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Single Intralesional Tracer Dose for Radio-Guided Excision of Clinically Occult Breast Cancer and Sentinel Node

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Abstract

Background: The purpose of this study was to determine the feasibility of both lymphatic mapping and probe-guided primary tumor excision by use of intralesional tracer administration in clinically occult breast cancer.

Methods: Sixty patients with a clinically occult breast lesion were prospectively included. Lymphoscintigraphy was performed after intratumoral injection of 99mTc-labeled nanocolloid guided by ultrasound or stereotaxis. A catheter over a localization wire was inserted for intraoperative blue dye administration by using the same imaging techniques. After sentinel node identification, the gamma-ray detection probe was used for radio-guided wide local excision in patients who underwent breast-conserving therapy.

Results: A sentinel node was visualized on the scintigrams in 56 patients 93% and could be identified intraoperatively in 58 patients 97%. A sentinel node contained tumor in 10 17% of these patients. Extra-axillary sentinel nodes were visualized in 43%, were collected in 38%, and contained metastasis in 7% of the patients. Complete excision of the primary tumor could be accomplished in 39 87% of 45 patients.

Conclusions: Both sentinel node biopsy and probe-guided excision of a nonpalpable breast cancer is feasible with the aid of intralesional tracer administration. Sentinel node metastasis was found in 17% of the patients. A remarkably high percentage of extra-axillary drainage 43% was observed.

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Correspondence to P. J. Tanis MD.

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Tanis, P.J., Deurloo, E.E., Valdés Olmos, R.A. et al. Single Intralesional Tracer Dose for Radio-Guided Excision of Clinically Occult Breast Cancer and Sentinel Node. Ann Surg Oncol 8, 850–855 (2001). https://doi.org/10.1007/s10434-001-0850-6

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  • DOI: https://doi.org/10.1007/s10434-001-0850-6

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