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Etapificación y
biopsia de ganglio
centinela
R2CG Pérez Rubio Nalleli Adriana
UMAE Manuel Ávila Camacho
Cirugía general
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
Asi
gnaci
ón d
e la
eta
pa c
línic
a
EF- Piel- Tej mamario- Ganglios Auxiliares diagnósticos Tamaño rel con mets
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
Ganglios supraclaviculares señala
enfermedad sistémica
sin embargo no esta
indicada su biopsia rutinaria
De Vita y cols. Cancer,
Principles and practice of
oncology. 8th edition
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
Bio
psi
a d
e
ganglio
centi
nela Cualquier ganglio
linfático que recibe drenaje linfático directo del tumor primario”
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
Cabañas 1987 Ca de
pene Morton 1992 Melanoma Kraq et al Ca de mama Evitar el vaciamiento
axilar completo
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
T1, T2 N0. T3 N0 QT neo NSBABP B27 428 pac
QT 85% de identificación
De Vita y cols. Cancer, Principles and
practice of oncology. 8th edition
Ganglio
centin
ela
Z 10 y
NSABP B32
5, 327 y
5210
ganglios neg
98.7 y 97%
No
diferencias
coloide Vs
azul
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
Coloide radioactivo mas azul isosulfan
1.Día previo 0.2 a 0.5ml
(3-4) de coloide tecnesio 992.Qx: 4ml de azul de
igual forma y 1ml en
cancer
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
3. Contador gama manual
4. Incisión de 3-4cm5. Exposición de contenido axilar6. Cuenta radioactividad
10 seg7. Se extirpa el ganglio
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
8. Segunda cuenta9. Anatomopatología
10. Todos los ganglios
mayor 10%
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
contr
ain
dic
aci
on
es
Linfadenopatía palpable Qx axilar previa
Multifocales Embarazo LactanciaNo sin confimración RHP
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
Com
plic
aci
ones
Anafilaxia 0.l% Parestesias 8.6% Linfaedema 5%
De Vita y cols. Cancer, Princi
ples and practice of oncolog
y. 8th edition
No hay diferencia en
cuanto a la identificación de ganlios positivo diseccion radical vs biopsia
