IMPROVEMENT OF THE ALGORITHM FOR INTRAOPERATIVE DIAGNOSTICS OF BREAST CANCER METASTASIS USING SENTINEL LYMPH NODE STAINING
Clinical medicine

IMPROVEMENT OF THE ALGORITHM FOR INTRAOPERATIVE DIAGNOSTICS OF BREAST CANCER METASTASIS USING SENTINEL LYMPH NODE STAINING

Published 2023-02-15

Authors:

R.P. Nikitenko
V.M. Kosovan
K.O. Vorotyntseva
E.A. Koichev
S.P. Degtyarenko
O.M. Kvasha
V.K. Likhachov

Abstract:
Lymphatic metastasis is one of the most important causes of local BC recurrence and an unfavourable prognosis factor. With the beginning of application in the surgical practice of staining sentinel lymph nodes using modern dyes (Patent Blue, ICG), the approach to determining the extent of surgical intervention has changed radically Performing the staining of sentinel lymph nodes in breast tumours allows for reducing the trauma of surgical intervention as much as possible (due to the refusal of axillary lymph node dissection), as a result of which the number of postoperative complications is minimised. The purpose of the study was to improve the algorithm for intraoperative detection of sentinel lymph nodes in patients with breast cancer. Between 2016 and 2021, 200 patients with T1-T3N0M0 breast cancer were operated on at the Odesa Regional Clinical Hospital using two dyes: Patent Blue and ICG. The proposed algorithm for diagnosis and treatment of breast cancer allows most cases to abandon traumatic operations in favour of organ-preserving operations with biopsy of sentinel lymph nodes.
Keywords:
breast cancer sentinel lymph nodes intraoperative staining of lymph nodes biopsy
References:
  1. Aikian A, Shynkevych V, Kaidashev I. Analysis of association between the density of infiltration in primary carcinoma of the mammary gland by tumor-associated macrophages and postoperative prognosis. The Medical and ecological problems. 2019; 23, 1–2: 3–7. doi.org/10.31718/mep.2019.23.1-2.01
  2. Canavese G, Bruzzi P, Catturich A. Sentinel lymph node biopsy versus axillary dissection in node-negative early-stage breast cancer: 15-year follow-up update of a randomized clinical trial. Ann Surg Oncol. 2016; 23: 2494–2500. https://doi.org/10.1245/s10434-016-5177-4
  3. Chen J. Regional lymph node metastasis and axillary surgery of microinvasive breast cancer: A population-based study. Diagnostics. 2022; 12, 5. 1049. https://doi.org/10.3390/diagnostics12051049
  4. Fan B. Role of sentinel lymph node biopsy in microinvasive breast cancer. Ann. Surg. Oncol. 2020; 27, 11: 4468–4473. https://doi.org/10.1245/s10434-020-08606-3
  5. Kim M, Kim HJ, Chung YR, Kang E, Kim EK, Kim SH et al. Microinvasive carcinoma versus ductal carcinoma in situ: A comparison of clinicopathological features and clinical outcomes. J. Breast Cancer. 2018; 21, 2: 197–205. https://doi.org/10.4048/jbc.2018.21.2.197
  6. Kuerer HM. DCIS margins and breast conservation: MD Anderson Cancer Center multidisciplinary practice guidelines and outcomes. J. Cancer. 2017; l, 8, 14: 2653–2662. https://doi.org/10.7150/jca.20871
  7. Li Y, Zhang S, Wei X, Zhang J. The clinical features and management of women with ductal carcinoma in situ with microinvasion: A retrospective Cohort study. Int J Surg. 2015; 19: 91–94. https://doi.org/10.1016/j.ijsu.2015.05.013
  8. Lillemoe TJ, Tsai ML, Swenson KK. Clinicopathologic analysis of a large series of microinvasive breast cancers. Breast J. 2018; 24, 574–579. doi: 10.1111/tbj.13001.
  9. Magnoni F. Sentinel lymph node biopsy in microinvasive ductal carcinoma in situ. Br. J. Surg. 2019; 106, 4: 375–383. https://doi.org/10.1002/bjs.11079
  10. Niu H.-F. Is adjuvant chemotherapy necessary for patients with microinvasive breast cancer after surgery? Cancer Biol. Med. 2016; 13, 1: 142–149. https://doi.org/10.28092/j.issn.2095-3941.2015.0093
  11. Pu T. Long term prognosis of ductal carcinoma in situ with microinvasion: A retrospective cohort study. Int J Clin Exp Pathol. 2018; 11, 5: 2665–2674.
  12. Si J. Multiple microinvasion foci in ductal carcinoma in situ is associated with an increased risk of recurrence and worse survival outcome. Front. Oncol. 2020; 10: 2735. https://doi.org/10.3389/fonc.2020.607502
  13. Zhang H. Significance of HER2 in microinvasive breast carcinoma: A single academic institution experience. Am. J. Clin. Pathol. 2021; 156, 1: 155–165. https://doi.org/10.1093/ajcp/aqaa222
  14. Zhang G. Comparison of breast ductal carcinoma in situ and ductal carcinoma in situ with microinvasion, and analysis of axillary lymph node metastasis. Medicine. 2020; 99, 52: e23593. https://doi.org/10.1097/MD.0000000000023593
  15. Zheng J, Yu J, Zhou T. Clinical characteristics of breast ductal carcinoma in situ with microinvasion: A narrative review. J. Int. Med. Res. 2020; 48, 11, 300060520969304. https://doi.org/10.1177/0300060520969304
Publication:
«World of Medicine and Biology» Vol. 19 No. 83 (2023) , с. 143-147
УДК 618.19-006.6-06:616.428-076]-091