Correlation of number and identification of sentinel nodes during radiographer led lymphoscintigraphy prior to sentinel lymph node biopsy in breast cancer patients

Camilleri, Gail; Grima, Karen Borg; Zarb, Francis

doi:10.1016/j.radi.2011.11.003

Cited by 2 publications

(3 citation statements)

References 34 publications

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“…The accuracy of the SNs to predict axillary status should ideally exceed 90% [21,46]. Nevertheless, the findings of the current local study established a lower rate of accuracy probably due to a number of factors: the SLNB was at its early stages of implementation with the staff still integrating the learning curve; the small sample size and the use of methylene blue only in some and not all of the cases [15]. These audit studies presented SN identification rates during SLNB ranging from 81% to 100%, which compare well with the local identification rate.…”

Section: Discussionmentioning

confidence: 90%

“…Successful lymphoscintigraphy, the use of the methylene blue dye technique together with the gamma-probe guided SLNB (combined method) and the absence of metastatically involved SNs and ALNs increase the ability of the intra-operative SN identification during SLNB [15,29]. There appears to be an ongoing debate on the optimal number of sentinel nodes that need to be harvested to ensure accurate axillary staging.…”

Section: Discussionmentioning

confidence: 99%

“…The SLNB was thus locally introduced in May 2009. The SLNB is based on the concept of the orderly progression of lymph node metastases, where only one or few lymph nodes (termed the sentinel node/s, (SN/s)) are the first to be reached by metastasizing cells from tumor dissemination [15,16]. All SNs need to be surgically harvested during SLNB to stage the disease, thus minimizing patient morbidity.…”

Section: Introductionmentioning

confidence: 99%

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The Initial Implementation of the Sentinel Lymph Node Biopsy (SLNB) for Breast Cancer Management in Malta

Camilleri¹,

Karen²,

Zarb³

2013

JCT

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Over the past two decades, the sentinel lymph node biopsy (SLNB) based on sentinel node (SN) being the first lymph node that harbors metastases, revolutionized breast cancer management. SLNB presents much less morbidity when compared to radical axillary lymph node dissection (ALND) where all nodes are dissected irrespective of their metastatic involvement. The purpose of this study was to evaluate the effectiveness of SLNB by investigating whether the histological characteristics of the SNs identified using scintigraphy are predictive of the histological characteristics of the ALN basin. Methods: Fifty-five female breast cancer patients underwent lymphoscintigraphy and SLNB followed by ALND. The histological status of the SN/s was correlated to the histological status of the ALNs to determine whether the SN accurately stages the ALNs in breast cancer. Results: During surgery, SNs were successfully isolated in 52 out of 55 cases (94.5%) (range, 0 to 9). No SNs were identified in 3 cases (5.5%). Results demonstrate a significant association (p = 0.05) between the metastatic status of SNs and the corresponding ALNs in 42 out of 52 patients (80.8%), but with a high false-negative rate (FNR) of 37.5%. Conclusion: The findings of this study show that the sentinel node concept provides the benefits of SLNB in the majority of instances. However, further work is required in reducing the FNR. Once the effectiveness of SLNB as a staging technique is locally established, the need of ALND in SN-negative patients would be limited, thus improving the quality of life of Maltese breast cancer patients.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Initial Implementation of the Sentinel Lymph Node Biopsy (SLNB) for Breast Cancer Management in Malta

Camilleri¹,

Karen²,

Zarb³

2013

JCT

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Radio-guided sentinel lymph node identification by lymphoscintigraphy fused with an anatomical vector profile: clinical applications

et al. 2013

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We have created a new, practical, inexpensive digital technique based on commercial software for fusing lymphoscintigraphic images with built-in anatomical reference profiles. It is easily reproducible and does not alter the original scintigraphic image. Our method allows a more meaningful interpretation of lymphoscintigraphies, an easier recognition of the anatomical site and better lymph node dissection planning.

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Correlation of number and identification of sentinel nodes during radiographer led lymphoscintigraphy prior to sentinel lymph node biopsy in breast cancer patients

Cited by 2 publications

References 34 publications

The Initial Implementation of the Sentinel Lymph Node Biopsy (SLNB) for Breast Cancer Management in Malta

The Initial Implementation of the Sentinel Lymph Node Biopsy (SLNB) for Breast Cancer Management in Malta

Radio-guided sentinel lymph node identification by lymphoscintigraphy fused with an anatomical vector profile: clinical applications

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