Skip to main content
SpringerLink
Log in

Dye-Guided Sentinel Node Biopsy Revisited; Validation and Observational Study from a Single Institute

  • Original Article
  • Published:
Breast Cancer Aims and scope Submit manuscript

Abstract

Background

The aims of this study were to evaluate the feasibility and accuracy of indigocarmine dye-guided sentinel node biopsy and to apply this method to avoid further axillary node dissection in sentinel node negative cases.

Methods

Sixty consecutive clinically node-negative breast cancer patients underwent sentinel node biopsy using 0.5% indigocarmine followed by standard axillary node dissection. Sentinel node biopsy was then applied to 42 clinically node-negative patients to avoid axillary node dissection with intraoperative diagnosis made by frozen section.

Results

Validation study: Sentinel nodes were successfully detected in all 60 patients. The mean number of harvested nodes was 1.7 (range 1-3). Sentinel nodes were positive in all 20 axillary node-positive patients, and therefore the false negative rate was 0% (0/20). Only sentinel nodes contained metastases in 55% (11/20) of node positive patients. Observational study: Sentinel nodes were successfully detected in all 42 patients. The mean number of harvested nodes was 1.6 (range 1-3). Sentinel nodes were positive in 12 patients by final histology, and there was one false negative case by frozen section (8%, 1/12). Only sentinel nodes contained metastases in 55% (6/11) of node positive patients. The detection rate, mean number of harvested sentinel nodes and proportion of node positive patients were similar between the validation and observational studies.

Conclusions

Indigocarmine dye-guided sentinel node biopsy was feasible and accurate. This method can be applied to observational studies after successful validation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Recht A, Houlihan MJ: Axillary lymph nodes and breast cancer: a review.Cancer 76: 1491–1512, 1995.

    Article  PubMed  CAS  Google Scholar 

  2. Krag DN, Weaver DL, Alex JC, Fairbank JT: Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe.Surg Oncol 2: 335–339, 1993.

    Article  PubMed  CAS  Google Scholar 

  3. Giuliano AE, Kirgan DM, Guenther JM, Morton DL: Lymphatic mapping and sentinel lymphadenectomy for breast cancer.Ann Surg 220: 391–398, 1994.

    Article  PubMed  CAS  Google Scholar 

  4. Hsueh EC, Hansen N, Giuliano AE: Intraoperative lymphatic mapping and sentinel lymph node dissection in breast cancer.CA Cancer J Clin 50: 279–291, 2000.

    Article  PubMed  CAS  Google Scholar 

  5. Wong SL, Chao C, Edwards MJ, Turtle TM, Noyes RD, Carlson DJ, Laidley AL, McGlothin TQ, Ley PB, Brown CM, Glaser RL, Pennington RE, Turk PS, Simpson D, McMasters KM: Accuracy of sentinel lymph node biopsy for patients with T2 and T3 breast cancers.Am Surg 67: 522–526, 2001.

    PubMed  CAS  Google Scholar 

  6. Chung MH, Ye W, Giuliano AE: Role for sentinel lymph node dissection in the management of large (> or = 5 cm) invasive breast cancer.Ann Surg Oncol 8: 688–692, 2001.

    PubMed  CAS  Google Scholar 

  7. Canavese G, Gipponi M, Catturich A, Di Somma C, Vecchio C, Rosato F, Percivale P, Moresco L, Nicolo G, Spina B, Villa G, Bianchi P, Badellino F: Sentinel lymph node mapping in early-stage breast cancer: technical issues and results with vital blue dye mapping and radioguided surgery.J Surg Oncol 74: 61–68, 2000.

    Article  PubMed  CAS  Google Scholar 

  8. Hum L, Bak M, Olsen KE, Kryh D, Berg V, Axelsson CK: Sentinel node localization in breast cancer patients using intradermal dye injection.Acta Oncol 39: 423–428, 2000.

    Article  Google Scholar 

  9. Hansen NM: Blue versus hot: learning the techniques with dye and isotopes.Ann Surg Oncol 8: 64S-66S, 2001.

    PubMed  CAS  Google Scholar 

  10. McIntosh SA, Purushotham AD: Lymphatic mapping and sentinel node biopsy in breast cancer.Br J Surg 85: 1347–1356, 1998.

    Article  PubMed  CAS  Google Scholar 

  11. Motomura K, Inaji H, Komoike Y, Hasegawa Y, Kasugai T, Noguchi S, Koyama H: Combination technique is superior to dye alone in identification of the sentinel node in breast cancer patients.J Surg Oncol 76: 95–99, 2001.

    Article  PubMed  CAS  Google Scholar 

  12. Morrow M, Rademaker AW, Bethke KP, Talamonti MS, Dawes LG, Clauson J, Hansen N: Learning sentinel node biopsy: results of a prospective randomized trial of two techniques.Surgery 126: 714–720, 1999.

    PubMed  CAS  Google Scholar 

  13. Imoto S, Hasebe T: Initial experience with sentinel node biopsy in breast cancer at the National Cancer Center Hospital East.Jpn J Clin Oncol 29: 11–15, 1999.

    Article  PubMed  CAS  Google Scholar 

  14. Motomura K, Inaji H, Komoike Y, Kasugai T, Noguchi S, Koyama H: Sentinel node biopsy guided by indocyanine green dye in breast cancer patients.Jpn J Clin Oncol 29: 604–607, 1999.

    Article  PubMed  CAS  Google Scholar 

  15. Guenther JM, Krishnamoorthy M, Tan LR: Sentinel lymphadenectomy for breast cancer in a community managed care setting.Cancer J Sci Am 3: 336–340, 1997.

    PubMed  CAS  Google Scholar 

  16. Rodier JF, Routiot T, Mignotte H, Janser JC, Bremond A, David E, Barlier C, Ghnassia JP, Treilleux I, Chassagne C, Velten M: Lymphatic mapping and sentinel node biopsy of operable breast cancer.World J Surg 24: 1220–1225, 2000.

    Article  PubMed  CAS  Google Scholar 

  17. Flett MM, Going JJ, Stanton PD, Cooke TG: Sentinel node localization in patients with breast cancer.Br J Surg 85: 991–993, 1998.

    Article  PubMed  CAS  Google Scholar 

  18. Giuliano AE, Jones RC, Brennan M, Statman R: Sentinel lymphadenectomy in breast cancer.J Clin Oncol 15: 2345–2350, 1997.

    PubMed  CAS  Google Scholar 

  19. Morgan A, Howisey RL, Aldape HC, Patton RG, Row-botham RK, Schmidt EK, Simrell CR: Initial experience in a community hospital with sentinel lymph node mapping and biopsy for evaluation of axillary lymph node status in palpable invasive breast cancer.J Surg Oncol 72: 24–30, 1999.

    Article  PubMed  CAS  Google Scholar 

  20. Chao C, Wong SL, Ackermann D, Simpson D, Carter MB, Brown CM, Edwards MJ, McMasters KM: Utility of intraoperative frozen section analysis of sentinel lymph nodes in breast cancer.Am J Surg 182: 609–615, 2001.

    Article  PubMed  CAS  Google Scholar 

  21. Motomura K, Inaji H, Komoike Y, Kasugai T, Nagu-mo S, Noguchi S, Koyama H: Intraoperative sentinel lymph node examination by imprint cytology and frozen sectioning during breast surgery.Br J Surg 87: 597–601, 2000.

    Article  PubMed  CAS  Google Scholar 

  22. Weiser MR, Montgomery LL, Susnik B, Tan LK, Borgen PI, Cody HS: Is routine intraoperative frozen-section examination of sentinel lymph nodes in breast cancer worthwhile?Ann Surg Oncol 7: 651–655, 2000.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Kansai Rosai Hospital, Japan

    Tomohiko Aihara & Yuichi Takatsuka

Authors
  1. Tomohiko Aihara
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuichi Takatsuka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tomohiko Aihara.

Additional information

Reprint requests to Tomohiko Aihara, Department of Surgery, Kansai Rosai Hospital, 3-1-69, Inabaso, Amagasaki, Hyogo 660-8511, Japan.

About this article

Cite this article

Aihara, T., Takatsuka, Y. Dye-Guided Sentinel Node Biopsy Revisited; Validation and Observational Study from a Single Institute. Breast Cancer 10, 254–259 (2003). https://doi.org/10.1007/BF02966726

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02966726

Key words

Search

Navigation