Chemo Secrets From a Breast Cancer Survivor

Breast Cancer Survivors

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At the present time, the standard of care for definitive staging of clinically early-stage invasive breast cancer is axillary node dissection. Because of the morbidity of this procedure, sentinel lymphadenectomy has been suggested as a means of identifying patients without lymphatic metastases, allowing them to forego the more morbid axillary dissection. Sentinel nodes have been identified using both vital stains and radiocolloid injection, with the highest success achieved by the combination of the two techniques. The role of preoperative lymphoscintigraphy is uncertain at this stage, but we recommend that it be considered at the initiation of a breast carcinoma sentinel node radiocolloid localization program as a further aid to localization.

It is apparent that if an axillary sentinel node can be imaged, surgeons will have no difficulty identifying the node intraoperatively because the sentinel node is emitting a significant number of counts. The real potential of lymphoscintigra-phy in breast cancer may be to identify a subpopulation of women who do not drain to the axilla and may not need any axillary procedure. In addition, this preoperative test may identify women whose tumors drain into the internal mammary nodes, and these nodes can then be included in the radiation ports if this modality is used with breast conservation.

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