ERKEN EVRE MEME KANSERİNDE SENTİNEL LENF NODU TESPİTİNDE SADECE MAVİ BOYA KULLANIMI İLE MAVİ BOYA VE RADYOKOLLOİD BİRLİKTE KULLANIMININ KARŞILAŞTIRILMASI

Öz

Amaç: 1990’lı yılların ortalarında sentinel lenf nodu biyopsisi , meme kanserli hastalarda aksiller lenf nodu durumunun değerlendirilmesinde kullanılmaya başlanmış ve günümüzde klinik olarak aksillası negatif meme kanserli hastalarda aksiller evreleme için tercih edilen bir prosedür haline gelmiştir. Sentinel lenf nodu tespitinde sadece mavi boya yöntemi veya sadece radyokolloid madde yöntemi ve her ikisinin birlikte kullanıldığı kombine yöntem uygulanmaktadır. Gereç ve Yöntemler: 01/07/2013-01/07/2014 tarihleri arasında meme kanseri nedeniyle opere edilen hastaların dosyaları retrospektif olarak incelendi. Klinik olarak aksilla negatif erken evre meme kanseri nedeniyle sentinel lenf nodu biyopsisi yapılan hastalar çalışmaya dahil edildi. Klinik olarak aksillası pozitif olan, lokal ileri ve ileri evre meme kanseri olan, neoadjuvan tedavi alan hastalar çalışmaya dahil edilmedi. Klinik olarak aksilla negatif erken evre meme kanseri nedeniyle sentinel lenf nodu biyopisi yapılan toplam 68 hasta çalışmaya dahil edildi. Hastalar sentinel lenf nodu biyopsisi mavi boya yöntemi ile yapılanlar ve kombine yöntemle (mavi boya+ radyokolloid) yapılanlar olmak üzere iki gruba ayrıldı. Mavi boya grubunda 41 hasta, kombine grupta 27 hasta mevcuttu. Çıkartılan sentinel lenf nodları intraoperatif frozen inceleme ile değerlendirildi ve metastaz görülen hastalara aksiller lenf nodu diseksiyonu yapıldı. Bulgular: Metilen mavi grubundaki 41 hastanın 6 tanesinde sentinel lenf nodu bulunamamış ve sentinel lenf nodu %85 oranında tespit edilmiştir. On hastanın sentinel lenf nodunda metastaz görülmüş ve pozitiflik oranı %24 olarak bulunmuştur. Kombine gruptaki 27 hastanın tamamında sentinel nodu bulunmuş ve sentinel lenf nodu %100 oranında tespit edilmiştir. On hastada sentinel lenf nodunda metastaz görülmüş ve pozitiflik oranı %37 olarak bulunmuştur. Sonuç: Bu çalışmada klinik olarak aksilla negatif erken evre meme kanserinde perop sentinel lenf nodu tespitinde kombine yöntemin sadece mavi boya yönteminden anlamlı olarak üstün olduğu tespit edilmiştir.

Anahtar Kelimeler

• Sentinel lenf nodu biyopsisi
• mavi boya
• radyokolloid
• meme kanseri

Comparison of the Use of Blue Dye Only and the Use of Blue Dye and Raiocolloid Together in Sentinel Lymph Node Detection in Early Stage Breast Cancer

Öz

Objective: In the mid-1990s, sentinel lymph node biopsy began to be used in the evaluation of axillary lymph node status in breast cancer patients and has now become the procedure of choice for axillary staging in clinically axilla-negative breast cancer patients. In the detection of sentinel lymph node, only the blue dye method or only the radiocolloid material method and the combined method where both are used together are applied. Material and Methods: The files of patients who were operated on for breast cancer between 01/07/2013 and 01/07/2014 were examined retrospectively. Patients who underwent sentinal lymph node biopsy due to clinically axilla-negative early stage breast cancer were included in the study. Patients with clinically positive axilla, locally advanced and advanced stage breast cancer, and patients receiving neoadjuvant treatment were not included in the study. A total of 68 patients who underwent sentinel lymph node biopsy due to clinically axilla-negative early stage breast cancer were included in the study. The patients were divided into two groups: those whose sentinel lymph node biopsy was performed using the blue dye method and those whose combined method (blue dye + radiocolloid) was performed. There were 41 patients in the blue dye group and 27 patients in the combined group. The removed sentinel lymph node was evaluated by intraoperative frozen examination, and axillary lymph node dissection was performed in patients with metastases. Results: Sentinel lymph nodes were not found in 6 of 41 patients in the methylene blue group, and sentinal lymph nodes were detected at a rate of 85%. Metastasis was observed in the sentinel lymph nodes of ten patients and the positivity rate was found to be 24%. Sentinal nodes were found in all 27 patients in the combined group, and sentinel lymph nodes were detected in 100%. Sentinel lymph node metastasis was observed in ten patients and the positivity rate was found to be 37%. Conclusion: In this study, it was determined that the combined method was significantly superior to the blue dye method alone in preoperative sentinel lymph node detection in clinically axilla-negative early stage breast cancer.

Anahtar Kelimeler

• Sentinal lymph node biopsy
• blue dye
• radiocolloid
• breast cancer

Kaynakça

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