[Sentinel lymph node biopsy technique in breast cancer surgery in a hospital without a nuclear medical service]. / Técnica del ganglio centinela en la cirugía del cáncer de mama en un hospital sin servicio de medicina nuclear.

INTRODUCTION: Knowledge of lymph node stage is the most important prognostic factor in breast cancer. The sentinel lymph node biopsy technique (SLNBT), initially developed to avoid unnecessary dissection in melanoma, has been shown to be able to predict the axillary stage of breast cancer. The difficulty of applying the SLNBT in hospitals without a nuclear medicine service has led to the existence of external teams that allow these hospitals to apply the technique. OBJECTIVE: To test the application of the SLNBT in our hospital which has no nuclear medicine service. PATIENTS AND METHODS: Coinciding with the validation of the SLNBT in the Germans Trias i Pujol Hospital in Badalona in November 1999, and with their help, the Centre Hospitalari de Manresa began to apply this technique. In 2002, the technique was used in all the hospitals of the ALTHAIA-Xarxa Assistencial de Manresa. From November 1999 to June 2005, the technique was applied in 163 patients. RESULTS: Of the 163 patients, the technical success rate was 97.55%. In 98% of the patients, the sentinel lymph node was found in the axilla. In 10.7% of the patients, the node was found in the internal mammary basin. Twenty-six percent of the axillas had metastases of over 2 mm, and 16% had micrometastases. One hundred and five patients were spared axillary dissection. CONCLUSIONS: The SLNBT can be performed in a hospital without a nuclear medicine service. This technique improves and simplifies the surgical technique and reduces length of hospital stay and morbidity.

Técnica del ganglio centinela en la cirugía del cáncer de mama en un hospital sin servicio de medicina nuclear / Sentinel lymph node biopsy technique in breast cancer surgery in a hospital without a nuclear medical service

Introducción. El conocimiento del estado ganglionar es el factor pronóstico más importante en el cáncer de mama. La técnica del ganglio centinela, desarrollada inicialmente para evitar vaciamientos innecesarios en los melanomas, ha demostrado su capacidad para predecir el estado axilar en el cáncer de mama. La dificultad en aplicar la técnica en hospitales sin servicio de medicina nuclear ha estimulado la existencia de equipos itinerantes que han permitido aplicarla en dichos hospitales. Objetivo. Comprobar la aplicabilidad de la técnica del ganglio centinela en nuestro hospital que carece de servicio de medicina nuclear. Pacientes y método. Coincidiendo con la validación de la técnica del ganglio centinela en el Hospital Universitari Germans Trias i Pujol de Badalona (Barcelona) en noviembre de 1999, se empezó a aplicarla en el Centre Hospitalari de Manresa (Barcelona) bajo su tutela. En 2002, se generalizó su uso en todos los hospitales de ALTHAIA-Xarxa Assistencial de Manresa. De noviembre de 1999 a junio de 2005, se estudió el ganglio centinela de un total de 163 pacientes. Resultados. En el 97,55% de las 163 pacientes, la técnica se realizó con éxito. En un 98% de los casos, el ganglio centinela se encontró en la axila. En un 10,7% de los casos, había ganglio centinela en la cadena de la mamaria interna. El 26% de las axilas tenían metástasis de más de 2 mm y el 16% tenía micrometástasis. Se pudo ahorrar el vaciamiento axilar a 105 pacientes. Conclusiones. La técnica del ganglio centinela se puede practicar en un hospital que no disponga de servicio de medicina nuclear, mejora y simplifica la técnica quirúrgica y reduce la estancia hospitalaria y las secuelas (AU)

Introduction. Knowledge of lymph node stage is the most important prognostic factor in breast cancer. The sentinel lymph node biopsy technique (SLNBT), initially developed to avoid unnecessary dissection in melanoma, has been shown to be able to predict the axillary stage of breast cancer. The difficulty of applying the SLNBT in hospitals without a nuclear medicine service has led to the existence of external teams that allow these hospitals to apply the technique. Objective. To test the application of the SLNBT in our hospital which has no nuclear medicine service. Patients and methods. Coinciding with the validation of the SLNBT in the Germans Trias i Pujol Hospital in Badalona in November 1999, and with their help, the Centre Hospitalari de Manresa began to apply this technique. In 2002, the technique was used in all the hospitals of the ALTHAIA-Xarxa Assistencial de Manresa. From November 1999 to June 2005, the technique was applied in 163 patients. Results. Of the 163 patients, the technical success rate was 97.55%. In 98% of the patients, the sentinel lymph node was found in the axilla. In 10.7% of the patients, the node was found in the internal mammary basin. Twenty-six percent of the axillas had metastases of over 2 mm, and 16% had micrometastases. One hundred and five patients were spared axillary dissection. Conclusions. The SLNBT can be performed in a hospital without a nuclear medicine service. This technique improves and simplifies the surgical technique and reduces length of hospital stay and morbidity (AU)