The Value of Combined Peritumoral and Subdermal Injection Techniques for Lymphoscintigraphy in Detection of Sentinel Lymph Node in Breast Cancer

Şanlı, Yasemin; Berberoğlu, Kezban; Türkmen, Cüneyt; Ozmen, V; Müslümanoğlu, Mahmut; İğci, Abdullah; Asoğlu, Oktar; Keçer, Mustafa; Tuzlali, Sıtkı; Cantez, Sema; Mudun, Ayşe

doi:10.1097/01.rlu.0000242603.06844.81

Cited by 13 publications

(9 citation statements)

References 14 publications

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“…The injection can be either superficial (subdermal, periareolar, or subareolar) or deep (peritumoral) (11)(12)(13). Superficial injections are easier to perform than deep injections but may not provide full information on drainage.…”

Section: Radiopharmaceuticals and Injection Parametersmentioning

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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Section: Radiopharmaceuticals and Injection Parametersmentioning

confidence: 99%

Lymphoscintigraphy and Sentinel Nodes

2015

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“…The success rate of SLN detection is higher in superficial injections such as intradermal and subdermal than deeper injections such as peritumoral and intratumoral (22). On the other hand, the detection rate of internal mammarian drainage is higher with deeper injection than superficial injection (18,19,20,21,22). The periareolar injection can eliminate the effects of excisional biopsy, nonpalpabl tumor and multicentric tumor (23).…”

Section: Discussionmentioning

confidence: 97%

“…In the literature, several authors have reported that previous biopsy had no effect on the success of the SLN identification (15,19). However some studies hypothesize that biopsy cavity may affect the SLN identification rate (15,16,17,18,19). The large excisional biopsy cavity may cause distruption of normal anatomic lymphatic pathways.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, periareolar intradermal injection techniques are preferred because of the rapid visualization and high rate of SLN detection, regardless of the localization of the tumor (18,21). The success rate of SLN detection is higher in superficial injections such as intradermal and subdermal than deeper injections such as peritumoral and intratumoral (22).…”

Section: Discussionmentioning

confidence: 99%

“…Surgeon's experience is another factor in the determination of SLN. The previous excisional biopsy may affect the visualization of lymphatic drainage and SLN due to distruption of normal lymphatic pathways (15,16,17,18,19). …”

Section: Introductionmentioning

confidence: 99%

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The Effect of the Excisional Biopsy in the Detection of the Sentinel Lymph Node By Lymphoscintigraphy and Intraoperative Gamma Probe in Breast Cancer

Arıcan¹,

Peksoy²,

Naldöken³

et al. 2011

MIRT

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Objective: Sentinel lymph node (SLN) scintigraphy is used widespread in breast cancer, but the effect of the radionuclide agent, injection technique, the method of biopsy, tumor localization, breast size remain controversial. We examined the effects of the excisional biopsy in the rate of the SLN identification with lymphoscintigraphy (LS) and intraoperative gamma probe (IGP).Material and Methods: One hundred patients (age range: 28-79 yr) with breast cancer were included in the study. They consisted of two groups: Group 1; there were 58 patients without excisional biopsy Group 2; there were 42 patients with excisional biopsy LS: 2 hours before the operation, 37 MBq/ ml Tc 99m colloidal rhenium sulphide was injected at the periaerolar region intradermally Anterior and lateral static images were acquired. IGP: The hot spot of greatest radioactivity were marked on the skin during the surgery with IGP and removed. Excised SLNs were examined with frozen section. After that histopathological and immunohistochemical examinations were performed.Results: SLNs were found in all patients in group 1 (100%), in 39 patients of group 2 (93%) with LS. SLNs were excised in 57 of the 58 patients of group 1 (98%), in 38 of the 42 patients of group 2 (90%) with IGF. Metastases were found in SLNs in 27 patients (28%). Axillary dissection was performed in these patients.Conclusion: According to results of our study the excisional biopsy was not the only factor but also other factors such as breast mass, calcified or metastatic lymph node may be affected the success rate of the SLN. Conflict of interest:None declared.

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The accuracy of sentinel node biopsy in breast cancer patients with the history of previous surgical biopsy of the primary lesion: Systematic review and meta-analysis of the literature

Javan

Gholami

Assadi

et al. 2012

European Journal of Surgical Oncology (EJSO)

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The Value of Combined Peritumoral and Subdermal Injection Techniques for Lymphoscintigraphy in Detection of Sentinel Lymph Node in Breast Cancer

Abstract: This results suggest that a combination of both PT and SD techniques increases the success rate of visualization SLN and enhances the visualization of extraaxillary nodes for further treatment planning.

Cited by 13 publications

References 14 publications

Lymphoscintigraphy and Sentinel Nodes

Lymphoscintigraphy and Sentinel Nodes

The Effect of the Excisional Biopsy in the Detection of the Sentinel Lymph Node By Lymphoscintigraphy and Intraoperative Gamma Probe in Breast Cancer

The accuracy of sentinel node biopsy in breast cancer patients with the history of previous surgical biopsy of the primary lesion: Systematic review and meta-analysis of the literature

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