Subareolar Versus Peritumoral Injection for Location of the Sentinel Lymph Node

Klimberg, V. Suzanne; Rubio, Isabel T.; Henry, R. G.; Cowan, Chris; Colvert, Maureen; Korourian, Soheila

doi:10.1097/00000658-199906000-00013

Cited by 308 publications

(137 citation statements)

References 18 publications

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“…25 These embryological studies are supported by the fact that the skin and parenchyma of the breast drain to the same sentinel nodes. 26,27 Therefore, other drugs applied to the skin of the breast should concentrate in the parenchyma to a greater degree than can be expected based on systemic absorption and delivery through the circulation, and the model of transdermal local pharmacotherapy . The skin samples from three subjects were used and each treatment condition was tested in duplicate on the skin samples from each subject in each experiment.…”

mentioning

confidence: 99%

In vitro human skin permeation of endoxifen: potential for local transdermal therapy for primary prevention and carcinoma in situ of the breast

Lee¹,

Ivancic²,

Chatterton³

et al. 2011

BCTT

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Purpose: Oral tamoxifen, a triphenylethylene (TPE), is useful for breast cancer prevention, but its adverse effects limit acceptance by women. Tamoxifen efficacy is related to its major metabolites 4-hydroxytamoxifen (4-OHT) and N-desmethyl-4-hydroxytamoxifen (endoxifen [ENX]). Transdermal delivery of these to the breast may avert the toxicity of oral tamoxifen while maintaining efficacy. We evaluated the relative efficiency of skin permeation of 4-OHT and ENX in vitro, and tested oleic acid (OA) as a permeation-enhancer. Methods: 4-OHT, ENX, and estradiol (E2) (0.2 mg/mL of 0.5 µCi 3 H/mg) were dissolved in 60% ethanol-phosphate buffer, ±OA (0.1%-5%). Permeation through EpiDerm TM (Matek Corp, Ashland, MA) and split-thickness human skin was calculated based on the amount of the agents recovered from the receiver fluid and skin using liquid scintillation counting over 24 hours. Results: In the EpiDerm model, the absorption of 4-OHT and ENX was 10%-11%; total penetration (TP) was 26%-29% at 24 hours and was decreased by OA. In normal human skin, the absorption of 4-OHT and ENX was 0.3%; TP was 2%-4% at 24 hours. The addition of 1% OA improved the permeation of ENX significantly more than that of 4-OHT (P , 0.004); further titration of OA at 0.25%-0.5% further improved the permeation of ENX to a level similar to that of estradiol. Conclusion: The addition of OA to ENX results in a favorable rapid delivery equivalent to that of estradiol, a widely used transdermal hormone. The transdermal delivery of ENX to the breast should be further developed in preclinical and clinical studies.

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mentioning

confidence: 99%

In vitro human skin permeation of endoxifen: potential for local transdermal therapy for primary prevention and carcinoma in situ of the breast

Lee¹,

Ivancic²,

Chatterton³

et al. 2011

BCTT

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“…Bilindiği gibi meme lenfatik akımı ilk olarak subareolar pleksusta toplanır ve buradan aksilla ya da mammaria interna grubuna dağılır. Daha önce eksizyonel biyopsi yapılan hastalarda enjeksiyon biyopsi kavitesinin duvarlarına yapılır [13,16]. Çalışmamızda periareolar subdermal enjeksiyon tercih edilmiştir.…”

Section: Discussionunclassified

Meme kanserinde sentinel lenf nodu uygulaması: 30 vakanın analizi

Köse

Erdem

2017

Archives of Clinical and Experimental Medicine

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Results: Sentinel lymph node involvement was detected in 14 (46.7%) of 30 patients. In the other 16 patients (53.3%), no involvement of the sentinel lymph nodes was detected and six of these patients (37.5%) did not undergo axillary dissection. None of the nine patients (56.2%) without sentinel lymph node involvement had also no axillary involvement. Axillary involvement was detected only in one patient. In our study, 10 patients (62.5%) who had no sentinel lymph node involvement but had axillary dissection showed false negativity in one patient and it was seen that this patient was the first patient to be included in the study. Sentinel lymph node detection rate was 88.2%, accuracy rate was 76.6%, sensitivity rate was 88.2% and false negative rate was 10%. Conclusion: The use of sentinel lymph node biopsy in the surgical treatment of breast cancer is a safe approach.

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“…Since then, many investigators have reported equally good results with the intradermal, subdermal or subareolar routes of injection, and a comparably low rate of false-negative procedures. 16,17 It appears from these studies that most of the breast tissue and its overlying skin drains to the same few axillary SLNs regardless of injection site. Intradermal and subdermal injections are given as a single dose into the breast skin directly over the tumour or just cephalad to a previous biopsy scar.…”

Section: Site and Volume Of Injectionmentioning

confidence: 96%

Sentinel lymph node biopsy in breast cancer: the node to recovery

Goyal

2010

Indian J Surg Oncol

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The widespread adoption of sentinel lymph node biopsy to stage the axilla has led to decrease in arm and shoulder morbidity. Sentinel lymph node biopsy is suitable for patients with clinically/radiologically node negative invasive breast cancer and selected patients with DCIS (those with clinical/radiological mass or extensive lesions requiring mastectomy). The combined isotope-blue dye injection technique gives the best results. We inject the isotope intra-dermally preoperatively and blue dye dye subdermally after anesthetic induction into the tumour quadrant peri-areolar tissue. Lymphoscintiscan is not necessary but is useful during the learning phase. Sentinel node biopsy can be performed through a small transverse or vertical axillary incision (~3 cm) appropriately placed to allow axillary lymph node clearance if needed.

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Subareolar Versus Peritumoral Injection for Location of the Sentinel Lymph Node

Cited by 308 publications

References 18 publications

In vitro human skin permeation of endoxifen: potential for local transdermal therapy for primary prevention and carcinoma in situ of the breast

In vitro human skin permeation of endoxifen: potential for local transdermal therapy for primary prevention and carcinoma in situ of the breast

Meme kanserinde sentinel lenf nodu uygulaması: 30 vakanın analizi

Sentinel lymph node biopsy in breast cancer: the node to recovery

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