Fallacies of preoperative lymphoscintigraphy in detecting sentinel node in breast cancer.
Fallacies of preoperative lymphoscintigraphy in detecting sentinel node in breast cancer.
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DOI：
10.1186/1477-7819-3-31
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发表时间：
2005-05-31
影响因子：
3.2
通讯作者：
Maharajan, R
中科院分区：
文献类型：
--
作者：
Pandey, Manoj;Deo, Surya Vs;Maharajan, R
背景：术前淋巴显像是评估乳腺癌前哨淋巴结的三种方法之一；然而，据报道它有很高的假阴性率。病例介绍：我们在此报告两例术前淋巴显像发现错误的病例。一例44岁T2N0型乳腺癌女性患者行术前淋巴显像检查，发现Tc99硫胶体未在腋窝或乳腺内链内被摄取。术中用蓝色染料和手持式伽玛探针扫描发现腋窝前哨淋巴结。另一名T2N0病变患者术前行淋巴显像检查，发现腋窝和锁骨上窝各有一个前哨淋巴结。术中显像未能显示锁骨上淋巴结，但腋窝淋巴结被正确识别。结论：这两例病例进一步加强了对乳腺癌前哨淋巴结进行三重检查的必要性。它也证明了术前淋巴显像的谬误。
BACKGROUND: Preoperative lymphoscintigraphy is one of the three methods of evaluating sentinel nodes in patients with breast cancer; however, it has been reported to have a high false negative rate. CASE PRESENTATIONS: We report here two cases where the preoperative lymphoscintigraphy was found to be fallacious. A 44-year-old female with T2N0 breast cancer underwent preoperative lymphoscintigraphy with Tc99 sulfur colloid which failed to show any uptake in axilla or internal mammary chain. Intraoperative scintigraphy with blue dye and hand held gamma probe identified sentinel lymph node in axilla. Another patient with T2N0 lesion underwent preoperative lymphoscintigraphy which showed a sentinel lymph node in axilla and another in supraclevicular fossa. Intraoperative scintigraphy failed to show supraclevicular node however axillary node was correctly identified. CONCLUSION: These two cases further strengthen the need to carry out triple test in identification of sentinel lymph node in patients with breast cancer. It also demonstrates the fallacies of preoperative lymphoscintigraphy.