ANALYSIS OF SENTINEL LYMPH NODE IN EARLY BREAST CANCER PATIENT – CLINICAL HOSPITAL CENTER RIJEKA

Autori:

Nives Jonjić, Elvira Mustać, Irena Seili Bekafigo, Koraljka Rajković Molek, Franjo Lovasić, Miljenko Lukanović, Svjetlana Grbac Ivanković, Neva Girotto, Ingrid Belac Lovasić, Marija Petković

Sažetak

Biopsija limfnog čvora čuvara (LČČ) pouzdana je metoda za detekciju aksilarnih metastaza kod bolesnica s ranim rakom dojke koja omogućava izbjegavanje nepotrebne disekcije aksile. Međutim, u svakodnevnoj praksi i sad se rabe različiti protokoli za detekciju i patohistološku evaluaciju čvora zbog čega postoji potreba za standardiziranjem načina rada, analize i pisanja izvješća kako bi se bolesnice pouzdano raščlanile u odgovarajuće prognostičke grupe. Cilj ovog rada bio je prikazati naše iskustvo u pregledu LČČ-a kod bolesnica s ranim rakom dojke i kliničkim stadijem bolesti T1-2 i N0. U razdoblju od 2003. do 2011. pregledana je 1071 uzastopna bolesnica, odnosno ukupno 1915 LČČ-a ili prosječno 2,1 po bolesnici. Protokol je uključivao intraoperacijski pregled histoloških smrznutih rezova, odnosno citoloških otisaka, a potom pregled parafinskih rezova prema protokolu koji uključuje narezivanje cijelog LČČ-a u intervalima od 250 µm. Ovakvom analizom utvrđen je negativan LČČ u oko 75% slučajeva. Postignuti rezultati analize LČČ-a uspoređeni su s literaturnim podatcima.

Summary

Sentinel lymph node (SLN) biopsy is an accurate method for the detection of axillary metastases in early breast cancer patients and is of value as a replacement for axillary dissection. However, variations in the methods and protocols used for the pathological evaluation of SLN exist in everyday practice. Therefore, standardization how to detect, dissect, process, stain, assess and report SNL is required in order to stratify patients into adequate prognostic groups. The aim of this study was to present our experience in SLN analysis in patients with early breast cancer and clinical stage T1-2 and N0. In the period between 2003 and 2011, 1071 consecutive patients or 1915 SLN were analyzed. The protocol included intraoperative analysis of histological frozen sections and cytological imprint, followed by analysis of paraffin sections according to the protocol that included sections of whole SLN with the interval of 250 µm. According to the accepted protocol 75% of SLN were negative. The obtained results were correlated with literature data.