Localização radioguiada de lesões mamárias impalpáveis orientada por ressonância magnética e pesquisa simultânea de linfonodo sentinela

• Ano de defesa: 2015
• Autor(a) principal: Docema, Marcos Fernando de Lima [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: breast diseases; magnetic resonance imaging; radionuclide imaging; sentinel lymph node biopsy; doenças mamárias; imagem por ressonância magnética; cintilografia; biópsia de linfonodo sentinela
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=3172698; https://repositorio.unifesp.br/handle/11600/46356

Background: Radio-guided occult lesion localization is a valid technique for the diagnosis of suspicious non-palpable lesions. Here we determine the feasibility of pre-operative localization of occult suspect non-palpable breast lesions using radio-guided occult lesion localization, as well as for identifying the sentinel lymph node. Methods: This is a descriptive study of data collected retrospectively. Pre-operative mapping of 34 breast lesions in 25 patients suspected of being malignant was performed using conventional imaging methods with a magnetic resonance imaging-guided radiopharmaceutical injection. Results: The mean time required to perform the localization was 25 minutes. After resection of the lesions using a gamma probe, malignancy was confirmed in fifteen patients (60.0%), with nine invasive ductal carcinomas, two invasive lobular carcinomas, and four in situ ductal carcinomas The resection was confirmed by the complete removal of the radioactive material. The pathologic results and images were concordant in all but two cases, which were submitted for new magnetic resonance imaging examinations and surgery that confirmed the malignancies. Of the 15 patients with confirmed malignancies, 10 had sentinel lymph node resection. Of these, eight were negative for metastasis, one had micro metastasis and one had confirmed metastasis. Three patients had full axillary node dissection, with metastasis found in only one. No side effects were observed with magnetic resonance-guided radiopharmaceutical injection. Conclusions: The sentinel node occult lesion localization technique is a simple, reproducible and effective alternative approach to occult lesions compared to other methods, such as mammotomy and the hook-wire localization technique, for mapping suspect breast lesions and identifying lymph node metastasis.