Evidence-Based Clinical Practice Guidelines on the Use of Sentinel Lymph Node Biopsy in Melanoma

2013 ◽  
pp. e320-e325
Author(s):  
Vernon K. Sondak ◽  
Sandra L. Wong ◽  
Jeffrey E. Gershenwald ◽  
John F. Thompson
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
Primary Melanoma ◽  
Lymph Node Biopsy ◽  
Evidence Based ◽  
Node Negative ◽  
Nodal Basin ◽  
Node Biopsy

Sentinel lymph node biopsy (SLNB) was introduced in 1992 to allow histopathologic evaluation of the “sentinel” node, that is, the first node along the lymphatic drainage pathway from the primary melanoma. This procedure has less risk of complications than a complete lymphadenectomy, and if the sentinel node is uninvolved by tumor the likelihood a complete lymphadenectomy would find metastatic disease in that nodal basin is very low. SLNB is now widely used worldwide in the staging of melanoma as well as breast and Merkel cell carcinomas. SLNB provides safe, reliable staging for patients with clinically node-negative melanomas 1 mm or greater in thickness, with an acceptably low rate of failure in the sentinel node-negative basin. Evidence-based guidelines jointly produced by ASCO and the Society of Surgical Oncology (SSO) recommend SLNB for patients with intermediate-thickness melanomas and also state that SLNB may be recommended for patients with thick melanomas. Major remaining areas of uncertainty include the indications for SLNB in patients with thin melanomas, pediatric patients, and patients with atypical melanocytic neoplasms; the optimal radiotracers and dyes for lymphatic mapping; and the necessity of complete lymphadenectomy in all sentinel node-positive patients.

Surgical Management of Sentinel Lymph Node Biopsy Outside Major Nodal Basin in Patients with Cutaneous Melanoma

2013 ◽  
Vol 21 (1) ◽  
pp. 300-305 ◽  
Author(s):  
Corrado Caracò ◽  
Ugo Marone ◽  
Gianluca Di Monta ◽  
Luigi Aloj ◽  
Corradina Caracò ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Surgical Management ◽  
Cutaneous Melanoma ◽  
Lymph Node Biopsy ◽  
Nodal Basin ◽  
Node Biopsy

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 Accuracy of lymphatic mapping and sentinel lymph node biopsy after previous wide local excision in patients with primary melanoma

Cancer ◽  
2006 ◽  
Vol 107 (11) ◽  
pp. 2647-2652 ◽  
Author(s):  
Christopher J. Gannon ◽  
Dennis L. Rousseau ◽  
Merrick I. Ross ◽  
Marcella M. Johnson ◽  
Jeffrey E. Lee ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Local Excision ◽  
Wide Local Excision ◽  
Lymphatic Mapping ◽  
Primary Melanoma ◽  
Lymph Node Biopsy ◽  
Node Biopsy

Predictors of post-mastectomy radiation (PMRT) in node-negative breast cancer patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12608-e12608
Author(s):  
Laura Sheriff ◽  
Erin Cordeiro ◽  
Jacob Hardy ◽  
Amanda Roberts
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Node Biopsy ◽  
High Grade ◽  
Breast Cancer Patients ◽  
Node Negative ◽  
Node Biopsy ◽  
Node Negative Breast Cancer

e12608 Background: Post-mastectomy radiation (PMRT) reduces the risk of locoregional failure for women with an elevated risk of recurrence from breast cancer. Therefore, PMRT is often indicated for women with node positive breast cancer including those with only 1-3 nodes involved. The need for PMRT in node negative breast cancer patients is less established. The objective of our study was to review the predictors of PMRT in women with node-negative breast cancer and evaluate the overall recurrence rates. Methods: A retrospective chart review was completed. Women with node-negative breast cancer who underwent mastectomy and sentinel lymph node biopsy at a regional breast cancer center between January 1st,2011 and December 31st, 2017 were included. Patient and tumor characteristics, treatment details and recurrence data were recorded. The primary outcome was recommendation of PMRT. Univariate analysis was completed and then a multivariable logistic regression was completed to determine independent predictors for PMRT. Results: Overall, 235 women with node-negative breast cancer underwent mastectomy and sentinel lymph node biopsy during the study period. Forty-three (18.3%) patients were recommended to undergo PMRT, with 39 of the 43 patients completing the recommended treatment. PMRT was offered more often to younger women (p<0.001), women with multifocal/centric disease (p=0.002), large tumors (p<0.001), high grade tumors (p < 0.001), lymphovascular positive tumors (p=0.04) and estrogen-negative disease (p =0.017). On multivariable analysis, the odds of radiation recommendation were highest for patients with high grade disease (OR 5.81, 95%CI: 2.08 – 16.20) followed by multifocal/centric disease (OR 3.12, 95%CI: 1.26 – 7.70). There were no differences in overall recurrence between patients who underwent PMRT versus those who did not have PMRT (p = 0.31). Conclusions: A moderate percentage of node negative patients are offered PMRT. Independent predictors for recommendation of PMRT in node negative patients are: decreasing age, increasing tumor size, multifocal/centric disease and higher grade disease. Surgeons can use this information to counsel patients regarding the possible need for PMRT, especially in the setting of planned immediate reconstruction.

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