Sentinel lymph node biopsy as an indicator for axillary dissection in early breast cancer

Veronesi, Umberto; Galimberti, Viviana; Zurrida, Stefano; Pigatto, Francesca; Veronesi, Paolo; Robertson, Chris; Paganelli, Giovanni; Sciascia, Valerio; Viale, Giuseppe

doi:10.1016/s0959-8049(00)00410-x

Cited by 145 publications

(64 citation statements)

References 12 publications

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“…With regard to this background SN detection proved to be an accurate technique in melanoma and breast cancer patients, in order to predict lymph node status (Ferwerda et al, 2000;Gennari et al, 2000;Veronesi et al, 2001). Corresponding to previously reported results in SN detection in easily accessible SCC of the upper aerodigestive tract like oral carcinoma (van den Brekel et al, 1999;Nieuwenhuis et al, 2000;Margolin et al, 2001;Zitsch et al, 2000), the SN concept may also be of significance in pharyngeal and laryngeal cancer, which so far have rarely been the topic of targeted investigations.…”

Section: Discussionmentioning

confidence: 99%

Sentinel node detection in N0 cancer of the pharynx and larynx

et al. 2002

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Neck lymph node status is the most important factor for prognosis in head and neck squamous cell carcinoma. Sentinel node detection reliably predicts the lymph node status in melanoma and breast cancer patients. This study evaluates the predictive value of sentinel node detection in 50 patients suffering from pharyngeal and laryngeal carcinomas with a N0 neck as assessed by ultrasound imaging. Following 99m-Technetium nanocolloid injection in the perimeter of the tumour intraoperative sentinel node detection was performed during lymph node dissection. Postoperatively the histological results of the sentinel nodes were compared with the excised neck dissection specimen. Identification of sentinel nodes was successful in all 50 patients with a sensitivity of 89%. In eight cases the sentinel node showed nodal disease (pN1). In 41 patients the sentinel node was tumour negative reflecting the correct neck lymph node status (pN0). We observed one false-negative result. In this case the sentinel node was free of tumour, whereas a neighbouring lymph node contained a lymph node metastasis (pN1). Although we have shown, that skipping of nodal basins can occur, this technique still reliably identifies the sentinel nodes of patients with squamous cell carcinoma of the pharynx and larynx. Future studies must show, if sentinel node detection is suitable to limit the extent of lymph node dissection in clinically N0 necks of patients suffering from pharyngeal and laryngeal squamous cell carcinoma. British Journal of Cancer (2002) Paralell to other tumour entities there were intensified efforts within the last two decades, which are still discussed controversially, to limit the extent of lymph node dissection in the clinically staged N0 situations also for head and neck cancer patients. The aim of reducing a potential excess of surgical therapy for the patient is currently achieved quite successfully in other tumour entities by applying the so-called sentinel node (SN) concept (Lingam et al, 1997;De Cicco et al, 2000;Lantzsch et al, 2001). The extensive investigations on large patient cohorts in breast cancer and malignant melanoma are opposed by a comparative paucity of experience with the SN concept for SCC of the upper aerodigestive tract (Pitman et al, 1998;Shoaib et al, 1999Shoaib et al, , 2001Alex et al, 2000;Chiesa et al, 2000;Colnot et al, 2001;Stoeckli et al, 2001). Most of these articles predominantely deal with oral cancer. Contrary to this, it was the aim of the present study to analyse the role of the SN procedure in patients with pharyngeal and laryngeal carcinoma, which are the most frequent cancers of the upper aerodigestive tract. Primary criterion for inclusion was the N0 neck as staged by ultrasound scanning. Further inclusion criterion was the feasibility of a transoral exposure of the tumour. Adequate injection of the tracer substance especially in the caudal margin of the tumour. Due to inadequate exposure of the tumour three patients (2x larynx, 1x hypopharynx) had to be excluded from the study. PATIENTS ...

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Section: Discussionmentioning

confidence: 99%

Sentinel node detection in N0 cancer of the pharynx and larynx

et al. 2002

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“…Histological status of the sentinel lymph node is predictive of the status of the regional nodal basin and is used to determine which patients can be spared an axillary dissection [13][14][15]. When multiple sections are cut through histologically negative lymph node(s), approximately 25% of patients otherwise deemed node negative have histologic evidence of micrometastasis [8,[16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Promoter hypermethylation in sentinel lymph nodes as a marker for breast cancer recurrence

Carraway

Wang²,

Blackford

et al. 2008

Breast Cancer Res Treat

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Purpose-Promoter methylation of tumor suppressor genes in histologically negative sentinel lymph nodes (HNSN) of early stage breast cancer patients has not been extensively studied. This study evaluates the methylation frequency and pattern in HNSN to determine if detection of hypermethylation of one or more genes is associated with an increased recurrence risk in node negative breast cancer.Experimental design-In 1998, a prospective study of patients with early stage breast cancer and HNSN was initiated in order to correlate sentinel node analysis with clinical outcome. Nodal tissue was selected from 120 HNSN patients for methylation analysis in at least one and up to six sentinel nodes using a panel of nine genes. Corresponding primary breast tumors from 79 patients were also evaluated for hypermethylation. Methylation analysis was performed using nested Methylation Sensitive PCR (n-MSP). Logistical regression was used to evaluate the relationship between clinical recurrence and methylation status.Results-Over a median follow-up of 79 months, 13 of the 120 patients had clinical recurrence. Hypermethylation of genes was frequently observed in HNSN, but there was no correlation of methylation pattern and clinical recurrence. However, increased frequency of gene methylation of the primary tumor correlated with clinical recurrence.Conclusions-Although hypermethylation of multiple genes occurs frequently in HNSN of breast cancer patients, it is not associated with breast cancer recurrence in the first 7 years of clinical follow-up.

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“…An increasing number of evidence reports published worldwide provide further confirmation that SLNB in early breast cancer is a reliable tool to assess the status of lymph nodes. In this manner SLNB provides indications for removal of axillary lymph system [24,25]. One of the main research issues in the study on SLNB application in CRC is the question of determining whether its introduction could improve the diagnostic accuracy of procedures Comprehensive evaluation of the SLN by application of a range of methods including serial sectioning and IHC staining might help to detect metastases that would not be recognized during routine histopathological examination.…”

Section: Legend: Ptnm -Pathological Classification Of Malignant Tumoumentioning

confidence: 99%

Sentinel lymph node in colorectal cancer — 5 years follow up

et al. 2011

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AbstractTo assess the impact of micrometastases in sentinel and non-sentinel lymph nodes on long-term survival rates of patients treated for colorectal cancer (CRC). Data of 57 patients diagnosed with CRC and treated in the Department of Surgical Oncology in Gdansk in the years 2002–2006 were retrospectively analyzed. Clinico-histopathological data were analyzed using chi-square tests. The effect on long-time survival rates was analyzed using Kaplan-Meier survival probability estimates. Identification of the SLN was performed using the blue dye staining method. All regional lymph nodes were subject to standard histopathological examination. Additionally in 32(56.14%) patients whose nodes were found negative for metastases on standard staining further immunohistochemical analyses were performed. In the analyzed group SLNB was performed in 42(73.7%) patients with colon cancer and in 15(26.3%) with rectal cancer. Identification of the SLN was possible in 45(78.9%) patients. The sensitivity of SLNB was 33%. False negatives were found in 66%. SLNB is a feasible method in CRC patients. We presume that lack of micrometastases in the SLN and non-SLN cannot be regarded as a prognostic factor.

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Sentinel lymph node biopsy as an indicator for axillary dissection in early breast cancer

Cited by 145 publications

References 12 publications

Sentinel node detection in N0 cancer of the pharynx and larynx

Sentinel node detection in N0 cancer of the pharynx and larynx

Promoter hypermethylation in sentinel lymph nodes as a marker for breast cancer recurrence

Sentinel lymph node in colorectal cancer — 5 years follow up

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