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  • If you have been diagnosed with breast cancer your doctor may want to perform

  • a sentinel lymph node biopsy there are three reasons to check lymph nodes

  • for any cancer but for breast cancer the reasons are to stage the patient

  • appropriately so we can predict

  • survival and outcome The second reason then is to determine treatment

  • based on that stage

  • of a patient and the third reason is to

  • remove cancer cells and decrease the amount tumor

  • by actually physically removing the lymph nodes that may harbor tumor cells

  • Our body contains two separate systems for transporting fluids

  • The circulatory system and the lymphatic system The more familiar circulatory

  • system transports blood

  • The lymphatic system is composed of lymphatic vessels and lymph nodes which

  • are collections

  • of grape like structures The lymphatic system

  • transports lymph, a colorless fluid and lymphocytes

  • specialized cells of the immune system Like small streams merging to form a

  • river

  • small lymph ducts merge into increasingly larger lymph vessels

  • that ultimately empty into the bloodstream the lymphatic system serves

  • many purposes including

  • the filtration of foreign objects like bacteria, fluid transport

  • and the initiation of the immune response the lymphatic system is also where

  • cancer cells can drain

  • collect and gain access to other parts of the body

  • Lymphatic fluid actually bathes the breast and then drains through lymphatic channels much

  • as

  • rivers would drain into a larger body of water

  • so these channels then drain into one or two or three or four lymph nodes

  • and with certain die injecting techniques we're able to identify those

  • important drainage lymph nodes

  • and the theory behind sentinel lymph node is if we check

  • those first and they do not harbor any tumor

  • if there's no tumor in those lymph nodes then we don't have to remove

  • more lymph nodes in that particular patient

  • The technique of sentinel lymph node mapping involves injecting a dye

  • and one can either use two different types of dye

  • a radioactive dye called technetium sulfur colloid

  • and/or a blue dye called isosulfan blue

  • or methylene blue It's very appropriate to use one or two

  • or both it just depends on that particular surgeons training and

  • abilities

  • to find the sentinel lymph node In the blue dye technique

  • a small amount of blue dye is injected into the breast near the tumor

  • the dye spreads rapidly through the region after five to 10 minutes

  • it will have traveled to the lymphatic vessels in the area A blue stained vessel

  • is found and followed until the lymph nodes are reached

  • The blue stained nodes closest to the tumor are the sentinel nodes

  • The sentinel nodes are then removed and examined for the presence of cancer

  • cells

  • In the radioactive colloid technique,

  • a small amount of radioactive material is injected into the breast

  • 4 to 6 hours before surgery After sufficient time had elapsed

  • A surgeon uses a special handheld detector to identify the areas

  • emitting high levels of radiation These areas contain lymph nodes that have taken

  • up larger amounts of the radioactive material These notes with high levels of

  • radiation

  • are called hot nodes and sometimes that is done the day before or the day of

  • surgery

  • so the patient would have to come in the day before perhaps

  • and get that injection which would be injected

  • around the tumor or around the nipple area or a complex

  • The amount of radioactive dye that we use for this procedure

  • is very minimal and it's quite safe to be around other people and being around

  • your children

  • traveling in your car on the bus and be next to people it's very similar to

  • the amount

  • used in a bone scan

  • In the operating room after we

  • identified the lymph nodes and removed them some surgeons will send them right

  • away to pathology to examine

  • by a frozen section to see if there are tumor cells

  • in those lymph nodes because if there are tumor cells in the lymph nodes then

  • again some surgeons that same day

  • will go ahead and perform a complete axillary lymph node dissection

  • in order to determine whether they're other lymph nodes involved

  • in that particular patient The side effects of sentinel lymph node biopsy are usually

  • limited to tenderness around the area of surgery that should subside with time

  • other more serious side effects that can occur include numbness,

  • limited range of motion, infection and Lymphedema

  • these side effects are less common but they may occur and can have lasting

  • implications on your daily life For more information on breast cancer please go

  • to www.cancerquest.org

  • www.cancerquest.org

If you have been diagnosed with breast cancer your doctor may want to perform

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B2 中高級

哨兵淋巴結活檢術 (Sentinel Lymph Node Biopsy)

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    keep seeing 發佈於 2021 年 01 月 14 日
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