Detection of Sentinel Lymph Node Micrometastases in Breast2conservation Therapy of Breast Cancer and Its Prognostic Signif icance

Objective 　To study the significance of sentinel lymph node (SLN) micrometastasis detection in breast2cons ervation therapy of breast cancer. Methods 　99m Tc2DX particles were injected into the breast tissue adjacent to the primary tumor or subcutaneously. Eighty2three patient s participated in this study, who were clinically judged to be suit to be carried out breast2conservation therapy. Af ter 2～4 hours the SLN identified by gamma detector were dissected out, followed by quadrantectomy plus axillary lymph node dissection (ALND) . The SLN were evaluated with histopathology, and reverse t ranscription poly2 merase chain reaction (RT2PCR) (examined CK19 mRNA) . Results 　There were 4 patient s failed to be find out the SLN. 127 SLN swere identified in 79 patient s, SLN metastasis positive rate was 26. 6 %(21/79) with histopathology, micrometastases positive rate of histopathology and RT2PCR were 13. 9 %(11/79) and 31. 6 %(25/ 79) respectively( P < 0. 01) . The rate of 5 years survival and distant metastasis in mi2 crometastases positive patient s cont rast with the negative were significant ( P < 0. 05), but the rate of 3 years survival and regional recurrence was not ( P > 0. 05) . Conclusion 　RT2PCR was a sensitive method to detect micrometastases. SLN micrometastases may be an independence prognostic factor of breast2con2 servation therapy.