The first reaction is “how long can I live” and the second reaction is “get me a clean cut”. “How long can I live” is related to the stage of the tumor, and to determine whether the breast cancer is early or late, we have to look at the tumor cells before and after surgery to see if they have expanded.
For breast cancer, the pathology of axillary lymph nodes is an important indicator to determine whether the cancer cells have spread out or not. If the lymph nodes in the axilla have metastasized severely, then the condition is relatively serious. “Currently, the main surgical methods for breast cancer are: breast-conserving surgery, simple mastectomy, modified radical mastectomy, radical mastectomy, extended radical mastectomy, etc. In the past, doctors used to simply think that “the more you cut, the better the treatment effect”. Later, after many experiments, it was found that this is not true at all! After years of clinical exploration, scientists found that breast cancer is a systemic disease from the beginning of the disease, that is to say, from the time the tumor starts to appear, the metastasis of the whole body has already started. No matter how much you cut the local area, it will not help! Instead of making the patient live longer, it leads to many postoperative complications, and the mortality rate increases instead of decreasing! Doctors have found that the key to surgery is how to weigh the pros and cons between the best treatment outcome and the least complications! If the axillary lymph nodes have metastases, they need to be completely cleared; if the axillary lymph nodes do not have cancer metastases, they do not need to be cleared, otherwise the chances of developing postoperative limitation of movement of the affected upper extremity or even upper extremity edema will be significantly increased. How to know whether the axillary lymph nodes have metastasized? This is where the “sentinel lymph nodes” need to be detected. The so-called “outpost” is the “sentry”, and the “axillary lymph nodes” are the “barracks”. The “sentinel” is the forefront of the “barracks”, if the “sentinel” is violated, the “barracks” may also be If the “sentinel” is invaded, the “barracks” may also be invaded; if the “sentinel” is not invaded, the “barracks” can basically be considered safe. The determination of whether the sentinel lymph node is metastatic can generally be done by preoperative imaging (ultrasound, mammography, MRI, etc.), physician’s physical examination, and puncture biopsy. However, the most reliable method is sentinel lymph node biopsy. Lymph nodes are about the same color as the surrounding fat in the body, and the trauma associated with cutting them open to find them one by one would be absolutely intolerable. This requires the use of a method to make it appear different from other tissues. Nowadays, the dye method, the nuclear tracer method or a combination of both are mostly used internationally for tracing. When these tracers are injected into the breast, blue-stained lymphatic vessels and lymph nodes can be seen, or a gamma ray detector can be used to detect the concentration of nuclei in the lymph nodes, and when they are found, they are cut out and sent for examination, and the results are known in half an hour.