Sentinel lymphnode biopsy in early breast cancer using methylene blue dye and radioactive sulphur colloid — a single institution Indian experience

Somashekhar, S. P.; Shabber, S. Zaveri; Venkatesh, K. Udupa; Venkatachala, K.; Parameshwaran,; Thirumalai, M. M. Vasan

doi:10.1007/s12262-008-0033-9

Cited by 20 publications

(14 citation statements)

References 70 publications

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“…The effectiveness and accuracy of determining the draining lymphatic pathways using dyes has been studied extensively and is currently used by surgeons to identify sentinel nodes in cancer patients [21]. In fact Bostick et al reported that “the blue dye technique remains the criterion standard for Sentinel Lymph Node Detection (SLND) in melanoma” [22].…”

Section: Discussionmentioning

confidence: 99%

“…After identifying the anatomical sites of inoculum interaction and presumptive initial viral infection, we then targeted these sites for submusosal injections with Gd G5 DOTA dendrimer followed by MRI or methylene blue followed by necropsy to define patterns of lymphatic draining and by inference, the likely pathway of virus dissemination. The effectiveness and accuracy of determining the draining lymphatic pathways using dyes has been studied extensively and is currently used by surgeons to identify sentinel nodes in cancer patients [21] . In fact Bostick et al reported that “the blue dye technique remains the criterion standard for Sentinel Lymph Node Detection (SLND) in melanoma” [22] .…”

Section: Discussionmentioning

confidence: 99%

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Tracking the Luminal Exposure and Lymphatic Drainage Pathways of Intravaginal and Intrarectal Inocula Used in Nonhuman Primate Models of HIV Transmission

et al. 2014

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Over 80% of sexual HIV-1 transmissions originate from a single viral variant, but the underlying basis for this transmission bottleneck remains to be elucidated. Nonhuman primate models of mucosal virus transmission allow opportunities to gain insight into the basis of this mucosal bottleneck. We used simulated inocula consisting of either non-infectious vital dye or contrast dye with non-invasive magnetic resonance imaging (MRI) to visualize mucosal exposure and passive lymphatic drainage patterns following vaginal and rectal exposures in Indian origin rhesus macaques. Results revealed a limited overall distance of dye coverage from the anal verge following 1 ml (n = 8) intrarectally administered, which greatly increased with a 3 ml (n = 8) volume. Intravaginal dye exposure using 2 ml revealed complete coverage of the mucosa of the vagina and ectocervix, however dye was not detectable in the endocervix, uterus, fallopian tubes or ovaries in nuliparous sexually mature rhesus macaques (n = 9). In addition, following submucosal and intranodal injections of vital dye or MRI contrast dye in the rectum (n = 9), or distal and proximal vagina (n = 4), the lymphatic drainage pathways were identified as first the internal then common iliac chain followed by para-aortic lymph nodes. Drainage from the distal descending colon (n = 8) was via the para-colonic lymph nodes followed by the inferior mesenteric and para-aortic lymph nodes. Analysis after vaginal challenge with infectious SIVmac239 followed by euthanasia at day 3 revealed a pattern of viral dissemination consistent with the imaging results. These results provide insights into potential patterns of viral dissemination that can help guide efforts to better elucidate the earliest events of virus transmission and potential intervention strategies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Tracking the Luminal Exposure and Lymphatic Drainage Pathways of Intravaginal and Intrarectal Inocula Used in Nonhuman Primate Models of HIV Transmission

et al. 2014

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“…The radiocolloid method, which has a better SLN detection rate as compared to blue dye, requires collaboration with nuclear medicine and availability of a gamma probe as well as some measures for radiation exposure. Although blue dye does not have such issues, it may lead to skin discoloration, decrease in saturation, allergies, anaphylactic reactions, injection site nodules and fat necrosis (6)(7)(8)(9)(10). The SLN detection rates are lower in SLNB with blue dye alone as compared to radiocolloid use (11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Sentinel lymph node biopsy under fluorescent indocyanin green guidance: Initial experience

Aydoğan

Arıkan

Aytaç

et al. 2016

UCD

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Objective: Sentinel lymph node biopsy can be applied by using either blue dye or radionuclide method or both in breast cancer. Fluorescent imaging with indocyanine green is a new defined method. This study evaluates the applicability of sentinel lymph node biopsy via fluorescent indocyanine green.Material and Methods: IC-VIEW (Pulsion Medical Systems AG, Munich, Germany) infrared visualization system was used for imaging. Two mL of indocyanine green was injected to visualize sentinel lymph nodes. After injection, subcutaneous lymphatics were traced and sentinel lymph nodes were found with simultaneous imaging. Sentinel lymph nodes were excised under fluorescent light guidance, and excised lymph nodes were examined histopathologically. Patients with sentinel lymph node metastases underwent axillary dissection.Results: Four patients with sentinel lymph node biopsy due to breast cancer were included in the study. Sentinel lymph nodes were visualized with indocyanine green in all patients. The median number of excised sentinel lymph node was 2 (2-3). Two patients with lymph node metastasis underwent axillary dissection. No metastasis was detected in lymph nodes other than the sentinel nodes in patients with axillary dissection. There was no complication during and after the operation related to the method. Conclusion:According to our limited experience, sentinel lymph node biopsy under fluorescent indocyanine green guidance, which has an advantage of simultaneous visualization, is technically feasible.

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“…In our institution, SLN biopsy (SLNB) was introduced in the early 2000s and has been performed regularly since then. As part of a validation study, SLNB using both gamma probe and blue dye had a falsenegative rate of 3.7 % with overall sensitivity, specificity, positive predictive value, and negative predictive value of SLNB of 96.2, 100, 100, and 98.6 %, respectively [5].…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Frozen Section Evaluation of Sentinel Lymph Nodes in Breast Carcinoma: Single-Institution Indian Experience

et al. 2013

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Sentinel lymph node biopsy is an established way of predicting axillary nodal metastasis in early breast cancer. Intraoperative frozen sections (FS) of sentinel lymph nodes (SLNs) can be used to detect metastatic disease, allowing immediate axillary lymph node dissection. The purpose of this study was to evaluate the accuracy of intraoperative frozen sections in evaluation of sentinel lymph nodes in cases of breast cancer. Between March 2006 and August 2010, a total of 164 patients with clinically node-negative operable breast cancer were subjected to sentinel lymph node biopsy of axillary lymph nodes using preoperative peritumoral injection of radioactive colloid and methylene blue. Intraoperative identification of sentinel nodes was done using a handheld gamma probe and identification of blue-stained nodes. The nodes were sent for frozen section examination. The results of frozen section were compared with the final histopathology. Out of the 164 cases, metastases were detected in SLN by frozen section in 38 cases. There were three false-negative cases (all showing micrometastasis on final histopathology). FS had sensitivity of 92.6 %, specificity of 100 %, and overall accuracy of 98.1 %. The positive predictive value was 100 %, and the negative predictive value was 97.6 %. FS for diagnosis of metastasis of SLNs is reliable. Patients with negative SLNs by the FS diagnosis can avoid reoperation for axillary lymph node dissection. However, FS may fail to detect micrometastases, especially in cases with small tumors.

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Sentinel lymphnode biopsy in early breast cancer using methylene blue dye and radioactive sulphur colloid — a single institution Indian experience

Cited by 20 publications

References 70 publications

Tracking the Luminal Exposure and Lymphatic Drainage Pathways of Intravaginal and Intrarectal Inocula Used in Nonhuman Primate Models of HIV Transmission

Tracking the Luminal Exposure and Lymphatic Drainage Pathways of Intravaginal and Intrarectal Inocula Used in Nonhuman Primate Models of HIV Transmission

Sentinel lymph node biopsy under fluorescent indocyanin green guidance: Initial experience

Intraoperative Frozen Section Evaluation of Sentinel Lymph Nodes in Breast Carcinoma: Single-Institution Indian Experience

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