Lymphoscintigraphy in breast cancer patients –comparison of peritumoural and intradermal injection

2000 ◽  
Vol 39 (06) ◽  
pp. 152-155 ◽  
Author(s):  
H. Kässmann ◽  
G. Galvan ◽  
C. Menzel ◽  
R. Reitsamer ◽  
J. Holzmannhofer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Primary Tumour ◽  
False Negative ◽  
False Negative Rate ◽  
Intradermal Injection ◽  
Injection Technique ◽  
Breast Cancer Patients ◽  
Identification Rate ◽  
Negative Rate

Summary Aim of this study was to determine whether the sentinel lymph nodes (SLNs) can be accurately identified in breast cancer patients with intradermal injection of the radiotracer above the primary tumour in comparison to peritumoural injection. Methods: In 45 women with breast cancer we performed lymphoscintigraphy on two separate days. We injected Tc-99m nanocolloid on the first day peritumourally, and on a separate day intradermally. The results of both investigations using different injection sites were compared in order to determine the number and location of SLNs. Results: The SLN identification rate using peritumoural injection was 71% (32 of 45 patients) and 96% (43 out of 45 patients) using intradermal injection. In 62% (28 of 45 patients) the number and location of the SLNs were identical. In 97% (31 of 32 patients) in whom a SLN was detected using peritumoural injection, the same SLNs reappeared with intradermal injection. There were no false negative findings with the peritumoural administration of tracer whereas the intradermal administration approach resulted in a false negative rate of 13%. Conclusion: In women with breast cancer the reproducibility of lymphoscintigraphy using peritumoural and intradermal injection sites was 62%. The intradermal injection modality enables the detection of a SLN in patients where the peritumoural injection failed but it has the disadvantage of a higher false negative rate in comparison to the peritumoural injection technique.

Influence of the injection technique on the false negative rate of SLNE in multifocal breast cancer

2008 ◽  
Vol 47 (05) ◽  
pp. 216-219 ◽  
Author(s):  
R. Stöcklein ◽  
R. Dorn ◽  
H. Vogt ◽  
A. Wischnik ◽  
J. Sciuk ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Detection Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Injection Technique ◽  
Breast Cancer Patients ◽  
Intraoperative Detection ◽  
Negative Rate ◽  
Multifocal Breast Cancer

Summary Aim: We investigated the influence of the injection technique on the false negative rate in identifying the sentinel lymph node in multifocal breast cancer. Patients, methods: 958 consecutive patients were divided into unifocal and multifocal breast cancer patients. The scintigrafic and intraoperative detection rate as well as the false negatives were calculated in relation to peritumoral or subareolar injection. Results: In all patients the scintigrafic and intraoperative detection rate exceeded 99%, except in patients with multifocal cancer, who were injected peritumorally. In this group the intraoperative detection rate declined to 96%. In patients with unifocal breast cancer the false negative rate was below 5%, independent of the injection technique. Multifocal breast cancer patients showed a significant dependence on the injection technique. The false negative rate was 26.3% in patients with peritumoral injection and 5.6% in those with subareolar injection. Conclusion: The results clearly demonstrate that in multifocal breast cancer a reliable detection of a SLN is impossible with the peritumoral injection technique. Subareolar injection seems to be a way to operate on multifocal breast cancer with SLNE, but the number of investigated patients is too low for statistic approval. So, prospective studies should be performed to validate these preliminary results before SLNE becomes routine in multifocal breast cancer.

False negative rate of the highest radioactive count of sentinel lymph node in early stage breast cancer patients

The Breast ◽  
2019 ◽  
Vol 44 ◽  
pp. S105
Author(s):  
P. Chirappapha ◽  
R. Panawattanakul ◽  
W. Vassanasiri ◽  
Y. Kongdan ◽  
P. Lertsithichai ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Cancer Patients ◽  
Early Stage ◽  
False Negative ◽  
False Negative Rate ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Negative Rate

scholarly journals Identification of sentinel lymph nodes using contrast-enhanced ultrasound in breast cancer patients who underwent neoadjuvant chemotherapy.

2019 ◽  
Vol 5 (suppl) ◽  
pp. 59-59
Author(s):  
Xiufeng Wu ◽  
Lina Tang ◽  
Yi Zeng ◽  
Xia Chen
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
False Negative ◽  
False Negative Rate ◽  
Breast Cancer Patients ◽  
Identification Rate ◽  
Contrast Enhanced ◽  
Sensitivity Specificity

59 Background: The aim of this prospective study was to evaluate the feasibility of contrast-enhanced ultrasonography (CEUS) for the identification of sentinel lymph node (SLN) in breast cancer patients with cN0 following neoadjuvant chemotherapy (NAC). Methods: Patients with cN0 following NAC (n=66) received a periareolar injection of SonoVue followed by ultrasound (US) to identify contrast-enhanced SLN before surgery. All patients underwent axillary lymph node dissection for verification of axillary node status after the SLN biopsy. The identification rate, sensitivity, specificity, accuracy, false negative rate, negative predictive value, positive predictive value was recorded. Results: In almost all cases, the SLNs were easily identified with an identification rate of 98.5 % (65/66). Compared with pathological diagnosis, sensitivity, specificity, accuracy, and false negative rate of CEUS for SLN diagnosis were 66.7%, 95.8%, 78.8%, and 14.3% respectively. Conclusions: Identification of SLN by CEUS is a technically feasible method with an identification rate as high as 98.5%. [Table: see text][Table: see text]

Validity of sentinel lymph node biopsy in breast cancer patients after neoadjuvant chemotherapy

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 11023-11023
Author(s):  
H. Jinno ◽  
S. Asaga ◽  
M. Sakata ◽  
T. Kubota ◽  
M. Kitajima ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Cancer Patients ◽  
False Negative ◽  
False Negative Rate ◽  
Control Group ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Negative Rate

11023 Background: Sentinel lymph node biopsy (SLNB) is a potential alternative procedure to conventional axillary lymph node dissection (ALND) in clinically node-negative breast cancer patients. Neoadjuvant chemotherapy (NAC) is a standard of care for patients with locally advanced breast cancer and indications of NAC have been widespread to operable breast cancer patients to facilitate breast conserving surgery. However, the validity of SLNB in breast cancer patients who received NAC is still controversial. Methods: Forty-six patients with stage II or III breast cancer who were treated with NAC from January 2002 to May 2006 were included in the study. Consecutive 122 patients who had SLNB without NAC during the same period were used as a control group. All patients underwent SLNB followed by completion ALND. Sentinel lymph node (SLN) was detected using a combined method of injecting isosulfan blue dye and small-sized technetium- 99m-labeled tin colloid (particle size: 200–400 nm in diameter) peritumorally and subcutaneously. SLNs were evaluated by means of H&E and immunohistochemical staining. Results: SLNs were successfully identified in 42/46 patients (91.3%) treated with NAC and 112/113 patients (99.1%) without NAC (p=0.01). Metastases in the SLNs were found in 16/42 patients (38.1%) with NAC and 32/112 patients (28.6%) without NAC (p=0.2). There were 5 false negative cases (false negative rate: 23.8%) in the NAC group and 2 false negative cases (false negative rate: 5.9%) in the control group (p=0.05). Accuracy of SLNB in the NAC group was also significantly inferior to the control group (88.1% vs. 98.2%, p<0.01). The presence of clinically positive axillary lymph nodes before NAC was not correlated with false negative rate. Conclusions: These data suggest that NAC might be considered a contraindication to SLNB even in patients with clinically negative axillary lymph nodes before NAC. No significant financial relationships to disclose.

Where to look for sentinel node in breast cancer?

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 2560-2560
Author(s):  
Anton J. Scharl ◽  
Andreas Düran ◽  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Node ◽  
Cancer Patients ◽  
Lymphatic Mapping ◽  
False Negative ◽  
False Negative Rate ◽  
Breast Cancer Patients ◽  
Standard Methods

2560 Background: It has been observed, that the caudal Axilla on the border to pectoralis muscle is predicive for the sentinel node. The sono-morphology of lymph nodes has been the subject of multiple publications, usually dealing with malignant melanoma. In the context of sentinel lymph node biopsy (SLNB) in breast cancer patients, the following study examines the feasibility of the sonographic differentiation of the Sentinel lymph node (SLN) from neighboring non-SLNs and whether sentinel-ultrasound-needle localization (SUN) is a useful addition or alternative to current methods of “lymphatic mapping”. Methods: During a prospective study performed from 1/2003 to 9/2005 including 404 breast cancer patients (Tis-T4), the SLNB was performed using patent blue+/- 99Tc-Nanocoll. In addition to and independent of this method, the axilla was sonographically examined for “reactive” lymph nodes n=180 pt. (Siemens Elegra 7.5 MHz). The “reactivity” of the nodes was quantified using an index , which allowed the comparison of adjacent nodes. The most “reactive” lymph node in the caudal axilla was identified as the “Ultrasound-Sentinel-Node”(US-SLN) and has been marked with a wire. Results: In 180 patients the SLN was localized using the standard methods as well as (SUN). The was no difference in detection rates of US-SLN and the standard methods in tumor-free nodes(SLN-). However, for patients with axillary metastases (SLN+) SUN provided superior detection rate (99,1%). The false-negative-rate was reduced from 10,7 % to 1,3%. This was attributed to the embolization of lymph vessels afferent to the metastasized (SLN+) node causing a bypass of the “lymphatic mapping” and inhibiting detection. Conclusions: The SUN–Method is comparable to “lymphatic mapping” in tumor free nodes (SLN -). If SLN is metastasized (SLN+) - SUN is superior to the standard methods in sensitivity and specificity (80%) and the false-negative-rate can be reduced. Systematic axilla sonography is an effective method for the SLN-Localisation, and offers an excellent method for quality control during SLNB.

A prospective study to evaluate the accuracy of axillary staging using ultrasound and USG-guided fine needle aspiration cytology in early breast cancer patients in a high-volume center.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12060-e12060
Author(s):  
Rashpal Singh ◽  
Ekta Dhamija ◽  
SVS Deo ◽  
Sandeep Mathur ◽  
Sanjay Thulkar
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
False Negative ◽  
False Negative Rate ◽  
High Volume ◽  
Axillary Staging ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Developing Nation

e12060 Background: In breast cancer, axillary lymph node involvement directly impacts the patient survival and prognosis.Sentinel lymph node biopsy (SLNB) is a procedure of choice for axillary staging in early breast cancer. Currently, management options for axilla management are ALND & SLNB in node positive & in node negative respectively. In developing nation like India,where resource constraints, logistics issues and over burden health institutes create difficulty in managing patients, our study address this issue by implementing USG and USG-FNAC in early breast cancer patients in developing nation. Methods: All early breast cancer patients were screend by ultrasound axilla to categorise the nodes as suspicious or non suspicious. Suspicious nodes underwent USG & FNAC using vascualr pedicle based nodal mapping for node targeted on USG-FNAC, if node found to be positive, patient underwent ALND & negative node patients underwent SLNB.All non-suspicious nodes patient underwent SLNB. Final histopathology was taken as gold standard. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value, accuacy and false negative rate calculated for USG & USG-FNAC. Results: Total 100 patients included in which 58 were non-suspicious and 42 suspicious nodes on USG. Among suspicious group, 24 were positive on USG-FNAC & 18 were negative.In non suspicious SLNB done in all. False negative rate of USG & USG-FNAC was 38% and 17% respectively. Conclusions: Our study indicates the feasibility of USG & USG-FNAC in a high volume centre with good accuracy of around 70- 80%.Overall, 24 % of total patients can be taken up for ALND without performing SLNB.This study can guide us to utilize ultrasound and ultrasound-guided FNAC as a routine evaluation tool in the pre operative assessment of axillary lymph nodes in early breast cancer. Our study showed good and acceptable result (75%) in isolating and retrieving the targeted node by just following the Vascular pedicle based node mapping of axilla to locate the suspicious node without using any tagging or marking of node from where FNAC was performed. This finding can act as a good practicing tool in a busy high volume, logistics issue and and resource constraint hospitals.[Table: see text]

scholarly journals Breast Cancer Sentinel Node Detection: An Alternative Solution for Centers Lacking Nuclear Technology

Breast Care ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. 265-268 ◽  
Author(s):  
Mahmoud A. Alhussini ◽  
Ahmed T. Awad ◽  
Mohamed H. Ashour ◽  
Ahmed Abdelateef ◽  
Haytham Fayed
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
False Negative ◽  
False Negative Rate ◽  
Surgical Oncology ◽  
Blue Dye ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Sentinel Node Detection ◽  
Identification Rate

Background: Sentinel lymph node (SLN) has become the gold standard for all cases with no axillary nodal metastasis. The combined radioisotope and blue dye technique is adopted in most centers. The lack of the technology for radioisotope in our institution encouraged us to study the feasibility of methylene blue (MB) for SLN detection in breast cancer patients admitted to Alexandria Surgical Oncology Unit. Methods: A total of 144 cases were subjected to SLN detection by injecting 2 ml of MB 1%. This was followed by standard axillary lymph node dissection. The safety and accuracy of MB as a tracer for detection of SLN were studied. Results: The identification rate was 93.15%. The number of SLN identified ranged from 1 to 8 nodes with a mean of 1.75 ± 1.17. The sensitivity of MB dye technique was 96.3%. The false negative rate was 3.7%. The negative predictive value was 97.6% and the accuracy was 98.5%. Conclusions: MB is a safe, reliable, cheap, and accurate alternative tracer for detection of SLN.

scholarly journals Neoadjuvant Chemotherapy Effect on Predictive Value of Sentinel Lymph Node Biopsy using Single Method Methylene Blue in Breast Cancer Patients at Low-resource Country

2021 ◽  
Vol 9 (B) ◽  
pp. 191-195
Author(s):  
Muhammad David Perdana Putra ◽  
Kristanto Yuli Yarso ◽  
Brian Wasita
Keyword(s):  
Breast Cancer ◽  
Methylene Blue ◽  
Cancer Patients ◽  
Predictive Value ◽  
False Negative ◽  
False Negative Rate ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Single Method

AIM: This study aimed to examine the application of neoadjuvant chemotherapy (NAC) effect on sentinel lymph node biopsy (SLNB) using single method methylene blue 1% in breast cancer patients at low-resource country. METHODS: This analytical observational study employed a retrospective case–control approach. The total sampling method was used by involving the entire population of Stage-I and -II breast cancer patients after performed core biopsy or open biopsy with clinically negative axillary lymph nodes that had performed SLNB and axillary lymph nodes dissection at several hospitals in Surakarta from January to May 2020. The descriptive data were presented in the frequency table. Sensitivity, specificity, positive predictive value, negative predictive value (NPV), and diagnostic values were reported with 95% confidence of interval (CI). RESULTS: From a total of 161 patients, 100 patients were given NAC. The identification rate of the non-NAC was 91.3% and the NAC group 80.6%. Non-NAC group obtained a false-negative rate of 24.4% with NPV of 94.4% (95% CI 85–100), while the false-negative rate of the NAC group was 10.8% with NPV of 74% (95% CI 65–80). CONCLUSIONS: NAC with single method methylene blue 1% injection in SLNB can reduce the identification and false-negative rates in breast cancer patients.

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