The Clinical Value For Predicting The Status Of Axillary Lymph Node Of Sentinel Lymph Node Biopsy In Breast Cancer

Mammary cancer surgery has a history of more than 100 years.During this time ,human being has been keeping fmgting with mammary cancer .Mammary cancer suegery exeperience.lt stepped from extended radical mammary,radical excision, modified radical mammary to reserve mastectomy for mammary cancer surgery.However,many epidemiologies displayed that mammary cancer has rised to top one of female malignant tumor and secondary in death rate . During recent years, incidence rate of mammary cancer has been still to remain rising .Both domestic and ex-domestic reseach domain are very active and with quickly progressing .With the understanding for mammary cancer is still developing, radiotherapy and chemotherapy are still progressing and the idea that mammary cancer is a total body disease is established step by step,operation is developing toward micro-wounded ,especially for earlier period mammary cancer,although operation is still main method to therapy mammary cancer .Reserve mastectomy becomes a great succeed during the history of mammary cancer surgery,perfects the quality of patients'life.In 1977,Cabanas set up the theory of sentinel lymph node(SLN).In 1993,firstly,Krag reported SLND in the therapy of mammary cancer.In 1994,Giuliano reported SLND with dye. With the developing of SLND, people started to discuss whether the tradition radical excision of axillary lymph nodes is necessary in mammary cancersurgery.From 1996 to today ,SLND has become the hot spot in reseach of mammary surgery.From June 2001 to June 2002,forty women needed mammary cancer operation are included inthis study.Using methylene blue dyeing method to study the clinical significance of SLND.And discuss the localization for SLND,method of stain, occasion of operation,pathologic diagnosis and the control of false-negative et al in sentinel lymph node biopsy .The results of our reseach indcates that the SLNs were identifiedin 35 of 40 patients with a detection rate of 87. 5%.SLN of 34 patients ((predict accuracy is 97. 1%) could predict axillary lymph node transfering accurately.false-negative rate is 2. 9% ,total sensitivity is 94. 7%,specificity is 100%,and total positive predictive value and negative predictive value are 100% and 94. l%.It's similar with result of domestic and ex-domestic reseach.And by IHC,we measure c-erbB-2 in 40 patients with breast cancer. We think, in earlier period mammary cancer SLND could take the place of classic radical excision of axillary lymph nodes.But it requires large scale clinical test ,the comparison with the classic radical excision of axillary lymph nodes .Before enter clinical application stage ,case accumulation is needed.In addition ,for SLND itself,the location,detection and diagnosis technique of lymph node is waiting for consummate and improvement .With overcome deficiency by new emerging PET technique ,SLND might become the new hot spot of investigation.