Sentinel Node Biopsy for Breast Cancer Patients: Issues for Discussion and Our Practice

Pechlivanides, George; Vassilaros, Dorothy; Tsimpanis, Anastasios; Apostolopoulou, A.; Vasilaros, S

doi:10.4061/2011/109712

Cited by 6 publications

(5 citation statements)

References 59 publications

(59 reference statements)

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“…Macrometastasis to SN and size of primary tumour are significant predictors for the involvement of non-SN metastasis. Similar findings have been reported in other studies [6][7][8]15,16]. 18% of our patients with a SN metastasis ≤ 2 mm had further nodal involvement.…”

Section: Non-sentinel Node Metastasessupporting

confidence: 92%

Axillary Recurrences after Sentinel Node Surgery—Results over Ten Years in a University Hospital

Eilertsen¹,

Schlichting²,

Harr³

et al. 2012

JCT

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Background: Sentinel node biopsy (SNB) was introduced at Ullevaal University Hospital in 2000. This article presents results from the first ten years use of the method. Material and Methods: A prospective registration of 2762 patients was made from 2000 through 2009. Results: The median follow-up time was 51 months. The overall detection rate was 93%. 36% of the patients with positive SNs had non-sentinel metastases. These were significantly associated with a macrometastatic SN and a primary tumour>20 mm. 18% of patients with sentinel metastasis≤2 mm had non-sentinel metastases. 14 patients with negative SN (0.7%) developed axillary recurrence. 32% with a preoperative diagnosis of ductal carcinoma in situ (DCIS) were upstaged to infiltrating carcinoma on final histology. None of the patients with pure DCIS had positive SNs. Conclusion: Few late events (0.7%) in SN negative axillas demonstrate the safety of the technique

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Section: Non-sentinel Node Metastasessupporting

confidence: 92%

Axillary Recurrences after Sentinel Node Surgery—Results over Ten Years in a University Hospital

Eilertsen¹,

Schlichting²,

Harr³

et al. 2012

JCT

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“…Only 0.1%-3% of DCIS cases have highrisk histopathologic features (24). After surgical resection (lumpectomy or mastectomy) and histopathologic analysis of the specimen, tumors previously diagnosed on core biopsy as DCIS are sometimes reclassified correctly as invasive cancer (25)(26)(27). Such reclassification is an upstaging of the patient's diagnosis.…”

Section: Cancer Indications Breast Cancermentioning

confidence: 99%

Lymphoscintigraphy and Sentinel Nodes

2015

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) generic fundamentals of lymphoscintigraphy procedures of sentinel lymph node biopsy (SLNB) protocols; (2) specific injection and imaging components of SLNB protocols used in the management of patients with breast cancer, melanoma, and head and neck malignancies; and (3) specific indications of breast cancer, melanoma, and head and neck malignancies that suggest inclusion of a SLNB in the management of a patient.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through June 2018.It has been validated that sentinel lymph node biopsy (SLNB) shows whether a patient's breast cancer or melanoma has spread to regional lymph nodes. As a result, management of patients with these cancers has been revolutionized. SLNB has replaced axillary lymph node dissection (ALND) as the staging modality of choice for early breast cancer and has replaced complete lymph node dissection as the staging modality of choice for melanoma in patients whose SLNBs indicate no metastases. Recently concluded multicenter, randomized trials for breast cancer with 5-to 10-y outcome data have shown no significant differences in disease-free survival rates or overall survival rates between SLNB and ALND groups but have shown significantly lower morbidity with SLNB than with ALND. The lowest false-negative rates (5.5%-6.7%) were seen in studies that used preoperative lymphoscintigraphy and dual mapping during surgery. To assess the survival impact of SLNB in melanoma, the Multicenter Selective Lymphadenectomy Trial I was performed. Melanoma-specific survival rates were not different between subjects randomized to SLNB with lymphadenectomy for nodal metastasis on biopsy and subjects randomized to observation with lymphadenectomy for nodal relapse. However, the 10-y disease-free survival rates were better for the SLNB group than for the observation group, specifically among patients with intermediate-thickness melanomas or thick melanomas.

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“…A SLN biopsy is strongly advised in cases of a multifocal, extensive DCIS tumor with existence of high-grade cytological characteristics on final pathology. It should be mentioned that in almost 15% of DCIS tumors, a SLN biopsy represents a second operation (11,23).…”

Section: Discussionmentioning

confidence: 99%

Contrast Enhanced Ultrasound (CEU) Using Microbubbles for Sentinel Lymph Node Biopsy in Breast Cancer: a Systematic Review

Gkegkes

Iavazzo

2015

Acta Chirurgica Belgica

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Sentinel Node Biopsy for Breast Cancer Patients: Issues for Discussion and Our Practice

Cited by 6 publications

References 59 publications

Axillary Recurrences after Sentinel Node Surgery—Results over Ten Years in a University Hospital

Axillary Recurrences after Sentinel Node Surgery—Results over Ten Years in a University Hospital

Lymphoscintigraphy and Sentinel Nodes

Contrast Enhanced Ultrasound (CEU) Using Microbubbles for Sentinel Lymph Node Biopsy in Breast Cancer: a Systematic Review

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