Minimally invasive breast carcinoma staging using lymphatic mapping with radiolabeled dextran

Offodile, Regina; Hoh, Carl K.; Barsky, Sanford H.; Nelson, Scott D.; Elashoff, Robert M.; Eilber, Frederick R.; Economou, James S.; Nguyen, Mai Thanh

doi:10.1002/(sici)1097-0142(19980501)82:9<1704::aid-cncr17>3.3.co;2-z

Cited by 5 publications

(2 citation statements)

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“…Probe‐directed mapping using a radioactive tracer is performed by injecting technetium‐99m (Tc‐99m) labeled sulfur colloid,32,36,38,39 albumin colloid,33–35 or dextran37 one to 24 hours prior to operation. A lymphoscintigram is usually obtained preoperatively to determine the axillary drainage pattern from the primary tumor (Fig.…”

Section: Surgical Techniquementioning

confidence: 99%

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Intraoperative lymphatic mapping and sentinel lymph node dissection in breast cancer

Hsueh¹,

Hansen²,

Giuliano³

2000

CA: A Cancer Journal for Clinicians

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Because the tumor status of the regional lymph nodes is the most important prognostic factor in patients with early-stage breast cancer, accurate histopathologic assessment of these nodes is essential for optimal management, including the selection of candidates for adjuvant systemic therapies. Intraoperative lymphatic mapping using a vital blue dye, with or without a radiocolloid, can identify the first axillary node to receive lymphatic drainage from a primary breast carcinoma. Focused histopathologic assessment of this sentinel node can be used to determine the tumor status of the entire axillary basin. The minimal morbidity and high accuracy of sentinel lymph node dissection (SLND) in breast cancer have been validated by multiple independent investigators, and the data suggest that this surgical technique may eventually replace complete lymph node dissection as the preferred axillary procedure for the management of early-stage disease. In experienced hands, SLND can be successfully performed in more than 90% of eligible breast cancer patients; the tumor status of the sentinel node accurately predicts the status of all axillary nodes in more than 95% of cases. This article reviews the current status, controversies, and future directions of SLND as a staging technique for patients with primary breast carcinoma.

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Section: Surgical Techniquementioning

confidence: 99%

“…Offodile et al 37 used Tc-99m labeled dextran as the radioactive tracer to identify a sentinel node in 40 of 41 patients (98%) who underwent SLND followed by ALND; the sensitivity of the sentinel node in predicting axillary tumor status was 100%, with no false-negative sentinel nodes.…”

Section: Probe-directed Intraoperative Mappingmentioning

confidence: 99%

Intraoperative lymphatic mapping and sentinel lymph node dissection in breast cancer

Hsueh¹,

Hansen²,

Giuliano³

2000

CA: A Cancer Journal for Clinicians

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Lymphatic mapping and sentinel node biopsy in breast cancer

McIntosh

Purushotham

1998

British Journal of Surgery

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Management of the axilla in early breast cancer: is it time to change tack?

Crowe

Temple

2000

Aust. N.Z. J. Surg.

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The standard surgical treatment of the axilla in patients with early breast cancer is about to undergo a radical change. Although axillary dissection is an excellent procedure for both staging and local control, particularly in the clinically positive axilla, it has considerable morbidity and may understage a significant proportion of patients, because it will usually miss micrometastases that can occur in approximately 10% of 'node negative' patients. An increasing number of patients whose tumours are either non-invasive (ductal carcinoma in situ; DCIS), micro-invasive, tubular cancers or low-grade T1a tumours without lymphovascular invasion may be spared axillary surgery because the risk of axillary disease is 0-3%. Many studies, both prospective trials and large retrospective series, show that axillary radiotherapy alone provides similar local control rates to axillary dissection in patients with clinically negative axillas. Primary treatment of the axilla with radiotherapy alone, however, does not allow appropriate staging. Sentinel lymph node biopsy is being increasingly used in patients with breast cancer to provide this information. When a sentinel node is identified it is equal to or better than axillary dissection for staging the axilla and, if the node is positive, it will help select patients who should then proceed to further axillary surgery or axillary radiotherapy. Although sentinel lymph node biopsy is being rapidly adopted in many centres worldwide, the results of randomized controlled trials are needed before it can be recommended as the standard of care.

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Minimally invasive breast carcinoma staging using lymphatic mapping with radiolabeled dextran

Cited by 5 publications

References 0 publications

Intraoperative lymphatic mapping and sentinel lymph node dissection in breast cancer

Intraoperative lymphatic mapping and sentinel lymph node dissection in breast cancer

Lymphatic mapping and sentinel node biopsy in breast cancer

Management of the axilla in early breast cancer: is it time to change tack?

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