Reasons for failure to identify positive sentinel nodes in breast cancer patients with significant nodal involvement

Kanter, A.Y. de; Menke-Pluijmers, Marian B. E.; Henzen‐Logmans, S. C.; Geel, A.N. van; Eijck, C.J.H. van; Wiggers, Theo; Eggermont, Alexander

doi:10.1016/j.ejso.2006.02.012

Cited by 30 publications

(16 citation statements)

References 22 publications

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“…There may also be inadequate radioactivity within an SLN due to extensive tumor involvement, which can result in false-negative examinations. 11 Furthermore, there have been reports of leakage of radiopharmaceuticals and blue dye tracer materials beyond the SLNs (ie, to second-echelon LNs), potentially resulting in a more extensive resection than might otherwise be needed. 9,10 Mattrey et al 33,34 were the first to report, as a proof of concept, on the use of microbubbles for lymphatic US evaluations in animals.…”

Section: Discussionmentioning

confidence: 99%

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Contrast-Enhanced Ultrasound Imaging of Sentinel Lymph Nodes After Peritumoral Administration of Sonazoid in a Melanoma Tumor Animal Model

Goldberg

Merton

Liu

et al. 2011

Journal of Ultrasound in Medicine

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etection and characterization of sentinel lymph nodes (SLNs) are important for the management of patients who have a variety of malignancies, including melanoma, breast, colon, and other cancers. [1][2][3][4] Various techniques and imaging agents have been developed to map lymphatic drainage from tumors, including the use of blue dye with surgical dissection and injection of radiopharmaceuticals followed by evaluation with a gamma camBarry B. Goldberg, MD, Daniel A. Merton, BS, RDMS, Ji-Bin Liu, MD, Flemming Forsberg, PhD, Kaijun Zhang, PhD, Madhukar Thakur, PhD, Stephanie Schulz, PhD, Robin Schanche, BS, George F. Murphy, MD, Scott A. Waldman, MD, PhD Received October 6, 2010, ORIGINAL RESEARCHObjectives-The purpose of this study was to compare lymphosonography (ie, contrast-enhanced ultrasound imaging [US] after interstitial injection of a US contrast agent) for the detection of sentinel lymph nodes (SLNs) in swine with naturally occurring melanoma tumors to lymphoscintigraphy using blue dye-guided surgical dissection as the reference standard. Also, we sought to determine if lymphosonography can be used to characterize SLNs.Methods-Sixty-three swine with 104 melanomas were evaluated. Contrast-specific US was performed after peritumoral injection (1 mL dose) of Sonazoid (GE Healthcare, Oslo, Norway). Lymphoscintigraphy was performed after peritumoral injections of technetium Tc 99m sulfur colloid. Peritumoral injection of 1% Lymphazurin (Ben Venue Labs, Inc, Bedford, OH) was used to guide SLN resection. The accuracy of SLN detection with the two imaging modalities was compared using the McNemar test. The SLNs were qualitatively and quantitatively characterized as benign or malignant based on the lymphosonography results with histopathology and RNA analyses used as the reference standards.Results-Blue dye-guided surgery identified 351 SLNs. Lymphosonography detected 293 SLNs and 11 false-positives, while lymphoscintigraphy detected 231 SLNs and 20 false-positives. The accuracy of SLN detection was 81.8% for lymphosonography, which was significantly higher than the 63.2% achieved with lymphoscintigraphy (P < .0001). The accuracy of lymphosonography for SLN characterization was 80%. When the size of the enhanced SLN was taken into consideration to characterize SLNs, the accuracy was 86%.Conclusions-Lymphosonography is statistically better than lymphoscintigraphy for the detection of SLNs in this animal model. The ability to use lymphosonography as a means to characterize SLNs as benign or malignant is limited.

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Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9][10][11] Several radiopharmaceutical agents are used for lymphoscintigraphy, including technetium Tc 99m antinomy trisulfate colloid, Tc 99m nanocolloid, and Tc 99m sulfur colloid. 3,7 Likewise, a number of dyes have been used to localize SLNs, including methylene blue, isosulfin blue, patent blue, and fluorescein.…”

mentioning

confidence: 99%

Contrast-Enhanced Ultrasound Imaging of Sentinel Lymph Nodes After Peritumoral Administration of Sonazoid in a Melanoma Tumor Animal Model

Goldberg

Merton

Liu

et al. 2011

Journal of Ultrasound in Medicine

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“…2,[9][10][11][12][13][14] This can be explained by nodal tracer uptake physiology: the radioactive tracer is bound to colloid, which is phagocytosed by macrophages within the normal lymph tissue of the SN. If the SN, or the afferent lymph tracts, show massive tumor infiltration and/ or extranodal growth, the lymph flow might be blocked, or Lymphatic tumor burden does not seem to affect blue dye uptake because, in contrast to the uptake of radiocolloid, which is based on sufficient functional lymph tissue, blue dye uptake is a process of passive diffusion through the lymphatic system.…”

Section: Extensive Nodal Tumor Infiltrationmentioning

confidence: 99%

“…9,20,24 Combined with ultrasoundguided FNA of enlarged or suspicious lymph nodes, preoperative ultrasound can detect metastatic disease, hence avoiding an unnecessary or potentially unsuccessful SN biopsy.…”

Section: Palpable Lymph Nodesmentioning

confidence: 99%

Additional Tracer Injection to Improve the Technical Success Rate of Lymphoscintigraphy for Sentinel Node Biopsy in Breast Cancer

et al. 2009

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“…Cette échographie permettrait également de limiter les faux-négatifs en proposant d'emblée un curage axillaire aux patientes présentant des ganglions massivement envahis [65]. La palpation peropératoire du creux axillaire lors de la biopsie du GS est indispensable pour ne pas passer à côté d'un ganglion no sentinelle envahi (l'envahissement massif semblant empêcher la progression des produits lymphophiles qui seraient alors dérivés vers des ganglions sains).…”

Section: Le Caractère N0 Axillaire Homolatéral Cliniqueunclassified

Chirurgie des cancers invasifs du sein (à l’exception de la reconstruction mammaire)

Classe¹,

Sentilhes

Jaffré³

et al. 2010

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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Reasons for failure to identify positive sentinel nodes in breast cancer patients with significant nodal involvement

Cited by 30 publications

References 22 publications

Contrast-Enhanced Ultrasound Imaging of Sentinel Lymph Nodes After Peritumoral Administration of Sonazoid in a Melanoma Tumor Animal Model

Contrast-Enhanced Ultrasound Imaging of Sentinel Lymph Nodes After Peritumoral Administration of Sonazoid in a Melanoma Tumor Animal Model

Additional Tracer Injection to Improve the Technical Success Rate of Lymphoscintigraphy for Sentinel Node Biopsy in Breast Cancer

Chirurgie des cancers invasifs du sein (à l’exception de la reconstruction mammaire)

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