Sentinel Lymph Node Biopsy for Occult Breast Cancer Detected during Breast Reduction Surgery

2006 ◽  
Vol 72 (5) ◽  
pp. 397-400 ◽  
Author(s):  
Mehra Golshan ◽  
Beth-Ann Lesnikoski ◽  
Susan Lester
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
Breast Reduction ◽  
Lymph Node Biopsy ◽  
Breast Reduction Surgery ◽  
Occult Breast Cancer ◽  
Node Biopsy

Breast reduction surgery is considered a relative contraindication to a sentinel node biopsy because of the possibility that lymphatics have been interrupted by the procedure. We describe six patients who underwent successful sentinel lymph node biopsy for occult carcinomas detected after breast reduction surgery. A subsequent skin-sparing mastectomy, along with a sentinel lymph node biopsy, was performed. Reconstruction was possible in five of six patients. Sentinel lymph node biopsy should not be considered a contraindication after breast reduction surgery.

scholarly journals A Pilot Study Evaluating the Effects of Magtrace® for Sentinel Node Biopsy in Breast Cancer Patients Regarding Care Process Optimization, Reimbursement, Surgical Time, and Patient Comfort Compared With Standard Technetium99

2020 ◽  
Author(s):  
Sina Shams ◽  
Kai Lippold ◽  
Jens Uwe Blohmer ◽  
Robert Röhle ◽  
Friedrich Kühn ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
Care Pathway ◽  
Lymph Node Biopsy ◽  
Patient Comfort ◽  
Surgical Time ◽  
Node Biopsy

Abstract Background Sentinel lymph node biopsy after technetium-99 (Tc99) localization is a mainstay of oncologic breast surgery. The timing of Tc99 injection can complicate operating room schedules, which can cause increasing overall costs of care and patient discomfort. Methods This study compared 59 patients who underwent breast cancer surgery including sentinel lymph node biopsy. Based on the surgeon’s choice, 29 patients were treated with Tc99, and 30 patients received the iron-based tracer, Magtrace. The primary outcomes were time spent on the care pathway and operating time from commissioning of the probe to removal of the sentinel node. The secondary outcomes were patient pain levels and reimbursement. Results The mean time spent on the preoperative breast cancer care pathway was significantly shorter for the Magtrace group (5.4 ± 1.3 min) than for the Tc99 group (82 ± 20 min) (p < 0.0001). The median time from probe usage to sentinel node extirpation was slightly but not significantly shorter in the Magtrace group (5 min; interquartile range [IQR], 3–15 min vs 10 min; IQR, 7–15 min; p = 0.151). Reimbursement and pain levels remained unchanged, and the hospital length of stay was similar in the two groups (Magtrace: 5.1 ± 2.3 days vs Tc99: 4.5 ± 3.2 days). Conclusions Magtrace localization shortened the preoperative care pathway and did not affect surgical time or reimbursement. Once established, it could allow for cost reduction and improve patient comfort.

scholarly journals The Ever-Changing Role of Sentinel Lymph Node Biopsy in the Management of Breast Cancer

2014 ◽  
Vol 138 (1) ◽  
pp. 57-64 ◽  
Author(s):  
Steven Goodman ◽  
Ashling O'Connor ◽  
Dina Kandil ◽  
Ashraf Khan
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Node Biopsy

Context.—Axillary nodal status remains one of the most important prognostic indicators in the management of breast cancer. Axillary node metastases are seen in fewer than half of breast cancer cases, and axillary lymph node dissection is associated with significant morbidity. Sentinel lymph node biopsy (SLNB) has become the gold standard for axillary staging of breast cancer. Objective.—To present a detailed review of the existing studies on SLNB in relation to the various techniques, the pathologic evaluation of the sentinel node, and special situations that can involve SLNB. We discuss recent trials that have already had an influence on surgical and pathologic management of breast cancer. In this article, we also discuss our practice and experience at UMass Memorial Medical Center, Worcester, Massachusetts, from a pathologic and surgical perspective. Data Sources.—Published articles from peer-reviewed journals in PubMed (US National Library of Medicine). Conclusions.—Sentinel node biopsy has become standard of care in the surgical management of breast cancer, and emerging data show that the survival benefits of axillary lymph node dissection may not be greater than sentinel node biopsy alone in patients with up to 2 positive sentinel nodes. Therefore, there have been recent changes to the role of intraoperative sentinel node evaluation, and an impact on overall breast cancer management.

scholarly journals Lymphoscintigraphy for Sentinel Lymph Node Biopsy in Breast Cancer: Do We Need a Delayed Image?

Breast Care ◽  
2019 ◽  
Vol 15 (1) ◽  
pp. 55-59
Author(s):  
Nadja Taumberger ◽  
Birgit Pernthaler ◽  
Thomas Schwarz ◽  
Vesna Bjelic-Radisic ◽  
Gunda Pristauz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
Late Results ◽  
Lymph Node Biopsy ◽  
Breast Cancer Patients ◽  
Node Biopsy ◽  
Early Results

Background: Sentinel lymph node biopsy has become a standard of care in the treatment of patients with early breast cancer, but clinical guidelines continue to be vague on details of the procedure. We were interested in the results of our 2-day protocol, which includes delayed lymphoscintigraphy at 18 h. Methods: We reviewed the results of preoperative lymphoscintigrams in patients undergoing surgery for breast cancer. Lymphoscintigraphy was performed 2 h after periareolar injection of 4 × 37 MBq 99mTc nanocolloid (early lymphoscintigraphy) and 18 h following injection (delayed lymphoscintigraphy). The early results were compared with the late results. Results: A total of 238 lymphoscintigraphies were performed in 232 patients (6 bilateral). At 2 h, ≥1 sentinel nodes were visualized in 154/238 (65%) cases; in 84 (35%), no sentinel node was visualized. Delayed lymphoscintigraphy visualized a sentinel node in 40 of 76 (53%) cases with no visualization at 2 h and failed to show a sentinel node in 36 (47%) of these cases (in 8 cases, no delayed lymphoscintigram was obtained). Conclusions: Delayed lymphoscintigraphy was useful in about 50% of the breast cancer patients in whom immediate scintigraphy failed to demonstrate a sentinel lymph node.

Sentinel Lymph Node Biopsy After Preoperative Chemotherapy for Breast Cancer: Findings from the Austrian Sentinel Node Study Group

2008 ◽  
Vol 15 (12) ◽  
pp. 3378-3383 ◽  
Author(s):  
Christoph Tausch ◽  
Peter Konstantiniuk ◽  
Franz Kugler ◽  
Roland Reitsamer ◽  
Sebastian Roka ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
Preoperative Chemotherapy ◽  
Lymph Node Biopsy ◽  
Study Group ◽  
Node Biopsy

scholarly journals Lymphatic Mapping in Solid Neoplasms: State of the Art

2002 ◽  
Vol 9 (3) ◽  
pp. 189-202 ◽  
Author(s):  
Emmanuel E. Zervos ◽  
William E. Burak
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
Head And Neck ◽  
Lymphatic Mapping ◽  
Lymph Node Biopsy ◽  
Node Biopsy ◽  
Sentinel Node Concept

Background Lymphatic mapping and sentinel lymph node biopsy is an established technique for the staging and treatment of melanoma. The success of lymphatic mapping in this realm has broadened its application to other solid neoplasms. This update reviews the status of sentinel lymph node biopsy in its most widely cited applications. Methods Seminal manuscripts on lymphatic mapping in melanoma, breast, colon, vulvar, cervical, lung, gastric, and head and neck cancers are reviewed. Results Studies suggest that the application of lymphatic mapping as a staging tool in breast cancer and melanoma is justified when applied by trained surgeons. Additional validation is necessary before sentinel node biopsy is advocated in gynecologic, colon, lung, and head and neck cancer. Conclusions As in breast cancer and melanoma, validation of the sentinel node concept in other solid tumors must occur in institutions other than those in which the technique is being developed before it is generally applied to other neoplasms.

scholarly journals Analysis of sentinel nodes biopsy in breast cancer: 12 years after introduction into clinical practice

2012 ◽  
Vol 65 (9-10) ◽  
pp. 363-367
Author(s):  
Andrija Golubovic ◽  
Milan Ranisavljevic ◽  
Zoran Radovanovic ◽  
Vladimir Selakovic ◽  
Aljosa Mandic ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Clinical Practice ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
Sentinel Node Biopsy ◽  
Lymph Node Biopsy ◽  
Node Dissection ◽  
Node Biopsy

Introduction. Sentinel node biopsy in breast cancer has been a standard procedure at the Institute for Oncology of Vojvodina since 1999 and we have done more than 700 biopsy. Before the introduction of axillary sentinel lymph node biopsy, lymph nodes were routinely dissected, and this approach was the gold standard in surgical treatment of breast cancer. The study was aimed at presenting our results in performing sentinel node biopsy in clinical practice for operative treatment in breast cancer. Material and Methods. All patients (n=791) were women with clinically T1-2, N0-1, M0 breast cancer. Sentinel lymph node marking was performed by both contrast blue dye (Patentblau V) and radiotracer (antimony sulfide marked with Tc99m). Both contrast media were applied peritumorally or periareolarly. After sentinel lymph node biopsy all patients underwent breast-conserving surgery or mastectomy with or without lymph node dissection of level I and II (depending on sentinel lymph node status). Results. Sentinel lymph node biopsy was negative in 543 (68.7%) patients, and positive in 248 (31.3%) patients. Solitary tumor was present in 722 (91.2%) cases, multifocal tumors in 36 (4.57%), multicentric in 28 (3.55%) and bilateral in 5 (0.68%) patients. The mean duration of follow-up was 60.59 months (median 65, range 12- 132). Distant metastases were mostly found in bones (39.13%). Conclusion. The number of complications related to axillary dissection can be reduced and the patient?s quality of life can be improved by avoiding complete axillary lymph node dissection.

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