Sentinel Lymphadenectomy In Node Negative Breast Cancer

  • Philip I. Haigh
  • Armando E. Giuliano
Part of the Cancer Treatment and Research book series (CTAR, volume 103)


Axillary lymphadenectomy (ALND) remains the gold standard for identifying axillary nodal metastases and managing patients with early stage breast cancer.1 A level I and II ALND accurately stages the patient, allowing for prognostication and decisions regarding adjuvant therapy. Furthermore, excellent regional control is achieved with ALND, with subsequent axillary recurrence a rare event.2,3 There may be an improvement in survival after ALND, however, this remains debatable. As the use of screening mammography increases, the size of primary breast cancers has been progressively diminishing over the last few decades, concomitant with a declining proportion of patients who have axillary metastases.4


Breast Cancer Sentinel Node Sentinel Node Biopsy Gamma Probe Lymphatic Mapping 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    National Institutes of Health. NIH consensus conference on the treatment of early-stage breast cancer. JAMA 265: 391–395, 1991.CrossRefGoogle Scholar
  2. 2.
    Halverson KJ, Taylor ME, Perez CA, et al. Regional nodal management and patterns of failure following conservative surgery and radiation therapy for stage I and II breast cancer. Int J Radiat Oncol Biol Phys 26: 593–599, 1993.PubMedCrossRefGoogle Scholar
  3. 3.
    Recht A, Pierce SM, Abner A, et al. Regional node failure after conservative surgery and radiotherapy for early-stage breast carcinoma. J Clin Oncol 9: 988–996, 1991.PubMedGoogle Scholar
  4. 4.
    Cady B, Stone MD, Schuler JG, et al. The new era in breast cancer: invasion, size, and nodal involvement dramatically decreasing as a result of mammographic screening. Arch Surg 131: 301–308, 1996.PubMedCrossRefGoogle Scholar
  5. 5.
    Keramopoulos A, Tsionou C, Minaretzis D, et al. Arm morbidity following treatment of breast cancer with total axillary dissection: A multivariated approach. Oncology 50: 445–449, 1993.PubMedCrossRefGoogle Scholar
  6. 6.
    Ivens D, Hoe AL, Podd TJ, et al. Assessment of morbidity from complete axillary dissection. Br J Cancer 66: 136–138, 1992.PubMedCrossRefGoogle Scholar
  7. 7.
    Larson D, Weinstein M, Goldberg I, et al. Edema of the arm as a function of the extent of axillary surgery in patients with stage I-II carcinoma of the breast treated with primary radiotherapy. Int J Radiat Oncol Biol Phys 12: 1575–1582, 1986.PubMedCrossRefGoogle Scholar
  8. 8.
    Early Breast Cancer Trialists’ Collaborative Group. Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy. Lancet 339: 1–15, 1992.Google Scholar
  9. 9.
    Early Breast Cancer Trialists’ Collaborative Group. Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy. Lancet 339: 71–85, 1992.Google Scholar
  10. 10.
    Silverstein MJ, Gierson ED, Waisman JR, et al. Axillary lymph node dissection for T1a breast carcinoma. Is it indicated? Cancer 73: 664–667, 1994.PubMedCrossRefGoogle Scholar
  11. 11.
    Jamali FR, Kurtzman SH, Deckers PJ. Role of axillary dissection in mammographically detected breast cancer. Surg Oncol Clin Nor Am 6: 343–358, 1997.Google Scholar
  12. 12.
    Morton DL, Wen DR, Wong JH, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 127: 392–399, 1992.PubMedCrossRefGoogle Scholar
  13. 13.
    Giuliano AE, Kirgan DM, Guenther JM, et al. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg 220: 391–401, 1994.PubMedCrossRefGoogle Scholar
  14. 14.
    Giuliano AE, Jones RC, Brennan M, et al. Sentinel lymphadenectomy in breast cancer. J Clin Oncol 15: 2345–2350, 1997.PubMedGoogle Scholar
  15. 15.
    Giuliano AE, Dale PS, Turner RR, et al. Improved axillary staging of breast cancer with sentinel lymphadenectomy. Ann Surg 222: 394–401, 1995.PubMedCrossRefGoogle Scholar
  16. 16.
    Turner RR, O11ila DW, Krasne DL, et al. Histopathological validation of the sentinel lymph node hypothesis for breast carcinoma. Ann Surg 226: 271–278, 1997.PubMedCrossRefGoogle Scholar
  17. 17.
    Cox CE, Pendas S, Cox JM, et al. Guidelines for sentinel node biopsy and lymphatic mapping of patients with breast cancer. Ann Surg 227: 645–653, 1998.PubMedCrossRefGoogle Scholar
  18. 18.
    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.PubMedGoogle Scholar
  19. 19.
    Koller M, Barsuk D, Zippel D, et al. Sentinel lymph node involvement: a predictor for axillary node status with breast cancer — has the time come? Eur J Surg Oncol 24: 166–168, 1998.PubMedCrossRefGoogle Scholar
  20. 20.
    Flett MM, Going JJ, Stanton PD et al. Sentinel node localization in patients with breast cancer. Br J Surg 85: 991–993, 1998.PubMedCrossRefGoogle Scholar
  21. 21.
    Dale PS, Williams JT, IV. Axillary staging utilizing selective sentinel lymphadenectomy for patients with invasive breast carcinoma. Am Surg 64: 28–32, 1998.PubMedGoogle Scholar
  22. 22.
    Krag DN, Weaver DL, Alex JC, et al. Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe. Surg Oncol 2: 335–339, 1993.PubMedCrossRefGoogle Scholar
  23. 23.
    Veronesi U, Paganelli G, Galimberti V, et al. Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes. Lancet 349: 1864–1867, 1997.PubMedCrossRefGoogle Scholar
  24. 24.
    Pijpers R, Meijer S, Hoekstra OS, et al. Impact of lymphoscintigraphy on sentinel node identification with Technetium-99m-colloidal albumin in breast cancer. J Nucl Med 38: 366–368, 1997.PubMedGoogle Scholar
  25. 25.
    Krag D, Weaver D, Ashikaga T, et al. The sentinel node in breast cancer. NEJM 339: 941–946, 1998.PubMedCrossRefGoogle Scholar
  26. 26.
    Borgstein PJ, Pijpers R, Comans EF, et al. Sentinel lymph node biopsy in breast cancer: guidelines and pitfalls of lymphoscintigraphy and gamma probe detection. J Am Coll Surg 186: 275–283, 1998.PubMedCrossRefGoogle Scholar
  27. 27.
    Crossin JA, Johnson AC, Stewart PB, et al. Gamma-probe-guided resection of the sentinel lymph node in breast cancer. Am Surg 64: 666–669, 1998.PubMedGoogle Scholar
  28. 28.
    Miner TJ, Shriver CD, Jaques DP, et al. Ultrasonographically guided injection improves localization of the radiolabeled sentinel lymph node in breast cancer. Ann Surg Oncol 5: 315–321, 1998.PubMedCrossRefGoogle Scholar
  29. 29.
    Offodile R, Hoh C, Barsky SH, et al. Minimally invasive breast carcinoma staging using lymphatic mapping with radiolabeled dextran. Cancer 82: 1704–8, 1998.PubMedCrossRefGoogle Scholar
  30. 30.
    De Cicco C, Cremonesi M, Luini A, et al. Lymphoscintigraphy and radioguided biopsy of the sentinel axillary node in breast cancer J Nucl Med 12: 2080–4, 1998.Google Scholar
  31. 31.
    Albertini JJ, Lyman GH, Cox C, et al. Lymphatic mapping and sentinel node biopsy in the patient with breast cancer. JAMA 276: 1818–1822, 1996.PubMedCrossRefGoogle Scholar
  32. 32.
    Borgstein PJ, Meijer S, Pijpers R. Intradermal blue dye to identify sentinel lymphnode in breast cancer. Lancet 349: 1668–1669, 1997.PubMedCrossRefGoogle Scholar
  33. 33.
    O’Hea BJ, Hill ADK, El-Shirbiny AM, et al. Sentinel lymph node biopsy in breast cancer: initial experience at Memorial Sloan-Kettering Cancer Center. J Am Coll Surg 186: 423–427, 1998.PubMedCrossRefGoogle Scholar
  34. 34.
    Barnwell JM, Arredondo MA, Kollmorgen D, et al. Sentinel node biopsy in breast cancer. Ann Surg Oncol 5: 126–130, 1998.PubMedCrossRefGoogle Scholar
  35. 35.
    Liberman L, Vuolo M, Dershaw DD et al. Epithelial displacement after stereotactic 11-gauge directional vacuum-assisted breast biopsy. AJR 172: 677–81, 1999.PubMedGoogle Scholar
  36. 36.
    Glass EC, Essner R, Giuliano AE. Sentinel node localization in breast cancer. Sem Nuc Med 24: 57–68, 1999.Google Scholar
  37. 37.
    Glass EC, Basinski JE, Krasne DL, Giuliano AE. Radiation safety considerations for sentinel node techniques. Ann Surg Oncol 6: 10–1, 1999.PubMedCrossRefGoogle Scholar
  38. 38.
    Larsen VH, Freundendal-Pedersen A, Fogh-Andersen N. The influence of Patent Blue V on pulse oximetry and haemoximetry. Acta Anaes Scand 39 (Suppl 107): 53–55, 1995.CrossRefGoogle Scholar
  39. 39.
    Hirsch JI, Tisnado J, Cho S-R et al. Use of isosulfan blue for identification of lymphatic vessels: experimental and clinical evaluation. AJR 139: 1061–1064, 1982.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  • Philip I. Haigh
    • 1
  • Armando E. Giuliano
    • 2
    • 3
  1. 1.Surgical OncologyJohn Wayne Cancer InstituteUSA
  2. 2.Saint John’s Health CenterJohn Wayne Cancer InstituteUSA
  3. 3.UCLA School of MedicineUSA

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