İNTRAOPERATİF KONSÜLTASYONUN MEME CERRAHİSİ VE SENTİNEL LENF NODU BİYOPSİSİNDEKİ ÖNEMİ

Yıl 2017, Cilt: 1 Sayı: 3, 99 - 106, 18.12.2017

Ferah Tuncel Daloğlu , Emre Çağatay Köse Ahmet Dağ

Öz

Amaç: ROLL mastektomi materyallerinde cerrahi sınır
değerlendirmesi ve sentinel lenf nodu biyopsisinin (SLNB) intraoperatif
konsültasyon ve frozen kesit ile değerlendirilmesinin güvenilirliği ve
kullanılabilirliğinin tespit edilmesi. 

Yöntemler: 1 Temmuz 2015 – 1 Ağustos 2017 tarihleri
arasında laboratuarımızda raporlanan mastektomi materyalleri dökümante edilmiş,
frozen çalışılan olgular belirlenmiştir. Frozen raporları ile kalıcı kesit
raporları karşılaştırılarak SLNB durumu ve ROLL mastektomi materyallerinde
cerrahi sınır durumu arasındaki uyum ve tedaviye katkısı değerlendirilmiştir. 

Bulgular: Belirlenen tarihler arasındaki 1278 mastektomi
olgusunun 657 tanesi ROLL mastektomidir. Bunların 30 tanesinde intraoperatif
cerrahi sınır değerlendirilmesi yapılmış; 1 tanesinde cerrahi sınırın pozitif
olduğu, 6 tanesinde tümörün cerrahi sınıra 1 mm’den daha yakın görülmüş
olduğundan re-eksizyon yapılmıştır. Sentinel lenf nodu ise 233 olguda frozen
kesitler ile değerlendirilmiş, %28’inde (n=72) metastaz görülmüş ve bu
olguların tamamına aksiller diseksiyon yapılmıştır. 

Sonuç: Meme kanserli kadınlarda meme koruyucu cerrahi
(MKC) operasyonlarında frozen değerlendirme, daha iyi cerrahi sınır negatifliği
sağlar ve re-eksizyon operasyonlarını azaltır. Aynı şekilde SLNB’nin frozen
değerlendirmesi, olası aksiller diseksiyon operasyonu sıklığını azaltır. Bu
nedenle her iki yöntem de güvenilir ve önerilebilirdir.  

Anahtar Kelimeler

Sentinel lenf nodu, ROLL, Frozen

IMPORTANCE OF INTRAOPERATIVE CONSULTATION IN BREAST SURGERY AND SENTINEL LYMPH NODE BIOPSY

Öz

Objective: Evaluation of the surgical margins in ROLL mastectomy
materials, and assessment of the safety and the usability of the
intra-operative consultation and frozen section for the evaluation of the sentinel
lymph node biopsy (SLNB).  

 

Methods: Mastectomy materials reported in our
laboratories between July 1, 2015 and August 1, 2017 have been documented, and
the cases with frozen sections have been detected. Frozen section reports, and
permanent section reports were compared to evaluate the conformity between the SLNB
situation and the ROLL mastectomy surgical margins’ situation, and their
contribution to the treatment.  

 

Results: Out of the 1278 mastectomy cases in the
described time interval, there were 657 ROLL mastectomies. In 30 of them intraoperative
surgical margin assessment has been done. Because in one of them the surgical
margin was positive, and 6 of them had tumor closer than 1 mm to surgical
margins, re-excision had to be done. Sentinel lymph nodes were evaluated with
frozen section in 233 of the cases, metastasis was seen in 28% (n=72) of them
and axillary dissection was done to all of them. 

 

Conclusion: In women undergoing breast
conserving surgery for the treatment of the breast cancer, frozen section
evaluation provides better surgical margin negativity and reduces the need for
the re-excision operations. Similarly, frozen section evaluation of the SLNB
decreases the frequency of the axillary dissection reoperations. 

Anahtar Kelimeler

Sentinel Lymph Node, ROLL, Frozen

Kaynakça

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