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.

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.

Cost comparison of two surgical strategies in the treatment of breast cancer: Sentinel lymph node biopsy versus axillary lymph node dissection

2004 ◽  
Vol 20 (4) ◽  
pp. 449-454 ◽  
Author(s):  
Lionel Perrier ◽  
Karima Nessah ◽  
Magali Morelle ◽  
Hervé Mignotte ◽  
Marie-Odile Carrère ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Medical Costs ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Direct Medical Costs ◽  
Node Biopsy

Objectives: The feasibility and accuracy of sentinel lymph node biopsy (SLNB) in the treatment of breast cancer is widely acknowledged today. The aim of our study was to compare the hospital-related costs of this strategy with those of conventional axillary lymph node dissection (ALND).Methods: A retrospective study was carried out to determine the total direct medical costs for each of the two medical strategies. Two patient samples (n=43 for ALND; n=48 for SLNB) were selected at random among breast cancer patients at the Centre Léon Bérard, a comprehensive cancer treatment center in Lyon, France. Costs related to ALND carried out after SLNB (either immediately or at a later date) were included in SLNB costs (n=18 of 48 patients).Results: Total direct medical costs were significantly different in the two groups (median 1,965.86€ versus 1,429.93€, p=0.0076, Mann-Whitney U-test). The total cost for SLNB decreased even further for patients who underwent SLNB alone (median, 1,301€). Despite the high cost of anatomic pathology examinations and nuclear medicine (both favorable to ALND), the difference in direct medical costs for the two strategies was primarily due to the length of hospitalization, which differs significantly depending on the technique used (9-day median for ALND versus 3 days for SLNB, p<0.0001).Conclusions: A lower morbidity rate is favorable to the generalization of SLNB, when the patient's clinical state allows for it. From an economic point of view, SLNB also seems to be preferred, particularly because our results confirm those found in two published studies concerning the cost of SLNB.

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.

Alteration of Blood Circulation in the Upper Limb Before and After Surgery for Breast Cancer Associated with Axillary Lymph Node Dissection or Sentinel Lymph Node Biopsy

2017 ◽  
Vol 15 (4) ◽  
pp. 343-348
Author(s):  
Maíta M.O.L.L. Vaz ◽  
Rinaldo Roberto de Jesus Guirro ◽  
Hélio Humberto Angotti Carrara ◽  
Thais Montezuma ◽  
Carla Silva Perez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Blood Circulation ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Node Biopsy ◽  
Before And After
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