Contralateral axillary sentinel lymph node drainage in breast cancer: Controversies and management according to the literature. A case report

BACKGROUND: Sentinel lymph node (SNL) biopsy in breast cancer for the determination of axillary status is standard procedures in surgical treatment of early-stage breast cancer. The identification of the SNL is usually performed by radiocolloid injection or/and injection of methylene blue due. The use of indocyanine green (ICG) dye, which is fluorescent dye, which movement in breast and axillar pit, can be followed with special cameras which detect near infrared specatar of light. CASE REPORT: In this paper, we present case report of patient with breast cancer, where we perform SNL detection with three methods: Use of radiocolloid which we trace with static gamma camera, and intraoperatively with hand held gamma probe, methylene blue dye which movement we followed by eye contact and using indocyanine green which movement was followed by specially constructed multispectral camera, which can detect near-infrared fluorescence that is emitted by ICG and methyline blue, respectively. CONCLUSION: Fluorescent imaging with ICG is a sensitive, valuable, and safe method for SNL biopsy. Finding new agents that would identify the SNL, especially if they are not radioactive would be an important step in wider application of this method.

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Pregnancy-associated breast cancer – Case report

Mastology ◽

10.29289/259453942020v30s1086 ◽

2020 ◽

Vol 30 (Suppl 1) ◽

Author(s):

Vanessa Monteiro Sanvido ◽

Mary Miyazawa Simomoto ◽

Afonso Celso Pinto Nazário

Keyword(s):

Breast Cancer ◽

Case Report ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Histological Grade ◽

Percutaneous Biopsy ◽

Lymph Node Biopsy ◽

Node Biopsy ◽

Axillary Lymphadenectomy ◽

The Right

Introduction: Mammographic screening is recommended yearly after the age of 40; however, many pregnant women are younger and should undergo the test. In these cases, anamnesis and clinical examination of the breasts are essential to detect any breast change. In case of clinical suspicion, it is recommended to undergo mammography with abdominal protection, and breast ultrasound is the examination of choice to assess the extension of the injury and guide the percutaneous biopsy. Breast surgery is safe, and can be performed in the three trimesters of pregnancy. It is important to emphasize the importance of the type of surgery according to gestational age. The reference axillary surgery during pregnancy is axillary lymphadenectomy. However, some articles present the safety of the sentinel lymph node biopsy. The use of technetium (Tc-99m) with lymphoscintigraphy is an acceptable technique, with fetal exposure to radiation inferior to the teratogenic limit of 50 mGv. Objective: To emphasize the importance of mammary propedeutics during pregnancy. Case report: 37 year-old patient, primiparous, of 34 weeks, referred a nodule in the right breast for 1 year. She denies having family history of carcinoma. At clinical examination, she presented with turgid breasts, absence of palpable nodules and negative axilla. Current mammography with presence of architectural distortion in the inferolateral quadrant of the right breast, and ultrasound with irregular and spiculated 2 cm nodule , both BIRADS category 5. Percutaneous biopsy showed invasive breast carcinoma of no special type, histological grade 2, and immunohistochemical with positive hormone receptors (estrogen and progesterone receptor with 90%), negative HER2 and Ki 67 of 20%> The conduct was conserving surgery (excision of the breast injury and radio-guided sentinel lymph node biopsy) on the 36th week of pregnancy. The intraoperative assessment of the sentinel lymph node showed presence of macrometastasis and, as a consequence of the exclusion of pregnancy in the ACOSOG Z0011 study, the patient was submitted to axillary lymphadenectomy. The definitive anatomopathological result was invasive breast carcinoma of no special type, histological grade 3, measuring 2.1 cm, and 1 lymph node compromised by macrometastasis of 15 dissected nodes (pT2 pN1a). The multidisciplinary team chose to wait for delivery, from 2 to 4 weeks, and a Cesarean section was performed after 40 weeks of pregnancy. The chemotherapy was scheduled to begin 4 weeks after delivery. The patient was referred to genetic counselling. Conclusions: The treatment of breast cancer during pregnancy is challenging for the multidisciplinary team, which must focus on maternal and fetal well-being. Therapy should be carried out similarly to non-pregnant patients, respecting the procedures that are allowed in each gestational trimester. It is important to mention how essential it is to not delay the treatment, in order to not compromise the patient’s prognosis.

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Sentinel Lymph Node Detection in Contralateral Axilla at Initial Presentation of a Breast Cancer Patient: Case Report

Molecular Imaging and Radionuclide Therapy ◽

10.4274/mirt.91300 ◽

2015 ◽

Vol 24 (2) ◽

pp. 90-93 ◽

Cited By ~ 6

Author(s):

Gülin Uçmak Vural ◽

Ilgın Şahiner ◽

Semra Demirtaş ◽

Hülya Efetürk ◽

Bedriye Büşra Demirel

Keyword(s):

Breast Cancer ◽

Case Report ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Cancer Patient ◽

Breast Cancer Patient ◽

Initial Presentation ◽

Sentinel Lymph Node Detection ◽

Patient Case

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Successful Sentinel Lymph Node Biopsy for Early-stage Breast Cancer in A Patient who Had Undergone Transaxillary Breast Augmentation: A Case Report

Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) ◽

10.4030/jjcs.44.13 ◽

2019 ◽

Vol 44 (1) ◽

pp. 13-20

Author(s):

Masahiro Wada ◽

Akinori Hashiguchi

Keyword(s):

Breast Cancer ◽

Case Report ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Sentinel Lymph Node Biopsy ◽

Breast Augmentation ◽

Early Stage ◽

Lymph Node Biopsy ◽

Node Biopsy ◽

Transaxillary Breast Augmentation

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Chyle leak following an axillary sentinel lymph node biopsy for breast cancer in a patient with superior vena caval thrombosis – a case report and review of the literature

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2018.0074 ◽

2018 ◽

Vol 100 (6) ◽

pp. e147-e149 ◽

Cited By ~ 4

Author(s):

Z Al-Ishaq ◽

S Gupta ◽

MA Collins ◽

T Sircar

Keyword(s):

Breast Cancer ◽

Case Report ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Sentinel Lymph Node Biopsy ◽

Superior Vena ◽

Lymph Node Biopsy ◽

Superior Vena Caval ◽

Chyle Leak ◽

Node Biopsy

Chyle leak is a very rare complication following an axillary lymph node dissection. We report a case of chyle leak following sentinel lymph node biopsy in a patient with breast cancer with superior vena caval thrombosis. To our knowledge, this is the first case report of chyle leakage following axillary sentinel lymph node biopsy. We describe the aetiology, prevention and treatment strategy that can be adopted in these patients.

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Primary ectopic breast cancer of the vulva, treated with local excision of the vulva and sentinel lymph node biopsy: a case report

Surgical Case Reports ◽

10.1186/s40792-017-0343-x ◽

2017 ◽

Vol 3 (1) ◽

Cited By ~ 6

Author(s):

Takayuki Ishigaki ◽

Yasuo Toriumi ◽

Ryouko Nosaka ◽

Rei Kudou ◽

Yoshimi Imawari ◽

...

Keyword(s):

Breast Cancer ◽

Case Report ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Sentinel Lymph Node Biopsy ◽

Local Excision ◽

Lymph Node Biopsy ◽

Node Biopsy ◽

Ectopic Breast

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Sentinel lymph node mapping of a breast cancer of the vulva: Case report and literature review

World Journal of Clinical Oncology ◽

10.5306/wjco.v6.i2.16 ◽

2015 ◽

Vol 6 (2) ◽

pp. 16 ◽

Cited By ~ 6

Author(s):

James Cripe

Keyword(s):

Breast Cancer ◽

Case Report ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Literature Review ◽

Sentinel Lymph Node Mapping ◽

Lymph Node Mapping

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Anaphylactic reaction to patent blue dye during sentinel lymph node biopsy in breast cancer

Mastology ◽

10.29289/259453942020v30s1095 ◽

2020 ◽

Vol 30 (Suppl 1) ◽

Author(s):

Flavio Rocha Gil ◽

Mariane de Melo Silveira ◽

Giovana Vilela Rocha ◽

Plinio Resende de Melo

Keyword(s):

Breast Cancer ◽

Case Report ◽

Lymph Node ◽

Surgical Treatment ◽

Sentinel Lymph Node ◽

Sentinel Lymph Node Biopsy ◽

Lymph Node Biopsy ◽

Blue Dye ◽

Patent Blue ◽

Node Biopsy

Introduction: Sentinel lymph node biopsy is indicated as gold standard in the surgical treatment of initial breast cancer, presenting as a more conservative approach and preventing total lymphadenectomy. Dyes or technetium radiopharmaceuticals can be used to identify the sentinel lymph node. The most used dyes for the identification of the sentinel lymph node are patent blue and isosulfan blue, and, in lower frequency, methylene blue. However, hypersensitivity reactions to blue dye have been described, estimating its prevalence in 0.6%‒2.7%. The clinical status that characterizes the allergic reaction to the dye can range from mild skin changes to the severe condition, with circulatory collapse. Objectives: To present a severe case of allergic reaction to patent blue in a patient submitted to surgical treatment for breast cancer. Method: This is a case report study based on the analysis of medical records and literature review. Case report: T.L.O.M, female, 49-year old woman, white, married, born in Patos de Minas, MG. Patient diagnosed with Breast cancer, T1N0A0, with indication for sentinel lymph node analysis with blue patent and segmental resection of the tumor. ASA 1 pre-anesthetic evaluation, without history of allergy. The patient was submitted to general inhalation anesthesia and subcutaneous injection in the left breast of 2ml of patent blue, followed by massage. During the anesthetic plan, after 40 minutes of surgery, the patient was hypotensive (40x20 mmHg), with low saturation (ETCO2 28), tachycardia (120 bpm), associated with bluish urticariform papules, and major edema in the ear lobes, being immediately assisted with adrenaline bolus, metaraminol, and decadron. The patient became stable, and it was possible to conclude the procedure. Then, she was referred to the intensive care unit, under sedation and intubated due to the risk of laryngospasm. She evolved hemodynamically stable, and was extubated without intercurrences. Conclusions: A severe anaphylactic reaction to patent blue can risk the life of a patient in an unpredictable manner. Considering this case, it is essential that the entire staff involved in the sentinel lymph node biopsy be aware of the possibility of a hypersensitive reaction to the dye, being prepared to recognize and immediately handle the possible repercussions.

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