Abstract
Background
There are various methods for the detection of sentinel lymph nodes (SLNs) in breast cancer by using a combined method with blue dye and radioisotope (RI) tracers. The purpose of the study was to reveal any correlation between concordance of the tracers and the order of harvest with the presence of metastases in SLNs.
Methods
The outcomes were reviewed in 408 cases with stage 0 to II breast cancer; the combined method was used in which blue dye and RI were injected subcutaneously around the tumor. The radioactivity and blue staining in each harvested SLN were checked.
Results
In 330 cases (81%), SLNs contained both blue dye and RI tracers (blue-hot cases), and in 42 (10%) and 31 (8%) cases, the SLNs contained only the blue stain (blue-only cases) and only RI (hot-only cases), respectively. The overall metastatic rate was 25% on a patient basis. Blue-only cases had a higher rate (42%) of metastasis than hot-only cases (14%). The rate of nodes containing both blue dye and RI gradually decreased from the first SLNs harvested to the third SLNs harvested. The rate of nodes containing RI only increased with the number harvested, and there was not so much change in the rate of nodes containing blue only.
Conclusions
These data suggest that RI tracer could detect a wide range of SLNs and that the blue dye tracer could efficiently detect SLNs with metastasis. The combined methods compensates for the deficiencies of each method and thus will probably help to prevent missing SLNs.
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References
DN Krag DL Weaver JC Alex JT Fairbank (1993) ArticleTitleSurgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe Surg Oncol 2 335–9 Occurrence Handle10.1016/0960-7404(93)90064-6 Occurrence Handle1:STN:280:ByuC2sjjtlM%3D Occurrence Handle8130940
AE Giuliano DM Kirgan JM Guenther DL Morton (1994) ArticleTitleLymphatic mapping and sentinel lymphadenectomy for breast cancer Ann Surg 220 391–401 Occurrence Handle1:STN:280:ByuA2sboslY%3D Occurrence Handle8092905
VS Klimberg IT Rubio R Henry C Cowan M Colvert S Korourian (1999) ArticleTitleSubareolar versus peritumoral injection for location of the sentinel lymph node Ann Surg 229 860–5 Occurrence Handle10.1097/00000658-199906000-00013 Occurrence Handle1:STN:280:DyaK1M3ptVGlug%3D%3D Occurrence Handle10363900
PJ Borgstein S Meijer RJ Pijpers PJ Diest Particlevan (2000) ArticleTitleFunctional lymphatic anatomy for sentinel node biopsy in breast cancer: echoes from the past and the periareolar blue method Ann Surg 232 81–9 Occurrence Handle10.1097/00000658-200007000-00012 Occurrence Handle1:STN:280:DC%2BD3czitVCqtQ%3D%3D Occurrence Handle10862199
LF Smith MJ Cross VS Klimberg (2000) ArticleTitleSubareolar injection is a better technique for sentinel lymph node biopsy Am J Surg 180 434–8 Occurrence Handle1:STN:280:DC%2BD3M7lvVWqsA%3D%3D Occurrence Handle11182393
K Tsugawa M Noguchi K Miwa et al. (2000) ArticleTitleDye- and gamma probe-guided sentinel lymph node biopsy in breast cancer patients; using patent blue dye and technetium-99m-labeled human serum albumin Breast Cancer 7 87–94 Occurrence Handle1:STN:280:DC%2BD3M%2FjtV2htw%3D%3D Occurrence Handle11029778 Occurrence Handle10.1007/BF02967195
EJ Donahue (2001) ArticleTitleSentinel node imaging and biopsy in breast cancer patients Am J Surg 182 426–8 Occurrence Handle10.1016/S0002-9610(01)00731-0 Occurrence Handle1:STN:280:DC%2BD3MnnsVOgsw%3D%3D Occurrence Handle11720685
RC Martin AM Derossis J Fey et al. (2001) ArticleTitleIntradermal isotope injection is superior to intramammary in sentinel node biopsy for breast cancer Surgery 130 432–8 Occurrence Handle10.1067/msy.2001.116412 Occurrence Handle1:STN:280:DC%2BD3MrhsV2hsw%3D%3D Occurrence Handle11562666
TW Bauer FR Spitz LS Callans et al. (2002) ArticleTitleSubareolar and peritumoral injection identify similar sentinel nodes for breast cancer Ann Surg Oncol 9 169–76 Occurrence Handle10.1245/aso.2002.9.2.169 Occurrence Handle11888875
KA Kern (2002) ArticleTitleConcordance and validation study of sentinel lymph node biopsy for breast cancer using subareolar injection of blue dye and technetium 99m sulfur colloid J Am Coll Surg 195 467–75 Occurrence Handle10.1016/S1072-7515(02)01312-1 Occurrence Handle12375751
TM Tuttle M Colbert R Christensen et al. (2002) ArticleTitleSubareolar injection of 99mTc facilitates sentinel lymph node identification Ann Surg Oncol 9 77–81 Occurrence Handle10.1245/aso.2002.9.1.77 Occurrence Handle11829434
G Zavagno F Meggiolaro CR Rossi et al. (2002) ArticleTitleSubareolar injection for sentinel lymph node location in breast cancer Eur J Surg Oncol 28 701–4 Occurrence Handle10.1053/ejso.2002.1340 Occurrence Handle12431465
E Pelosi M Bello M Giors et al. (2004) ArticleTitleSentinel lymph node detection in patients with early-stage breast cancer: comparison of periareolar and subdermal/peritumoral injection techniques J Nucl Med 45 220–5 Occurrence Handle14960639
S Imoto T Hasebe (1999) ArticleTitleInitial experience with sentinel node biopsy in breast cancer at the National Cancer Center Hospital East Jpn J Clin Oncol 29 11–5 Occurrence Handle10.1093/jjco/29.1.11 Occurrence Handle1:STN:280:DyaK1M7nt1yjsg%3D%3D Occurrence Handle10073145
S Imoto H Fukukita K Murakami H Ikeda N Moriyama (2000) ArticleTitlePilot study on sentinel node biopsy in breast cancer J Surg Oncol 73 130–3 Occurrence Handle10.1002/(SICI)1096-9098(200003)73:3<130::AID-JSO2>3.0.CO;2-X Occurrence Handle1:STN:280:DC%2BD3c3gsVaqtw%3D%3D Occurrence Handle10738263
M Morrow RS Foster SuffixJr (1981) ArticleTitleStaging of breast cancer: a new rationale for internal mammary node biopsy Arch Surg 116 748–51 Occurrence Handle1:STN:280:Bi6B3cnmtV0%3D Occurrence Handle7016069
F Ikomi GK Hanna GW Schmid-Schonbein (1995) ArticleTitleMechanism of colloidal particle uptake into the lymphatic system: basic study with percutaneous lymphography Radiology 196 107–13 Occurrence Handle1:STN:280:ByqA3cvgtFQ%3D Occurrence Handle7784553
OE Nieweg SH Estourgie (2004) ArticleTitleWhat is a sentinel node and what is a false-negative sentinel node? Ann Surg Oncol 11 169S–173S Occurrence Handle10.1245/ASO.2004.12.911 Occurrence Handle15023746
PJ Borgstein R Pijpers EF Comans PJ Diest Particlevan RP Boom S Meijer (1998) ArticleTitleSentinel lymph node biopsy in breast cancer: guidelines and pitfalls of lymphoscintigraphy and gamma probe detection J Am Coll Surg 186 275–83 Occurrence Handle10.1016/S1072-7515(98)00011-8 Occurrence Handle1:STN:280:DyaK1c7mvFSktQ%3D%3D Occurrence Handle9510258
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Supported in part by a Grant for Scientific Research Expenses for Health Labor and Welfare Programs and the Foundation for the Promotion of Cancer Research and by the 2nd-Term Comprehensive 10-Year Strategy for Cancer Control.
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Published by Springer Science+Business media, Inc. ©2005 The Society of Surgical Oncology, Inc.
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Wada, N., Imoto, S., Yamauchi, C. et al. Correlation Between Concordance of Tracers, Order of Harvest, and Presence of Metastases in Sentinel Lymph Nodes With Breast Cancer. Ann Surg Oncol 12, 497–503 (2005). https://doi.org/10.1245/ASO.2005.07.013
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DOI: https://doi.org/10.1245/ASO.2005.07.013