Nonliposuction Endoscopic Sentinel Lymph Node Biopsy Through the Periareolar Incision

Abstract

Background. Sentinel lymph node biopsy (SLNB) has been an alternative to axillary lymph node dissection as a standard procedure for breast cancer patients with clinically negative lymph nodes. Endoscopic technique has been developed for over 20 years but remains to be mastered by a slice of surgeons. Suction and squeezing in the liposuction endoscopic procedures may increase risk of local recurrence and metastasis. In this study, we present our method of SLNB procedure through the periareolar incision which improves the shape of the breast-conserving surgery. Patients and Procedures. Twenty-eight breast cancer patients with clinically negative lymph nodes received this procedure. Methylene blue dye and technetium-99m sulfur colloid were used to be the tracker of sentinel lymph nodes (SLNs). Periareolar incision was the main surgical technique. The STORZ HD endoscopic system and some special instruments were used during the operation. Results. SLNs can be accurately located and biopsied under an endoscope without additional incisions. The SLNs detection rate, sensitivity, and false-negative rate are 88%, 80%, and 11.1%, respectively. And, the complications such as paresthesia and upper limb lymphedema are similar compared with traditional breast-conserving surgery (10.7% vs 9.8% and 7.1% vs 7.8%). Conclusion. Endoscopic technique can be used to accurately assess the status of SLNs in patients with breast cancer. Nonliposuction endoscopic breast-conserving surgery is one of the safe and alternative surgical procedures for early breast cancer.

Comparison of single-pore non-liposuction near-infrared laparoscopy with conventional open surgery for axillary sentinel lymph node biopsy in patients with early breast cancer: a single-center, small-sample retrospective study

“…Is it possible to perform an endoscopic sentinel lymph node biopsy (SLNB) using a non-liposuction method? We reviewed domestic and foreign literature and found several reports on this topic; however, most involved traditional endoscopic and single dyeing methods [ 8 , 9 ], which is contrary to the fact that pigment combined with the fluorescence double dyeing method is widely used in domestic clinical practice to reduce the false negativity rate of SLNB [ 10 ]. In addition, the traditional endoscope has no near-infrared (NIR) fluorescence function, which limits its application as this form of fluorescence is used as a tracer in domestic mainstream SLNB.…”