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Revista de Oncología

, Volume 6, Issue 3, pp 122–129 | Cite as

Controversias en la biopsia del ganglio centinela de la mama

  • A. Moreno Elola
  • J. M. Román Santamaría
  • J. Ruiz Rodríguez
  • A. González Mate
  • R. Delgado Bolton
  • M. N. Cabrera Martín
  • F. Sánchez-Alonso
  • A. Aguilar Olivan
  • V. Furio Bacete
  • A. Aguilar Olivan
Revisiones

Resumen

La biopsia del ganglio centinela en el carcinoma de mama fue descrita por A. Giuliano en el año 1994. En la actualidad, la mayor parte de los expertos en Patología Mamaria reconocen que la biopsia del ganglio centinela permite la estadificación axilar con un mínimo porcentaje de falsos negativos, y prácticamente sin morbilidad.

A pesar de las cuestiones discutidas tanto en el seno de la Reunión Nacional de Consenso sobre Ganglio Centinela y Cáncer de mama organizada por la Sección de Patología Mamaria de la Asociación Española de Cirujanos en octubre de 2000 como en la organizada por la Sociedad Española de Oncología Quirúrgica (SEOQ, miembro de la FESEO) en este mismo período, no todos los investigadores están de acuerdo en ciertos puntos controvertidos, tanto en cuanto a la técnica como en relación con las indicaciones.

En este artículo se discuten ciertos temas controvertidos como: la necesidad de una curva de aprendizaje clásica antes de la incorporación de la técnica del ganglio centinela a la clínica rutinaria, métodos de localización del ganglio centinela, consideraciones técnicas en la punción del radiotrazador, procedimientos diagnósticos que optimizan el resultado de la biopsia del ganglio centinela, biopsia del ganglio centinela después de neoadyuvancia, biopsia del ganglio centinela en la mastectomía profiláctica, biopsia de la cadena mamaria interna, estudio intraoperatorio del ganglio centinela y micrometástasis del ganglio centinela.

Palabras clave

biopsia del ganglio centinela carcinoma de mama temas controvertidos 

Controversies surrounding sentinel node biopsy of the breast

Abstract

Sentinel node biopsy in breast cancer was first described in 1994 by Giuliano and, currently, is an integral part of the surgical management of the disease. As indications spread, new issues concerning special cases that can profit from this surgery are arising and are the cause of controversy. A national consensus meeting on sentinel node biopsy for breast cancer held in October 2000 and organised by the Spanish Society for Surgical Oncology (SSSO) in conjunction with the Spanish Association of Surgeons generated some interesting conclusions. Not all the participants were in agreement with respect to certain aspects of technique, and of clinical indications.

In the present article the points discussed are: need for a training procedure before incorporating this technique into routine clinical practice, methods of site location of sentinel nodes, technical considerations of radio-colloid injection, diagnostic procedures prior to sentinel node biopsy, indications for axillary lymph node dissection following a positive result indicating malignancy in sentinel node frozen section, sentinel node biopsy post-neoadjuvant treatment, prophylactic mastectomy, biopsy of the internal mammary channel, intra-operative assessment of sentinel nodes and micro-metastatic disease in sentinel nodes.

Key words

sentinel node biopsy breast cancer controversial issues 

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Copyright information

© FESEO 2004

Authors and Affiliations

  • A. Moreno Elola
    • 1
  • J. M. Román Santamaría
    • 1
  • J. Ruiz Rodríguez
    • 1
  • A. González Mate
    • 2
  • R. Delgado Bolton
    • 2
  • M. N. Cabrera Martín
    • 2
  • F. Sánchez-Alonso
    • 1
  • A. Aguilar Olivan
    • 1
  • V. Furio Bacete
    • 3
  • A. Aguilar Olivan
    • 1
  1. 1.Departamento de Obstetricia y GinecologíaHospital San CarlosMadridEspaña
  2. 2.Servicio de Medicina NuclearHospital San CarlosMadridEspaña
  3. 3.Servicio de Anatomia PatológicaHospital San CarlosMadridEspaña

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