Sentinel lymph node biopsy for breast cancer

Abstract

This manuscript is a brief discussion of the developments of the technology and concepts that led to modern procedures of radiotracer guided surgery of sentinel nodes (SNs) for breast cancer. The past section highlights some of the contributions by key persons involved with SN methods. The present section describes the magnitude of types of published material to date. The future section describes the major international trials and some important technical challenges yet to be solved.

Fluorescence Imaging and Whole-Body Biodistribution of Near-Infrared-Emitting Quantum Dots after Subcutaneous Injection for Regional Lymph Node Mapping in Mice

“…The day before surgery, the radiocolloid is injected, many routes of injection being used (peritumoral, intratumoral, subcutaneous, intradermal, or subareolar), followed by mammary and axillary lymphoscintigraphy between 30 min and 4 h post-administration. During the surgery, a mean volume of 3-4 mL of blue dye is delivered by the same way, and SLNs are identified as blue and/or hot lymph nodes (LNs) [6,7]. Despite the significant improvement of SLNB over ALDN, the problems related to an extra cost of the radioisotope, to allergic reactions and in a few cases anaphylactic shocks after radiocolloid or blue dye injection, and the overall procedure duration are limiting factors for this technique [8][9][10][11].…”

Uniform Silica Coated Fluorescent Nanoparticles: Synthetic Method, Improved Light Stability and Application to Visualize Lymph Network Tracer

“…Moreover, as the diameter of dye particles is too small, it will diffuse and disappear in 15 to 20 min from the SLN, which restrict the duration of the procedure [4]. Furthermore, if the lymph node was embedded in fat tissue, then it may result in the negative or negligible detection of the lymph node [5]–[6]. The radioisotope method requires radioactive agents and therefore can only be performed at a limited number of hospitals because of the regulations for handling radioactive agents.…”

Computed tomographic lymphography for sentinel lymph node biopsy in male breast cancer: report of two cases

“…As one possible solution to this problem, lymphangiography using an oil-in-water emulsion of contrast medium has been employed to assess the stages of malignancies. However, several complications have hampered widespread adoption of this method (Sato et al, 2007; Tangoku et al, 2004). Another possibility is CTLG, which allows visualization of the anatomy and provides functional data about lymphatic flow after interstitial injection of commercially available and commonly used intravenous contrast agents designed to enhance CT images.…”