In 1990s, sentinel lymph node biopsy of breast cancer became a milestone in the field of breast surgery. The application of this technique makes breast cancer patients with negative axillary lymph nodes avoid axillary lymph node dissection. At the European Oncology Congress held in Lisbon, Portugal at the end of May 438+10 this year, the research report on sentinel lymph nodes is not limited to breast cancer, and radical surgery to expand the resection range of other early malignant tumors is also being challenged. The development direction of tumor therapy is to attract people's attention, further narrow the scope of surgery, reduce the trauma caused by surgery and improve the quality of life of patients.

For example, sentinel lymph nodes are the first stop of lymph node metastasis in breast cancer. In partial mastectomy plus sentinel lymph node biopsy, a small incision is made in the armpit, and sentinel lymph nodes are accurately removed and biopsied. If the pathology is negative, the operation is terminated, and if it is positive, axillary lymph node dissection is performed. Therefore, finding sentinel lymph nodes has become an important link in surgery.

The picture on the right shows the relationship between sentinel lymph nodes and breast tumors. At present, there are only three methods to detect sentinel lymph nodes in the world:

1. blue dye method, this method is more traditional, using blue dyes such as methylene blue, the effect is not good, and doctors need to have a long learning curve. 2. Radionuclide detection method, because it involves radioactive elements, has a certain radiation effect on human body, and at the same time it will cause pollution to the environment, which is more troublesome to use, has not been popularized in clinic, and the equipment system is expensive. 3. Fluorescence detection is a new rapid and safe detection method. Using PDE to observe ICG tracer and image it on the display, sentinel lymph nodes can be found quickly, but the equipment system is expensive. Recently, People's Hospital of Peking University has also started to use this equipment, and there are many academic papers about this method in the world.

With the continuous improvement of the quality of surgery, the requirements for surgery are getting higher and higher, and the fineness and micro-injury of surgery are paid more and more attention. Sentinel lymph node biopsy can effectively avoid the trauma caused by axillary lymph node dissection, thus avoiding postoperative injury.

Intraoperative fluorescent navigation images: