Importance of Lymphoscintigraphy to Find Sentinel Ganglion in the Context of Malignant Neoplasm of Breast

S. Gonçalves, F. Gonçalves, C. Rodrigues, R. Macedo
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Abstract

Aim: To assess the importance of the sentinel ganglion (GS) detection technique by lymphoscintigraphy in order to avoid lymphedema of the upper limbs in malignant neoplasms of the breast. The sentinel ganglion is the first ganglion of the lymphatic chain to drain the lymph from the primary tumor. The lymphoscintigraphy allows to identify this ganglion, to facilitate its removal by the surgeon and to be analyzed by the pathological anatomy through an extemporaneous analysis in order to avoid axillary emptying in case of negative analysis for metastases. Material and Methods: All lymphoscintigraphy were performed with the BrigthView Philips model camera at the SESARAM, E.P.E.. All of these studies followed the same protocol according to the EANM guidelines. An anamnesis of the patient was carried out, the explanation of the procedure and the positioning of the patient according to the protocol in force. A dynamic study was performed immediately after administration of the radiopharmaceutical and then static, anterior, oblique and lateral images. After processing the acquired images and marking GS on the skin with the aid of the Europrobe 3 probe, clinical reports were performed. For the analysis of the data, we selected female patients with breast neoplasia, who underwent the examination between June 23, 2017 and March 22, 2018, aged between 33 and 88 years. Results: Through the evaluation of the sample of 56 users we can verify that this technique allowed to avoid axillary emptying in 39 patients. Of the 56 patients, 2 had bilateral breast neoplasia, 33 right breast neoplasm and 21 left breast cancer. Of the 2 patients with bilateral malignant neoplasia, one presented both negative ganglia and the other presented negative right GS and positive left GS and consequent axillary emptying. Of the 33 patients with neoplasia of the right breast 8, they emptied, and of the 21 patients with left breast neoplasia, 9 performed emptying. Conclusions: According to the data obtained in the SESARAM E.P.E. Nuclear Medicine study, it was verified that lymphoscintigraphy allowed to avoid axillary emptying in 39 patients, which corresponds to 70% of the sample. It is confirmed that this diagnostic technique is an asset in the preservation of the lymphatic chain. The availability of this technique in a hospital regimen for the detection of sentinel ganglion in the Regional Health Service is considered important to avoid the limitations associated with axillary emptying and consequent improvement in the quality of life of these patients".
乳腺恶性肿瘤淋巴显像对前哨神经节发现的重要性
目的:探讨淋巴闪烁扫描前哨神经节(GS)检测技术对避免乳腺恶性肿瘤上肢淋巴水肿的重要性。前哨神经节是淋巴链中第一个从原发性肿瘤排出淋巴的神经节。淋巴闪烁扫描可以识别神经节,便于外科医生切除神经节,并通过即时分析通过病理解剖进行分析,以避免在转移阴性分析的情况下腋窝排空。材料和方法:所有淋巴闪烁扫描均使用BrigthView Philips模型相机在SESARAM,E.P.E.进行。根据EANM指南,所有这些研究均遵循相同的方案。根据现行方案对患者进行了回顾、手术解释和患者定位。在给药放射性药物后立即进行动态研究,然后进行静态、前部、倾斜和横向图像。在Europrobe 3探针的帮助下处理采集的图像并在皮肤上标记GS后,进行临床报告。为了分析数据,我们选择了女性乳腺肿瘤患者,她们在2017年6月23日至2018年3月22日期间接受了检查,年龄在33岁至88岁之间。结果:通过对56名用户样本的评估,我们可以验证这项技术可以避免39名患者的腋窝排空。56例患者中,双侧乳腺肿瘤2例,右侧乳腺肿瘤33例,左侧癌症21例。在2例双侧恶性肿瘤患者中,一例同时出现神经节阴性,另一例出现右侧GS阴性和左侧GS阳性,并伴有腋窝排空。在33名右乳房肿瘤患者中,8名患者排空,21名左乳房肿瘤患者,9名患者排空。结论:根据SESARAM E.P.E.核医学研究中获得的数据,证实淋巴闪烁扫描可以避免39名患者的腋窝排空,相当于70%的样本。已经证实,这种诊断技术是保存淋巴链的一项资产。这项技术在区域卫生服务的前哨神经节检测医院方案中的可用性被认为是重要的,以避免与腋窝排空相关的限制,从而提高这些患者的生活质量”。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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