Молодежный инновационный вестник

2415-7805

Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации

10283

Conference Proceedings

On the issue of using the biopsy technique of signaling lymph nodes in breast cancer in patients with GBUZ TOKOD

Maximov

Dmitry Anatolyevich

PhD.ammorozovv@gmail.comhttps://orcid.org/0000-0001-5690-4277Shepel

Evgeniy Viktorovich

PhD.ammorozovv@gmail.comhttps://orcid.org/0009-0004-6079-7493Utkina

Valeria Antonovna

ammorozovv@gmail.comhttps://orcid.org/0009-0000-4449-4995Utkina

Anastasia Antonovna

ammorozovv@gmail.comhttps://orcid.org/0009-0006-8695-3444Morozov

Artem Mikhailovich

PhD., Associate Professor of the Department of General Surgeryammorozovv@gmail.comhttps://orcid.org/0000-0003-4213-5379

Tver State Medical University

30062025

1416972

20022025

21022025

2025

In the statistics of diseases among women caused by oncological aspects, breast cancer is a leading group worldwide. According to the American Cancer Society, the incidence of breast cancer continues to increase by an average of 1% between 2012-2021. Goal. Analysis of the technique of biopsy of signaling lymph nodes in breast cancer in patients with GBUZ TOKOD. Materials and methods. In this work, the object of study was the clinical cases of patients of the Tver Regional Clinical Oncological Dispensary of the Oncological department No. 4 (Department of breast and Skin tumors). Results. In the first case, using the technique of signal lymph node biopsy (BSLU), it was possible to preserve the lymph nodes, while avoiding complications such as lymphostasis, lymph outflow disorders along the cephalic vein, and others. In the second case, it was also possible to preserve the axillary lymph nodes and perform an organ-preserving operation, which minimized the occurrence of complications in the postoperative period. Conclusion. The BSLU method allows surgeons and oncologists to assess the status of lymph nodes, while minimizing the amount of surgery and reducing the risk of postoperative complications.

breast cancerbiopsy of signaling lymph nodessentinel nodeindocyanine green (ICG)oncology

рак молочной железыбиопсия сигнальных лимфатических узловсторожевой узелиндоцианиновый зеленый (icg)онкология

Introduction. In the statistics of diseases among women caused by oncological aspects, breast cancer is a leading group worldwide. According to the American Cancer Society, the incidence of breast cancer continues to increase by an average of 1% between 2012-2021. Surprisingly, this indicator is growing to a greater extent among women under the age of 50 and amounts to 1.4% annually, among women over 50 this indicator is slightly less than 0.7%. Breast cancer accounts for 23% of the overall incidence of cancer among women. In Russia, the rate of breast cancer is slightly lower, accounting for 22.4% of the total incidence of malignant neoplasms among women in Russia [1,2]. Since this problem is widespread, and surgical treatment until recently was radical in nature, the removal of the affected organ and all groups of axillary lymph nodes, regardless of the affected and not, its weight is quite heavy both psychoemotionally and as frequent complications. Thus, patients often needed serious psychoemotional help after such operations, and complications often required additional treatment [3,4]. With the development of science and medicine in modern times, it has become possible to diagnose breast cancer at an early stage without massive involvement of the lymph nodes. In such cases, a biopsy of the signaling (sentinel) lymph nodes (BSLU) makes it possible to accurately determine the stages of the lymph nodes, which is important both for the prognosis (early stage of the disease) and for treatment (for regional disease control) in patients with breast cancer [5]. The signaling (sentinel) lymph node is the first lymph node draining a specific area of the breast, including the tumor bed. Thus, this is the first lymph node affected by metastases, and its biopsy and pathology assessment will help to avoid complete dissection of the axillary lymph nodes. Thus, BSLU reduces the risk of a decrease in the quality of life in the early and late postoperative period [6,7]. Having a high diagnostic value, a biopsy of signaling lymph nodes helps in treatment planning. With a positive result, patients can be referred for additional therapy, while with a negative result, organ-preserving surgery is possible. In recent years, various technologies have been used, including the use of radioisotopes and fluorescent dyes, which improves accuracy and eliminates operational risks. This approach has significantly changed the tactics of breast cancer treatment, minimizing interventions and improving treatment outcomes, which confirms its importance in oncology [8,9]. The purpose of the work was to analyze the technique of biopsy of signaling lymph nodes in breast cancer in patients with GBUZ TOKOD. Materials and methods of research. Modern domestic and foreign scientific sources were studied, the field of research of which concerned the issue of the use of signal lymph node biopsy techniques in breast cancer. Also in this work, the object of study was the clinical cases of patients of the Tver Regional Clinical Oncological Dispensary of the Oncological department No. 4 (Department of breast and Skin tumors). The results of the study. Two cases of treatment of patients with breast cancer were analyzed. In both cases, the BSLU technique was used. Patient R., 50 years old, discovered the formation of the right breast on her own. First, as a result of the oncoconsillium, chemotherapy was prescribed. Surgical intervention was chosen as the second stage of treatment. Radical breast resection with "B" mammoplasty (according to Redno) and BSL was performed. The IC-Flow device performed a revision of the "luminous" lymph nodes, as well as palpation and visual hyperplastic lymph nodes. Rapid examination of the removed "signaling" lymph nodes revealed no data for breast cancer metastases. Established diagnosis: C50.4 Cancer of the right breast. The tumor is 1.5 cm. Therapeutic pathomorphosis according to RCB 1 (minimal residual tumor). Patient P., 61 years old. The tumor was discovered at the medical examination. Radical breast resection with mammoplasty (lumpectomy) and BSLU was performed. The tumor is 2.5 cm. After dissection of subcutaneous tissue and superficial fascia, the IC-Flow device revealed "signal" lymph nodes, followed by their removal. An express examination of the removed "signaling" lymph nodes revealed no data for breast cancer metastases. According to the results of the pathological and anatomical examination of the surgical material obtained by biopsy after surgery, the following data were obtained: pT1pN0 L1V0Pn0. Thus, in the first case, using the BSLU technique, it was possible to preserve the lymph nodes, while avoiding complications such as lymphostasis, impaired lymph outflow along the cephalic vein, and others. In the second case, it was also possible to preserve the axillary lymph nodes and perform an organ-preserving operation, which minimized the occurrence of complications in the postoperative period. Conclusions. The advantage of BSL in breast cancer lies in its ability to provide early and accurate detection of metastasis, which is critical for choosing treatment tactics. This method allows surgeons and oncologists to assess the status of lymph nodes, while minimizing the amount of surgery and reducing the risk of postoperative complications. It helps to avoid unnecessary dissections and prevents the development of lymphedema. An important aspect is that this method not only increases the accuracy of diagnosis, but also significantly improves the quality of life of patients, allowing them to maintain the functionality of the upper extremities.

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