Removing only metastasized lymph nodes
Have shared their experience with Irkutsk colleagues: the head of the microsurgical group, candidate of medical sciences, surgeon-oncologist of the highest category, SSC FMBC named after A.I. Burnazyan Arkady Aksenenko, radiologist of the highest category of the radiological department No. 3, GAUZ TO “Multipurpose Clinical Medical Center" Medical City” (Tyumen) Ruslan Khusnutdinov, candidate of medical sciences, oncologist, thoracic surgeon, plastic surgeon, doctor of the highest qualification category, head of the mammology department, “Nizhny Novgorod Regional Clinical Oncology Center” (Nizhny Novgorod) Alexey Vorontsov, candidate of medical sciences, oncologist of the highest qualification category, head of the oncological department of reconstructive and plastic surgery, GBUZ SK “Stavropol Regional Oncological Center” (Stavropol) Elbrus Baichorov.
The main theme of the master class was a modern method for identifying affected lymph nodes in breast cancer. This technology makes possible avoiding operations that needlessly mutilate a woman. Earlier in case of metastasis, it was customary to remove all axillary lymph nodes, but today it has become unnecessary. After all, large invasive operations lead to various severe complications, such as erysipelas and lymphostasis of the upper extremities: it is manifested by severe edema, due to which one or both hands increase greatly in volume (another name for this disease is elephantiasis), may lose mobility, and at the irreversible stage, tissue necrosis occurs. This can be avoided with a biopsy of the sentinel lymph node, in which the introduction of a special radiopharmaceutical helps to clearly identify specific lymph nodes containing micrometastases and remove only them, without touching those not affected by metastasis.
“This technology is not among the newest: nowdays it is simply becoming available to Russian doctors due to cheaper production of radioisotopes. It can also be used for some other localizations. However, today breast cancer occupies one of the first positions among all cancer localizations. Moreover, this disease is rapidly “getting younger”: if before it was almost impossible to meet a patient at the age of 17-18, now such cases are recorded annually,”comments Arkady Aksenenko.
So, in the near future, the doctors of the center plan to adopt this technique. The information received during the master class will be of great help, especially since its program included both lectures and practical work in operating rooms: five operations were performed in a day.