Keywords
How to Cite
Abstract
Introduction. Breast cancer (BC) accompanied by edema is one of the most aggressive types of malignant tumor. This type of BC is characterized by specific clinical signs. Fluorescence diagnostics using indocyanine green are actively used to perform biopsies on the 'sentinel' lymph node in the treatment of nodular BC. There is potential for its use in the edematous form. This method can be used to visualize the lymphatic drainage pathways of the breast and study their characteristics.
Aim. To study the features of lymph drainage in the breast in edematous and nodular cancer using fluorescence diagnostics.
Materials and Methods. The study included patients with nodular BC stage I-IIB cT1-3N0 (n = 35) and edematous form stage IIIB cT4bN0-1 (n = 35) who underwent intraoperative lymphography using fluorescence diagnostics with the lymphotropic dye indocyanine green.
Results. The average age of patients with nodular BC was 49 ± 0.54 years, and with edematous BC was 53 ± 0.71 years. Having analyzed the lymphography images obtained, we categorized the types of lymph drainage into four types. In nodular and edematous forms, the lymphatic circulation of the breast differed in both lymph drainage variants and structural distribution. Exclusively in the edematous form of BC, diffuse and mixed lymph drainage types were observed. The linear type was present in both groups, but it was significantly more prevalent in nodular cancers, for which the number of main 'pathways' in this type was notably higher.
Conclusion. Fluorescence diagnostics can also be used to determine the boundaries of breast skin edema intraoperatively. This can help to achieve intact resection boundaries or solve certain diagnostic problems. The technical feasibility of using the sentinel lymph node biopsy method in the edematous form of BC depends on the type of lymphatic circulation.
References
Сарибекян Э.К., Болотина Л.В., Данилова Н.В., et al. Факторы прогноза лечения отечно-инфильтративного рака молочной железы. Онкология. Журнал им. П.А. Герцена. 2014; 2(1): 10-13. [Saribekyan E.K., Bolotina L.V., Danilova N.V., et al. Prognostic factors for the treatment of edematous-infiltrative breast cancer. Oncology. P.A. Herzen Journal. 2014; 2(1): 10-13 (In Rus)].
Сарибекян Э.К. Отечная форма рака молочной железы. Российский онкологический журнал. 2012; 17(2): 4-8.-DOI: 10.17816/onco39917. [Saribekyan E.K. Edematous form of breast cancer. Russian Journal of Oncology. 2012; 17 (2): 4-8.-DOI: 10.17816/onco39917 (In Rus)].
Amin M.B., Greene F.L., Edge S.B., et al. AJCC Cancer Staging Manual. 8th edition. NY: Springer. 2017.-URL: https://emedicine.medscape.com/article/2007112-overview?form=fpf.
Зикиряходжаев А.Д., Сарибекян Э.К., Багдасарова Д.В., et al. Биопсия сторожевого лимфатического узла при раке молочной железы с применением метода флуоресцентной визуализации красителя индоцианин зеленый. Biomedical Photonics. 2019; 8(4): 4-10.-DOI: 10.24931/2413-9432-2019-8-4-4-10. [Zikiryakhodzhaev A.D., Saribekyan E.K., Bagdasarova D.V., et al. Sentinel lymph node biopsy for breast cancer using indocyanine green fluorescence visualization. Biomedical Photonics. 2019; 8(4): 4-10.-DOI: 10.24931/2413-9432-2019-8-4-4-10 (In Rus)].
National Comprehensive Cancer Network (NCCN). NCCN Clinical practice guidelines in oncology. Version 3.2025. 2025.-URL: https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf.
de Oliveira-Junior I., Nahas EAP, Cherem A.C., et al. Sentinel lymph node biopsy in T3 and T4b breast cancer patients: analysis in a tertiary cancer hospital and systematic literature review. Breast Care (Basel). 2021; 16(1): 27-35.-DOI: 10.1159/000504693.
Зикиряходжаев А.Д., Сарибекян Э.К., Захарова М.А., Найдина К.А. Способ флюоресцентного определения скорости лимфотока от молочной железы до регионарных лимфоколлекторов. Патент на изобретение RU 2805793 C2, 24.10.2023. Заявка № 2023110424 от 24.04.2023. [Zikiryakhodjaev A.D., Saribekyan E.K., Zakharova M.A., Naidina K.A. Method for fluorescence determination of lymph flow velocity from the mammary gland to regional lymph collectors. Patent for invention RU 2805793 C2, 10.24.2023. Application No. 2023110424, dated 04.24.2023 (In Rus)]. Амосова В.А., Загаштокова А.К., Карпова М.С., et al. Методология расчета площади локального отека кожи при раке молочной железы. Злокачественные опухоли. 2021; 11(4): 14-22.-DOI: 10.18027/2224-5057-2021-11-4-14-22. [Amosova V.A., Zagashtokova A.K., Karpova M.S., et al. Methodology for calculating the area of local skin edema in breast cancer. Malignant Tumors. 2021; 11(4): 14-22.-DOI: 10.18027/2224-5057-2021-11-4-14-22. (In Rus)].
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
© АННМО «Вопросы онкологии», Copyright (c) 2025