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Turkish Journal of Cancer
2001, Volume 31, Number 1, Page(s) 27-34
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Detection of metastases in the sentinel lymph nodes of primary breast cancer patients by lymphatic mapping and intraoperative gamma probe: initial experience
MEHMET T KİTAPÇI1, B BÜLENT MENTEŞ2; AYTUĞ ÜNER3, EVRİM ABAMOR1, AYŞE DURSUN4, MEHMET KAPLAN2, ZAFER FERAHKÖŞE2, ERTAN TATLICIOĞLU2
Departments of 1Nuclear Medicine,2Surgery, 3Oncology, and 4Pathology, Gazi University Medical School, Ankara- Turkey

This study documents our initial experience for visualisation of sentinel lymph nodes (SLNs) with lymphoscintigraphy and intraoperative detection of SLN with the handheld gamma probe in patients with primary breast cancer. Fourteen women with palpable breast cancer had peritumoral injection of 99mTc labeled nanocolloid in four different regions. 1 mCi of 99mTc labeled nanocolloid in 0.8 ml saline were divided into four equal portions. Thirty minutes' dynamic images and static images, every 30 minutes for 3 hours, were obtained. After intraoperative identification and resection of the SLN(s), ail the patients underwent fuil axillary dissection. We were able to visualize and Iocalize the SLN(s) in all patients. An average of 30.1 lymph nodes (range 19-44) were harvested. Metastatic involvement of the axillary nodes was found in only 4 of the 14 patients in this series (28.6%). In one of these 4 patients with axillary involvement, the sentinel lymph node was the only involved node. In the other three patients, metastases were also found in lymph nodes other than the SLN. Our initial experience is promising that SLNs can be accurately localised with our technique of combination Iymphoscintigraphy and intraoperative gamma probe. The SLN was predictive of the presence or absence of IN metastasis in all patients. If our future results accumulate to give the same success rate with no or very infrequent false evaluations, we might then proceed to targeting only the SLN as a reliable predictor of the axillary LN status.

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