Clinical and histopathological factors affecting failed sentinel node localization in axillary staging for breast cancer

Dordea, Matei; Colvin, Hugh; Cox, Phillip; Nicolas, Andrea Pujol; Kanakala, Venkat; Iwuchukwu, O.

doi:10.1016/j.surge.2011.10.006

Cited by 15 publications

(10 citation statements)

References 17 publications

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“…First, next to older age, a high body weight appears to result in an increased likelihood for a non-vSLN. It has been hypothesized that lymph nodes in older or more obese patients consist of more fat which decreases the nodes' capacity for colloid uptake [18][19][20]. Although there was no information on body weight in the present study, this study did show an increased likelihood of non-vSLN with increasing age.…”

Section: Discussioncontrasting

confidence: 68%

Non-visualized sentinel nodes in breast cancer patients; prevalence, risk factors, and prognosis

Verheuvel

Voogd

Tjan‐Heijnen

et al. 2017

Breast Cancer Res Treat

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Section: Discussioncontrasting

confidence: 68%

Non-visualized sentinel nodes in breast cancer patients; prevalence, risk factors, and prognosis

Verheuvel

Voogd

Tjan‐Heijnen

et al. 2017

Breast Cancer Res Treat

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“…15e18 Altered lymphatic dynamics secondary to tumor burden may play a role in failed sentinel node localization. Dordea et al 16 reported that in cases wherein mapping fails, the radiocolloid persists around the injection site in the breast, showing limited local diffusion only. They hypothesized that the integrity of periareolar lymphatics is important for successful localization.…”

Section: Discussionmentioning

confidence: 99%

Robotic blue-dye sentinel lymph node detection for endometrial cancer – Factors predicting successful mapping

Eitan

Sabah

Krissi

et al. 2015

European Journal of Surgical Oncology (EJSO)

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“…Studies have shown that older age, a high body weight, larger tumor size, and a high number of positive lymph nodes and macrometastases can decrease the success rate of the SLN procedure 5,18–23. Therefore, perioperative palpation of the axilla remains important, especially in case of a non-vSLN, to locate any suspicious nodes that are not identified by Patent Blue or lymphoscintigraphy.…”

Section: Discussionmentioning

confidence: 99%

“…More recently, studies such as the Z0011 trial also showed that the ALND could be omitted in selected SLN-positive patients 1–4. However, in 2–4% of SLN procedures, the sentinel node cannot be visualized and retrieved (non-vSLN), after which an ALND should still be performed according to the current Dutch guideline 5–7…”

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confidence: 99%

What to Do with Non-visualized Sentinel Nodes? A Dutch Nationwide Survey Study

et al. 2017

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IntroductionInternational guidelines differ regarding their recommendations on axillary treatment of patients with non-visualized sentinel lymph nodes (non-vSLN). Therefore, we distributed a survey among Dutch oncological surgeons to determine their routine practice and opinion regarding axillary treatment in case of a non-vSLN, with the emphasis on whether these practices and opinions have changed since publication of the Z0011 trial.MethodsA Dutch nationwide survey containing 10 questions regarding clinical routine during the sentinel node procedure and axillary treatment of non-vSLN patients was distributed among 510 oncological surgeons.ResultsThe survey was completed by 122 (24%) oncological surgeons, of whom 116 (95%) were registered as specialized breast surgeons. These surgeons had, on average, 13 years of experience. The majority of respondents used both lymphoscintigraphy and Patent Blue during the sentinel node procedure, and 39% estimated the prevalence of a non-vSLN to be 1–2%. Most surgeons are currently more reserved when considering whether to perform an axillary lymph node dissection (ALND) than prior to publication of the Z0011 trial (15 vs. 80%, respectively). Sixty percent base their decision on various clinicopathological characteristics. Twenty-three respondents (20%) opted for an alternative axillary treatment.ConclusionThis study shows that, in daily practice, most specialized breast surgeons think that a non-vSLN is rare. If so, most currently opt not to perform an ALND, whereas a small proportion consider an alternative axillary treatment. These decisions differ than in the period prior to the Z0011 trial. More research is needed to provide optimal treatment recommendations in case of a non-vSLN.Electronic supplementary materialThe online version of this article (doi:10.1245/s10434-017-5824-4) contains supplementary material, which is available to authorized users.

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Clinical and histopathological factors affecting failed sentinel node localization in axillary staging for breast cancer

Cited by 15 publications

References 17 publications

Non-visualized sentinel nodes in breast cancer patients; prevalence, risk factors, and prognosis

Non-visualized sentinel nodes in breast cancer patients; prevalence, risk factors, and prognosis

Robotic blue-dye sentinel lymph node detection for endometrial cancer – Factors predicting successful mapping

What to Do with Non-visualized Sentinel Nodes? A Dutch Nationwide Survey Study

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