Intradermal blue dye to identify sentinel lymph node in breast cancer

Borgstein, P. J.

doi:10.1016/s0140-6736(05)63298-9

Cited by 88 publications

(110 citation statements)

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“…Os campos utilizados foram o parênquima mamário residual ho- A introdução da técnica do linfonodo-sentinela na mastologia atual tem promovido crescente interesse no estudo da anatomia e fisiologia do sistema linfático da mama. O conceito de que ambas as mamas e a pele que as recobre possuem um caminho de drenagem linfática comum para o mesmo linfonodo 13 tem sido estudado por quase um século. Porém alguns estudos têm mostrado o aparecimento de metástase em níveis II e III sem evidência de acometimento ganglionar no nível I, as chamadas skip metastases 14 .…”

Section: Discussionunclassified

Linfonodo-sentinela no câncer de mama acessória: relato de caso

Tiezzi¹,

Valejo²,

Nai³

et al. 2006

Rev. Bras. Ginecol. Obstet.

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RESUMONo último século, grandes avanços foram surgindo na forma de tratar o câncer de mama. A remoção radical da glândula e das estruturas adjacentes tem sido substituída por cirurgias conservadoras e a abordagem cirúrgica dos linfonodos axilares vem se tornando fundamental. Relatamos o caso de paciente com câncer de mama ectópica na axila esquerda e a identificação do linfonodo-sentinela pela técnica do azul patente. Discutimos os estudos relacionados à drenagem linfática do tecido mamário ectópico e a identificação do linfonodo-sentinela nesta rara situação. PALAVRAS-CHAVE: ABSTRACTDuring the last century, remarkable progress has been made in the treatment of breast cancer. Radical surgical removal of the breast and surrounding structures has been replaced by conservative surgery and the surgical management of axillary lymphnodes has been fundamental. We report a case of a patient with an ectopic breast cancer in the left axilla and sentinel lymphnode identification by the patent blue dye technique. The studies about lymphatic drainage of the ectopic mammary tissue and sentinel lymph node identification in this rare situation were also reviewed. KEYWORDS:Sentinel lymph node biopsy; Breast neoplasms; Breast/abnormalities; Lymphatic metastasis; Lymphatic vessels; Case reports [Publication type] Introdução A incidência de polimastia na população geral varia de 2 a 6%¹, sendo as mamas acessórias, na quase totalidade das vezes, consideradas como um problema meramente estético. Entretanto, essas estruturas, como qualquer tecido mamário, podem ser alvo de alterações patológicas variadas, benignas ou malignas, uma vez que respondem às variações hormonais fisiológicas e estão sujeitas aos mesmos agentes carcinogênicos. Representando 0,3% dos carcinomas mamários², o câncer de mama ectópica é um problema real e deve ser divulgado, já que sua baixa freqüência na população pode tornar o diagnósti-co difícil de ser feito.Durante os últimos anos, grandes avanços foram surgindo na forma de tratar o câncer de mama. As grandes cirurgias radicais foram substituídas por tratamentos conservadores e, na atualidade, a abordagem cirúrgica para avaliação do envolvimento de linfonodos axilares tem sido objeto de estudo. Acreditase que o envolvimento dos linfonodos ocorre continuamente, um a um, da periferia para a região medial da axila³. Sendo assim, estão surgindo métodos de predição de acometimento axilar através de procedimentos pouco invasivos, como a avaliação do linfonodo-sentinela, que permite evitar a linfadenectomia e seus efeitos colaterais em pacientes com axila negativa 4 .

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Section: Discussionunclassified

Linfonodo-sentinela no câncer de mama acessória: relato de caso

Tiezzi¹,

Valejo²,

Nai³

et al. 2006

Rev. Bras. Ginecol. Obstet.

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“…Internal mammary node drainage occurs in a significant proportion after peritumoural injection but not after intradermal injection [47] . However, the intradermal technique has been shown to identify the SLN in the axilla with a frequency of 98% compared with 90% for peritumoural parenchymal technique [10,48] . Periareolar injections are made just outside the areolar border at four equally spaced sites.…”

Section: Site Of Injectionmentioning

confidence: 99%

What the clinician wants to know: radiation oncology perspective

Leer

2005

Cancer Imaging

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The delineation of the target volume, i.e. the volume which should be irradiated with a therapeutic dose of irradiation, is of utmost importance in radiotherapy. Modern imaging techniques cannot be missed in this process. Diagnosticians and radiation oncologists therefore should understand each other's needs and potential. Keywords: Radiotherapy; treatment planning; target volumes; biological target volume. Staging for radiotherapyRadiotherapy like surgery is a treatment for locoregional tumour growth. So, imaging modalities are extremely important for staging. Computerized tomography (CT), ultrasonography and magnetic resonance imaging (MRI) are used in the work-up of many tumours, e.g. in cervical cancer and head and neck tumours to detect lymph nodes, in rectal cancer to judge whether a free margin can be obtained to make the patient a suitable candidate for short term irradiation followed by surgery. New imaging modalities are also being introduced for staging such as fluorodeoxy glucose positron emission tomography (FDG-PET) scanning in lung cancer and MR lymphography with nanoparticles in prostate cancer. Image guided radiotherapy volumesWhereas surgery is tumour eradication under direct vision, radiotherapy is tumour eradication under indirect vision. So, imaging is of extreme importance for radiotherapy planning. In radiation oncology the target volume is that part of the body where a therapeutic dose of irradiation should be applied. This target volume is subdivided into several subsets: the gross tumour target volume (GTV), the clinical target volume (CTV) and the planning target volume (PTV). The GTV and CTV have a biological background. The GTV is what you can see, measure or palpate. The CTV is the suspected microscopic extension of the disease, and as in surgery, radiation oncologists also take a margin around the visible tumour. The GTV can include regional lymph nodes when microscopic spread to lymph nodes is expected; and when they should be treated electively, one could consider this as a nodal CTV. The PTV is a geometric and not a biological concept. This volume by two margins takes into account organ movement (internal margin) and positioning in accuracies and inaccuracies of the irradiation delivering equipment (set-up margin). The PTV is created to ensure that the therapeutic dose is indeed delivered to the CTV.Although one could imagine that the delineation of the GTV is most simple, we have to realise that different imaging modalities 'see' tumours or organs differently, e.g. the size of the prostate is different on MRI than CT. What is the truth? Often radiation oncologists use both. Consequently image registration or image fusion has become of paramount importance. Like surgery, in radiotherapy we also do some harm to normal tissues. Healthy tissue is unavoidably irradiated. However, the radiation dose in these tissues should be kept below tolerance which means below the dose which creates clinically manifest severe damage. For this reason a fourth volume in the irradiated part ...

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“…14 The sentinel lymph node (SLN) apprehension was first addressed by Gould's report on the James Ewing Society in 1960 and later expanded by Cabanas in 1977. Initially investigated in melanoma 15 and breast cancer 16 patients in short time SLN biopsy gained a considerable interest in head and neck research. The concept of SLN may be regarded as a modern approach enrooted and established by continuous anatomic and clinical exploration of the lymphatic systems' anatomy and physiology.…”

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confidence: 99%

A Review of Techniques for Sentinel Lymph Node Mapping with Special Reference to the Head and Neck Region

Sun¹

2016

ICPJL

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Sentinel lymph node biopsy is an extensively explored diagnostic mean for reducing surgical risks while improving staging in different human malignancies. Several different techniques have been introduced to clinical use during last two decades. Methods as ink lymphography and lymphoscintigraphy have already established their position in sentinel nodes mapping. Novel approaches as CT, MRI-lymphography, contrast enhanced ultrasound and near-infrared fluorescence imaging possesses prominent potential advantages and demand further experience gaining. A review of the clinically utilized techniques is presented a special attention is drawn to their usefulness in the head and neck carcinomas work-up. Keywords

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Intradermal blue dye to identify sentinel lymph node in breast cancer

Cited by 88 publications

References 0 publications

Linfonodo-sentinela no câncer de mama acessória: relato de caso

Linfonodo-sentinela no câncer de mama acessória: relato de caso

What the clinician wants to know: radiation oncology perspective

A Review of Techniques for Sentinel Lymph Node Mapping with Special Reference to the Head and Neck Region

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