The Use of Periareolar Intradermal Tc-99m Tin Colloid and Peritumoral Intraparenchymal Isosulfan Blue Dye Injections for Determination of the Sentinel Lymph Node

Argon, Asuman; Duygun, Ülkem Yararbaş; Acar, Ebru; Daglioz, Gozde; Yenjay, Levent; Zekioglu, O.; Kapkaç, Murat

doi:10.1097/01.rlu.0000246855.80027.b7

Cited by 22 publications

(20 citation statements)

References 26 publications

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“…The authors consequently adapted the subareolar injection technique, moving the radioactive injection away from the axilla, where most draining nodes are supposed to be located [14]. Argon et al [29] conclude that periareolar intradermal injection of radiocolloid combined with peritumoral intraparenchymal injection of blue dye is an accurate and easy method of locating SLN with very high detection rates but with low visualisation rate of the internal mammary nodes.…”

Section: Discussionmentioning

confidence: 99%

Sentinel Lymph Node Identification in Breast Cancer - Comparison of Planar Scintigraphy and SPECT/CT

Kraft¹,

Havel²

2012

TONMEDJ

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Aim: Assess the role of planar lymphoscintigraphy and fusion imaging of SPECT/CT in sentinel lymph node (SLN) identification in patients with breast cancer.Methods: Planar scintigraphy and hybrid modality SPECT/CT were performed in 223 consecutive women with breast cancer (mean age 59,5 yrs with range 25 -82 years).In 190 women with a palpable mass radiocolloid was injected in four peritumoral sites and one subdermal injection above the tumour (GROUP A), in 33 women with nonpalpable tumour radiotracer was injected in four subareolar sites (GROUP B).Planar and SPECT/CT images were interpreted separately by two nuclear medicine physicians. Ability of these two techniques to image SLN was compared.Results: In GROUP A the overall hot LN detection rate by planar and SPECT-CT lymphoscintigraphy was 87,9 % (167 patients). In 10 patients (5,3 %), hot LNs were detected only by SPECT-CT. 18 (5,3 %) foci of uptake in 13 (6,8 %) patients interpreted on planar images as hot LNs were found to be false positive non-nodal sites of uptake when further assessed on SPECT/CT.In GROUP B the overall hot LN detection rate on planar and SPECT-CT was 97 % (32 patients). In one (3,0 %) patient hot LNs were identified only on SPECT/CT. Four (6,6 %) foci of uptake in four (12,1 %) patients were found to be false positive when further correlated with SPECT/CT. Differences in detection of SLNs between planar and SPECT/CT imaging in all 223 patients were statistically significant (P< 0.001). Conclusion:In some patients with breast cancer SPECT/CT improves the detection of sentinel lymph nodes. It can image nodes not visible on planar scintigrams, exclude false positive uptake and exactly localize axillary and non-axillary SLN.

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Section: Discussionmentioning

confidence: 99%

Sentinel Lymph Node Identification in Breast Cancer - Comparison of Planar Scintigraphy and SPECT/CT

Kraft¹,

Havel²

2012

TONMEDJ

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“…The optimal method of SLN identifi cation remains controversial. SLN detection is more successful when using both periareolar intradermal injection of Tc-99m sulfur colloid and subareolar injection of blue dye techniques (6). Obtaining a careful tattoo history and physical examination are valuable in the evaluation of any patient undergoing work-up for breast cancer (7).…”

Section: Discussionmentioning

confidence: 99%

A tattoo pigmented node and breast cancer

Soran¹,

Kanbour‐Shakir²,

O³

et al. 2014

BLL

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Over the last decade, the axillary SLNB has replaced routine ALND for clinical staging in early breast cancer. Studies describe a potential pitfall in the identifi cation of a true sentinel node during surgery due to lymph node pigmentation secondary to migration of tattoo dye. These pigmented "pseudo-sentinel" nodes, if located superfi cially in the axilla, may mimic the blue sentinel node on visual inspection, therefore missing the true sentinel node and potentially understaging the patient. Here, we present a case report of a breast cancer patient with a tattoo and discuss the importance of tattoo pigment in the LN (Fig. 1, Ref. 8). Text in PDF www.elis.sk.Acknowledgement: All of the authors declare that they have no confl ict of interest in the information contained in the manuscript.Abbreviations: SLNB -sentinel lymph node biopsy, ALNDaxillary lymph node dissection, LN -lymph node, SLN -sentinel lymph node.

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“…We believe that both deep and superficial injection approaches are valid techniques and often complementary; combinations of injection techniques (either peritumoral and subareolar/periareolar injections [33] or subdermal/ peritumoral injection [34]) may improve detection accuracy and decrease false-negative rates (FNR). This is supported by the results from Suami et al's [35] human cadaver study of breast lymphatic anatomy which showed that although the majority of superficial lymph vessels of the breast drain to only one sentinel node some show alternative lymphatic drainage.…”

Section: Methods Of Inoculationmentioning

confidence: 99%

Development of sentinel node localization and ROLL in breast cancer in Europe

Paganelli

Luini

Sansovini

et al. 2015

Clin Transl Imaging

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The concept of a precise region in which to find the lymph nodes that drain the lymph directly from the primary tumor site can be traced back to a century ago to the observations of Jamieson and Dobson who described how cancer cells spread from cancer of the stomach in a single lymph node, which they called the â\u80\u9cprimary glandâ\u80\u9d. However, Cabanas was the first in 1977 to realize the importance of this concept in clinical studies following lymphography performed in patients with penile cancer. Thanks to Mortonâ\u80\u99s studies on melanoma in 1992, we began to understand the potential impact of the sentinel lymph node (SN) on the surgical treatment of this type of cancer. The use of a vital dye (blue dye) administered subdermally in the region surrounding the melanoma lesion led to the identification of the sentinel node, and the vital dye technique was subsequently applied to other types of solid tumors, e.g. breast, vulva. However, difficulties in using this technique in anatomical regions with deep lymphatic vessels, e.g. axilla, led to the development of lymphoscintigraphy, started by Alex and Krag in 1993 on melanoma and breast cancer and optimized by our group at European Institute of Oncology (IEO) in Milan in 1996. Today, lymphoscintigraphy is still considered as the most reliable method for the detection of the SN. In 1996, a new method for the localization of non-palpable breast lesion called radioguided occult lesion localization (ROLL) was also developed at IEO. Retrospective and prospective studies have since shown that the ROLL procedure permits the easy and accurate surgical removal of non-palpable breast lesions, overcoming the limitations of previous techniques such as the wire-guided localization. The purpose of this paper is to describe the evolution of SN biopsy and radioguided surgery in the management of breast cancer. We also include a review of the literature on the clinical scenarios in which SN biopsy in breast cancer is currently used, with particular reference to controversies and future prospects

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The Use of Periareolar Intradermal Tc-99m Tin Colloid and Peritumoral Intraparenchymal Isosulfan Blue Dye Injections for Determination of the Sentinel Lymph Node

Cited by 22 publications

References 26 publications

Sentinel Lymph Node Identification in Breast Cancer - Comparison of Planar Scintigraphy and SPECT/CT

Sentinel Lymph Node Identification in Breast Cancer - Comparison of Planar Scintigraphy and SPECT/CT

A tattoo pigmented node and breast cancer

Development of sentinel node localization and ROLL in breast cancer in Europe

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