Breast cancer is the number one cancer among women in Hong Kong. Breast cancer in the middle and late stage has spread to the axillary lymph nodes, so it is necessary to perform axillary lymph node dissection during the operation, and remove the affected lymph nodes; about 20% of the patients will have different symptoms later. Degree of edema affects life. Therefore, in recent years, for breast cancer cases that have not spread in the early stage, only the sentinel lymph nodes are removed to reduce sequelae.
Dr. Hong Jiawei, a specialist in surgery, pointed out that in addition to the smaller tumor size, early breast cancer has not spread to the nearby axillary lymph nodes. Removal of axillary lymph nodes will not only not help the treatment, but will also have long-term effects. “Axillary lymph nodes not only manage the lymph of the breast, but also the lymph of the upper limbs will pass through the axillary lymph nodes and then lead to the heart. Once the axillary lymph nodes are damaged, lymphedema may occur in the arms.”
Sentinel lymph node test for evaluation
Generally speaking, about 20% of patients experience varying degrees of edema after undergoing axillary lymph node removal surgery, and this is a long-term problem. There is currently no effective drug or surgery to cure this condition. For patients with early breast cancer, if the “sentinel lymph nodes” can be identified and tested, there is a chance to avoid unnecessary resection.
Hong Jiawei said that the sentinel lymph node is the first lymph node eroded by cancer cells. “We can use the sentinel lymph node test to assess whether the breast cancer has spread to the axillary lymph nodes, evaluate the stage of the tumor, and examine whether the patient needs to receive other treatments after surgery. , including chemotherapy and radiotherapy, to reduce the risk of recurrence.”
The risk of edema is greatly reduced
As long as no lymph node is found to be affected during the preoperative examination, the patient can undergo “sentinel lymph node examination” to remove the sentinel lymph node that was first eroded by cancer cells for immediate frozen section test, and then decide whether further treatment is needed Axillary lymph node removal surgery. If the test shows that the sentinel lymph node is not invaded by cancer cells, the patient does not need to undergo axillary lymph node dissection, and the risk of arm edema can be greatly reduced from 20% to less than 2%.
or only single trace object potion
To do a random check of the sentinel lymph nodes, the doctor needs to inject the tracer potion (Tracer) into the breast before the operation. The radioisotope potion and the blue potion are two traditional tracer potions. It is most effective to use it at the same time and successfully find out Sentinel lymph nodes have a 97% chance. Hong Jiawei reminded, “Not all hospitals have departments for storing and processing radioactive medicines, so sometimes doctors can only use blue medicines to find out the sentinel lymph nodes with the naked eye. The success rate is generally lower than using double tracer medicines.”
Magnetic Potion No Radiation
The newer method is to use the magnetic tracer potion (Magnetic tracer). The main components are fine metal molecules, and there is no radiation. The principle is to use the instrument to detect the magnetic field released by the metal molecules, find out the sentinel lymph nodes and remove them. In addition to no radiation, the magnetic tracer potion is also more flexible in the arrangement of the operation. After the injection, the operation can be performed at any time within 28 days; it does not need to be injected like radioisotopes, and can only be injected on the day of the operation. “Not all patients are suitable for the new magnetic medicine. If there are metal implants in the upper chest, such as artificial heart valves, pacemakers, etc., it may affect the detection of magnetic fields. In addition, on the surface of the injected skin, there may be a small amount of Metal molecules remain, making the skin grayish, but these metal molecules are harmless to the human body. Patients should consult their doctors in detail before making a choice.” Hung Ka-wai added.
Originally published on AM730 https://www.am730.com.hk/Health/New technology to find sentinel lymph-help reduce hand swelling after breast cancer surgery/363216?utm_source=yahoorss&utm_medium=referral
