Gezielte Entfernung axillärer Lymphknoten nach Kohlenstoffmarkierung bei Patientinnen mit primär systemisch behandeltem Mammakarzinom

Steffi Hartmann; Angrit Stachs; Thorsten Kühn; Jana de Boniface; Maggie Banys-Paluchowski; Toralf Reimer

doi:10.1055/a-1782-3342

TumorDiagnostik & Therapie, Table of Contents

TumorDiagnostik & Therapie 2022; 43(03): 197-203
DOI: 10.1055/a-1782-3342

Thieme Onkologie aktuell

Gezielte Entfernung axillärer Lymphknoten nach Kohlenstoffmarkierung bei Patientinnen mit primär systemisch behandeltem Mammakarzinom

Targeted Removal of Axillary Lymph Nodes After Carbon Marking in Patients with Breast Cancer Treated with Primary Chemotherapy

Steffi Hartmann

¹Klinik für Gynäkologie und Geburtshilfe, Rostock, Universitätsklinikum Rostock, Rostock, Germany

,

Angrit Stachs

²Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Rostock, Rostock

,

Thorsten Kühn

³Gynaekologie, Klinikum Esslingen, Esslingen, Germany (Ringgold ID: RIN15004)

,

Jana de Boniface

⁴Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Schweden

⁵Department of Surgery, Capio St. Göranʼs Hospital, Stockholm, Schweden

,

Maggie Banys-Paluchowski

⁶Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck

⁷Medizinische Fakultät der Heinrich-Heine-Universität Düsseldorf, Düsseldorf

,

Toralf Reimer

⁸Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Rostock, Rostock

› Author Affiliations

Abstract

Zusammenfassung

Die Markierung und gezielte Entfernung initial suspekter axillärer Lymphknoten bei Mammakarzinompatientinnen, die eine primäre Systemtherapie erhalten und anschließend klinisch und/oder bildgebend keine suspekten Lymphknoten mehr aufweisen, wird aktuell sowohl in Deutschland als auch international als Alternative zur kompletten axillären Lymphknotendissektion diskutiert und praktiziert. Hierzu wird derzeit die Tätowierung der suspekten Lymphknoten mit hochgereinigter Kohlenstoffsuspension im Rahmen klinischer Studien untersucht. Im Vergleich zu anderen Techniken sind Vorteile dieser Methode die hohe Detektionsrate des Lymphknotens intraoperativ, der Verzicht auf Lokalisationsverfahren unmittelbar präoperativ und die geringen Kosten. Im Folgenden sollen die praktische Durchführung der Lymphknotentätowierung und die aktuelle Datenlage zu dieser Methode erörtert werden.

Abstract

In breast cancer patients who have received primary chemotherapy and then no longer have any suspicious lymph nodes clinically and/or on imaging, marking of initially suspicious axillary lymph nodes with targeted removal has recently been discussed and practised both in Germany and internationally as an alternative to complete axillary lymph node dissection. Tattooing of the suspicious lymph nodes with a highly purified carbon suspension is currently being investigated in clinical studies. Compared with other techniques, the advantages of this method are the high rate of intraoperative lymph node detection, avoidance of an immediately preoperative localisation procedure and the low costs. The practical aspects of lymph node tattooing and the current data regarding this method will be described.

Schlüsselwörter

Mammakarzinom - Lymphknoten - Kohlenstoffmarkierung - primäre Chemotherapie - targeted axillary dissection - TAD

Keywords

breast cancer - lymph nodes - carbon marking - primary chemotherapy - targeted axillary dissection - TAD

Full Text

References

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