Sentinel node biopsy for breast cancer under local anesthesia

Abstract

ntroduction: The technique of sentinel lymph node biopsy (SLB) is the gold standard method to pre- dict the axilar status for breast cancer. However, the intraoperative evaluation of the sentinel lymph node has disadvantages. Some services, attempting to minimize these disadvantages, have begun to carry out the sentinel lymph node biopsy under local anesthesia. The aim of this prospective study is to demonstrate our experience in the sentinel lymph node biopsy, which was carried out under local anesthesia, and this procedure’s feasibility. Methods: This is a prospective study that targets the patients enrolled in the Hospital de Câncer de Barretos, suffering from breast cancer. The patients underwent sentinel lymph node biopsy under local anesthesia from January to November, 2009, according to the established protocol. Results: From January to December, 2009, 41 research procedures were performed of the sentinel lymph node under local anesthesia. During the procedure under local an- esthesia, the dissected average was 2.4 (0-5) lymph nodes. In four cases, the result of the resected pathological lymph nodes was positive; in one case for macrometastases; and the remaining three for micrometastases. In all patients, the procedure was performed uneventfully, using doses of anesthetic below their toxic levels. All patients survived without any complications intra- or postoperatively. Conclusion: The sentinel lymph node biopsy under local anesthesia is a feasible procedure that brings little discomfort to the patient, and should be indicated whenever possible. It has many advantages, when comparing with the technique under general anesthesia.