A New Method of Predicting of the Preoperative Effectiveness of Lymph Node Dissection in Patients with Breast Cancer

Abstract


Relevance About 60% of patients with breast cancer to beginning of the examination and treatment have affected regional lymph node metastases, and 10% of patients with histologically pN0, additional immunohistochemical study reveals presence of micrometastases. On the other hand, low probability of hitting zones regional metastasis, based on data complementary methods of examination, would give the opportunity to evaluate effectiveness the proposed lymphadenectomy. Thus, the identification of regional lymph system in patients with primary operable breast cancer with no visualized on preoperative regional lymph nodes (N0) is an important task. The purpose of the study To improve effectiveness of preoperative prediction lymphodissection in patients with breast cancer. Materials and methods In line with the study goals and objectives were examined and treated 83 patients with primary breast cancer who were treated at the Clinic GBOU DPO RMAPO Health Ministry of Russia, Moscow and MSH Road Clinical Hospital Art. Voronezh-I JSC "Russian Railways". In addition to standard screening patients underwent planar scintigraphy mammary glands and organs of the chest with 99mTc-technetril. All data about patients, including the rating of the medical history were collected and combined into one table in Microsoft Excel format for further analysis. Results and their discussion As a result of multivariate statistical data analysis of patients in the study was a mathematical model consisting of three classifying functions, allowing to predict lymph node metastases in breast cancer. In this case, the data series are calculated each patient in three classifying functions and maximum value in one of the features include the patient to the appropriate group effectiveness lymphadenectomy. On the basis of the developed mathematical model was established and registered computer program "Preoperative evaluation of lymphadenectomy effectiveness " (registration number - 50200901168 from 12.02.2010 years), which allows preoperative patient referred to one of three groups of breast cancer with a certain percentage of probability.Based on the data generated conclusions. Conclusion The results indicate that the developed method of forecasting the number of metastatic regional lymph nodes in the preoperative stage may be included in a clinical algorithm of examination of patients with breast cancer. Specify the place planar 99mTc-MSH with technetril in the general algorithm of diagnosis of breast cancer. This study should be carried out to improve the preoperative diagnosis of breast cancer in patients with N0 or in case of questionable status of regional lymph nodes to evaluate the effectiveness of the forthcoming lymphadenectomy. In the future, the planar 99mTc-MSH with technetril help identify preoperative group of patients at low risk of metastasis to regional lymph nodes. This technique, combined with supporting biopsy "sentinel" lymph node may refuse to allow a certain number of diagnostic lymphadenectomy. Key words Lymphadenectomy, breast cancer, preoperative prediction

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Author for correspondence.
Email: author@vestnik-surgery.com
MD, Prof., Head of department of oncology, radiation therapy and radiodiagnosis of the N.N. Burdenko Voronezh State Medical Academy

Russian Medical Academy of Postgraduate Education, 2/1 Barrikadnaia Str., Moscow, 125993, Russian Federation

Email: author@vestnik-surgery.com
Ph.D., oncologist of clinic of the Russian Medical Academy of Postgraduate Education

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Email: author@vestnik-surgery.com
Ph.D., associated prof. of department of oncology, radiation therapy and radiodiagnosis of the N.N. Burdenko Voronezh State Medical Academy

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Email: author@vestnik-surgery.com
Ph.D., assistant of department of general surgery of N.N. Burdenko Voronezh State Medical Academy

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Email: author@vestnik-surgery.com
MD, doent assistant Professor of instrumental methods of diagnosis EITI N.N. Burdenko Voronezh State Medical Academy

MSH "Road Hospital at the Voronezh Station - 1 JSC "RZD", 2 Zdorov'ia Str., Voronezh, 394024, Russian Federation

Email: author@vestnik-surgery.com
Ph.D., head of oncological department of "Road clinical hospital on the station Voronezh-1 of JSC RZD

MSH "Road Hospital at the Voronezh Station - 1 JSC "RZD", 2 Zdorov'ia Str., Voronezh, 394024, Russian Federation

Email: author@vestnik-surgery.com
sugery oncological department of "Road clinical hospital on the station Voronezh-1 of JSC RZD

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Email: author@vestnik-surgery.com
MD, Prof., Head of department of general surgery of N.N. Burdenko Voronezh State Medical Academy

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