Sentinel Node Biopsy in Breast Cancer: An Overview

Reintgen, Douglas S.; Giuliano, Rosemary; Cox, Charles E.

doi:10.1046/j.1524-4741.2000.20057.x

Cited by 38 publications

(16 citation statements)

References 9 publications

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“…2 Sentinel lymph node biopsy has replaced axillary lymph node dissection in patients with a low risk of axillary nodal metastases because of decreased morbidity. [3][4][5][6][7] Sentinel lymph node status is a representative indicator for the entire lymph node basin. However, false-negative results of sentinel lymph node biopsy have been found.…”

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confidence: 99%

Role of Sonographic Elastography in the Differential Diagnosis of Axillary Lymph Nodes in Breast Cancer

Choi

Kang

Kim

et al. 2011

Journal of Ultrasound in Medicine

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xillary lymph node status is the most important prognostic factor in breast cancer. 1 The presence of nodal metastases decreases 5-year survival by approximately 40% compared to node-negative patients. 2 Sentinel lymph node biopsy has replaced axillary lymph node dissection in patients with a low risk of axillary nodal metastases because of decreased morbidity. [3][4][5][6][7] Sentinel lymph node status is a representative indicator for the entire lymph node basin. However, false-negative results of sentinel lymph node biopsy have been found. 4,8,9 Noninvasive imaging techniques have been used to predict the preoperative axillary lymph node status. Sonography has higher diagnostic accuracy than mammography, computed tomography, magnetic resonance imaging, and positron emission tomographyJae Jeong Choi, MD, Bong Joo Kang, MD, PhD, Sung Hun Kim, MD, Ji Hye Lee, MD, Seung Hee Jeong, MPH, Hyun Woo Yim, MD, PhD, Byung Joo Song, MD, Sang Seol Jung, MD Received September 20, 2010, ORIGINAL RESEARCHObjectives-The purpose of this study was to evaluate the diagnostic utility of sonographic elastography in differentiating reactive and metastatic axillary lymph nodes in breast cancer.Methods-A total of 64 lymph nodes (reactive, n = 33; metastatic, n = 31) from 62 patients with breast cancer were examined by both B-mode sonography and elastography from April to July 2009. Two experienced radiologists retrospectively assessed B-mode sonograms by the sum of scores for 4 criteria: short diameter, shape, hilum, and cortical thickening. Elastographic images were given scores of 1 to 4 according to the percentage of high-elasticity areas in the lymph nodes. We compared the diagnostic performance of B-mode sonography, elastography, and combined examinations. We also calculated the strain ratio of the lymph node and subcutaneous fat tissue.Results-The elasticity score for malignant lymph nodes (mean, 3.1) was higher than the score for benign lymph nodes (mean, 2.2; P < .0001). With a cutoff between elasticity scores of 2 and 3, elastography showed 80.7% sensitivity, 66.7% specificity, and 73.4% accuracy. With a cutoff between B-mode sonographic scores of 1 and 2, B-mode sonography showed 74.2% sensitivity and 78.8% specificity. Combined B-mode and elastographic sonography showed higher sensitivity (87.1%) than B-mode sonography alone. With a strain ratio cutoff point of 2.3, sensitivity was 82.8%, and specificity was 56.3%.Conclusions-Sonographic elastography may increase the sensitivity of B-mode sonography in the detection of metastatic axillary lymph nodes.

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confidence: 99%

Role of Sonographic Elastography in the Differential Diagnosis of Axillary Lymph Nodes in Breast Cancer

Choi

Kang

Kim

et al. 2011

Journal of Ultrasound in Medicine

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“…The results of these major studies (including the very small number of cases with failed SND mapping) and the reported overviews of the SND approach 11,13,17 were used to produce a weighted average for the sensitivity of SND to use in the model. Using this method of compositing, a sensitivity of approximately 0.92 was estimated for SND.…”

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confidence: 99%

“…The details of the SND procedure have been well documented and a variety of techniques have been used and continue to be developed. [5][6][7][8][9][10][11][12][13][14][15][16][17] By assessing the status of the first echelon draining lymph node (i.e., the "sentinel" lymph node) of the primary tumor, SND identifies patients who require an AND. However, caution is warranted because the false-negative (FN) rate for SND, albeit small, may have an impact on survival.…”

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confidence: 99%

Sentinel lymph node versus axillary lymph node dissection for early‐stage breast carcinoma

Jani

Basu

Heimann

et al. 2003

Cancer

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The selectivity of reactions on active patches over those on a partially active carrier surface is investigated for patch‐covered spheres. The effects of relevant parameters including patch and carrier reactivities, patch coverage, patch size, and patch separation state are studied. The selectivity is found to increase with increasing relative dominance of the patch reactivity over the carrier reactivity and patch coverage, as expected. Interestingly, it also increases with decreasing patch size and increasing patch separations. Decrease in patch size creates more patch–carrier interfaces and thus enhances the competition effectiveness of the patches against the carrier surface. With respect to the patch separation state, more complete utilization of the patches is achieved for well‐separated patches and thus enhances the selectivity toward the patches. © 2007 American Institute of Chemical Engineers AIChE J 2007

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“…Radioguided SLN biopsy in breast cancer entails peritumoural injection of 99m Tc, lymphoscintigraphy and node identification during surgery guided by gamma probe [2]. In early-stage breast carcinoma, SLN biopsy has replaced complete axillary lymph node dissection, as analysis of the SLN accurately predicts the status of all axillary nodes in more than 95% of cases with minimal morbidity [3].…”

Section: Introductionmentioning

confidence: 99%

Radioguided localisation of non-palpable breast lesions and simultaneous sentinel lymph node mapping

Barros

Cardoso

Sheng

et al. 2002

European Journal of Nuclear Medicine and Molecular Imaging

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The authors report their experience with a new strategy for radioguided breast surgery that combines radioguided occult lesion localisation (ROLL) and sentinel lymph node (SLN) mapping. The study population comprised 38 women with non-palpable breast lesions suspicious for breast cancer (BI-RADS 4-5). On the day before surgery, 0.2 ml solution containing particles of dextran labelled with approximately 15 MBq of technetium-99m was injected under stereotaxic guidance by mammography. All patients underwent open surgical biopsy guided by gamma probe, radiographic control of the surgical specimen and frozen section analysis. The rate of confirmation of lesion removal was 100% and the rate of simultaneous SLN mapping was 97.3% (37/38). Eleven cases of infiltrating carcinoma and eight of ductal carcinoma in situ (DCIS) were diagnosed intraoperatively. In the first eight invasive lesions, the SLN was biopsied and complete axillary lymph node dissection was performed; in the three other invasive lesions and in two aggressive cases of DCIS, only the SLN was dissected. The intraoperative results of SLN analysis and the definitive histopathological examinations of the SLN were always negative. It is concluded that ROLL and SLN can be employed simultaneously when dextran is used as a tracer; this technique allows frozen section diagnosis and intra-operative node analysis, and has many advantages over the conventional two-step procedure.

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Sentinel Node Biopsy in Breast Cancer: An Overview

Cited by 38 publications

References 9 publications

Role of Sonographic Elastography in the Differential Diagnosis of Axillary Lymph Nodes in Breast Cancer

Role of Sonographic Elastography in the Differential Diagnosis of Axillary Lymph Nodes in Breast Cancer

Sentinel lymph node versus axillary lymph node dissection for early‐stage breast carcinoma

Radioguided localisation of non-palpable breast lesions and simultaneous sentinel lymph node mapping

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