METHOD OF BIOPSY OF THE SENTINEL LYMPH NODE DURING RESECTION OF THE MAMMARY GLAND IN CASE OF STAGE TISN0M0, OR T1N0M0, OR T2N0M0, OR T3N0M0 AND TUMOR LOCALIZATION IN THE UPPER OUTER QUADRANT OF THE MAMMARY GLAND Russian patent published in 2023 - IPC A61B17/00 A61B10/02 A61B6/03 

FIELD: surgery; oncology.

SUBSTANCE: method of biopsy of the sentinel lymph node during resection of the mammary gland in the case of stage TisN0M0, or T1N0M0, or T2N0M0, or T3N0M0 and localization of the tumor in the upper outer quadrant of the mammary gland, including dissection of the skin and subcutaneous fat, removal of the mammary gland sector with the tumor node, definition, isolation and removal of the "sentinel" lymph node, characterized be the incision made as shown in Fig. 1a, the skin and subcutaneous fat are dissected, the sector of the mammary gland is isolated and removed to the fascia of the pectoralis major muscle, the removed preparation is sent for macroscopic examination of the width of the resection edges, scrapings are performed from all resection edges: upper, lower, lateral, medial, fascial and sent for an urgent cytological examination, then access to the tissue of the axillary region, in the lateral corner of the surgical wound, the axillary fascia is dissected and, using a portable gamma sensor, the “sentinel” lymph node is isolated, sent for an urgent intraoperative morphological study, the axillary fascia is sutured with absorbable suture material, and if there are no tumor cells in the examined lymph node, the postoperative wounds are sutured in layers, leaving vacuum drains in the bed of the removed tumor node of the mammary gland and axillary region removed through the counter-opening along the anterior axillary line; upon detection of tumor cells, axillary-subscapular lymphadenectomy is performed, drainage and suturing of the surgical wound are performed.

EFFECT: method allows to reduce the operation time by removing the sentinel lymph node before the end of breast resection and mastectomy, to search for the sentinel lymph node using a portable gamma detector directly in the axillary tissue.

1 cl, 1 ex, 2 dwg