underwent standard axillary lymphadenectomy. Subareolar injection of indocyanine green 1 ml (5 mg/ml) was performed immediately before surgery. Fluorescence imaging was performed using the MARS system. Results. Detection rate was 100%. Mean number of sentinel lymph nodes was 2. Metastatic lesions of sentinel lymph nodes were observed in 6 patients (24%) with micro-metastases in 2 cases. In 50% of cases, metastatic lesion did not extend beyond sentinel lymph nodes. False negative result was obtained in 1 (4%) patient. Mean number of metastases was 1.8 (max 3 in one patient). Conclusion. Sentinel lymph node biopsy with fluorescence lymphography is a sensitive method. The advantages of this technique are visualization of subcutaneous lymphatic vessels and skin incision for access to sentinel lymph nodes, as well as visualization of sentinel lymph nodes after skin incision.

KW - breast cancer

KW - fluorescence lymphography

KW - indocyanine green

KW - sentinel lymph node biopsy

UR - https://www.mendeley.com/catalogue/5a67c761-deca-311b-ad00-d72c7f1a9e09/

U2 - 10.17116/hirurgia202402248

DO - 10.17116/hirurgia202402248

M3 - статья

SP - 48

EP - 54

JO - ХИРУРГИЯ. ЖУРНАЛ ИМ. Н.И. ПИРОГОВА

JF - ХИРУРГИЯ. ЖУРНАЛ ИМ. Н.И. ПИРОГОВА

SN - 0023-1207

IS - 2-2

ER -