Axilloscopy and endoscopic sentinel node detection in breast cancer patients

Background: Sentinel node biopsy is a promising technique that allows the a xillary status of breast cancer patients to be predicted with high accuracy . Reducing false negative results remains a major challenge for the improve ment of this procedure. Furthermore, new techniques are required to achieve axillary clearing with less morbidity in cases of unsuccessful mapping or multicentric carcinoma. We analyzed whether axilloscopy and endoscopic sent inel node biopsy is a feasible procedure for visualization of the axillary space and resection of the sentinel node using endoscopic techniques. Methods: Following blue dye-guided lymphography and liposuction of the axil lary fat, endoscopic axillary sentinel node biopsy was performed in 35 brea st cancer patients. We then assessed the exposure of anatomical landmarks, the detection rate of the sentinel node, the false negative rate, and the a ccuracy of consecutive axillary clearing. Results: In almost every case, an excellent anatomical orientation was achi eved. The detection rate for the sentinel node was 83.3%. In one case, the sentinel node did not reflect the status of the residual axilla. A mean num ber of 17.1 lymph nodes was harvested at consecutive axillary clearing. Conclusions: Axilloscopy and endoscopic sentinel node biopsy, following lip osuction of the axillary fat, is a feasible procedure that allows identific ation and minimally invasive resection of the sentinel node with high accur acy. The endoscopic approach might help to minimize the pitfalls of sentine l node biopsy by visualizing the axillary space. In future, it may become a technique that enables minimally invasive axillary clearing when complete lymphadenectomy is required.