Sentinel lymph node mapping in early breast cancer — Our experience

Challa, Vasu Reddy; Seenu, Vuthaluru; Srivastava, Anurag; Kumar, Rakesh; Dhar, Anita; Chumber, Sunil; Parshad, Rajinder; Misra, Mahesh Chandra

doi:10.1007/s13193-010-0012-z

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…6,16 However, if both techniques or only radioactive dye was used, the sentinel node detection rates and accuracy of the procedure ranged from 86 to 98% and 97.5 to 98%, respectively. 6,[11][12][13][14][15][16][17][18][19][20] In previous reported studies, the sensitivity of the procedure of SNB was 88 to 89% when only blue dye was used compared with 92.2 to 94.2% when both techniques were utilized. 13,15 Studies have reported hypersensitivity to isosulfan blue dye at rates of 1 to 2%.…”

Section: Discussionmentioning

confidence: 99%

Sentinel Lymph Node Biopsy Using a Single-Dye Technique in a Cancer Center of North-East India

Das

Kodali

Khanna

et al. 2021

South Asian J Cancer

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Background Sentinel lymph node (SLN) is the first node to receive the drainage directly from a tumor. SLN biopsy can be done in lieu of a formal lymphadenectomy in selected clinically node-negative cancers and minimizes morbidity compared with the latter. Methods This prospective study was done in patients with operable clinically node-negative breast cancer, penile cancer, and malignant melanoma of extremities in a cancer center of North-east India from January 2019 to December 2019. All the patients underwent formal lymph nodal dissection after the SLN biopsy. Besides intraoperative frozen section study of the sentinel node(s), all the specimens, including the sentinel node(s), were subjected to paraffin section histopathology. Results SLN was identified successfully in 96% of patients. Mean number of sentinel node(s) dissected was 2.3. Study of SLN biopsy with methylene blue dye for staging was done with 100% sensitivity and 95.3% specificity. The SLN procedure was able to negatively predict the drainage nodal basin in 100% with an overall accuracy of staging of 96.5%. The true-positive rate noted was 88.8%, and the false-positive rate was 4.6%. Conclusions SLN using a single-dye technique reliably identifies a sentinel node. This procedure can be safely adopted in patients with node-negative cancers as mentioned above to pathologically study the drainage basin.

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Section: Discussionmentioning

confidence: 99%

Sentinel Lymph Node Biopsy Using a Single-Dye Technique in a Cancer Center of North-East India

Das

Kodali

Khanna

et al. 2021

South Asian J Cancer

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“…The other patient had undergone previous surgery which could have disrupted lymphatic drainage to the axillary nodes. Therefore, tumor size, localization, previous surgery could have negative effects on the accuracy of the SLN biopsy [ 27 – 29 ].…”

Section: Discussionmentioning

confidence: 99%

Sentinel Lymph Node Detection Using Carbon Nanoparticles in Patients with Early Breast Cancer

Lin

Chen

et al. 2015

PLoS ONE

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PurposeCarbon nanoparticles have a strong affinity for the lymphatic system. The purpose of this study was to evaluate the feasibility of sentinel lymph node biopsy using carbon nanoparticles in early breast cancer and to optimize the application procedure.MethodsFirstly, we performed a pilot study to demonstrate the optimized condition using carbon nanoparticles for sentinel lymph nodes (SLNs) detection by investigating 36 clinically node negative breast cancer patients. In subsequent prospective study, 83 patients with clinically node negative breast cancer were included to evaluate SLNs using carbon nanoparticles. Another 83 SLNs were detected by using blue dye. SLNs detection parameters were compared between the methods. All patients irrespective of the SLNs status underwent axillary lymph node dissection for verification of axillary node status after the SLN biopsy.ResultsIn pilot study, a 1 ml carbon nanoparticles suspension used 10–15min before surgery was associated with the best detection rate. In subsequent prospective study, with carbon nanoparticles, the identification rate, accuracy, false negative rate was 100%, 96.4%, 11.1%, respectively. The identification rate and accuracy were 88% and 95.5% with 15.8% of false negative rate using blue dye technique. The use of carbon nanoparticles suspension showed significantly superior results in identification rate (p = 0.001) and reduced false-negative results compared with blue dye technique.ConclusionOur study demonstrated feasibility and accuracy of using carbon nanoparticles for SLNs mapping in breast cancer patients. Carbon nanoparticles are useful in SLNs detection in institutions without access to radioisotope.

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“…The patients scheduled for surgery were injected with radioactive isotope Tc99m-tagged sulphur colloid of 200-300 microcurie in 0.1-0.2 mL normal saline in sub-areolar region 1-3 h before surgery. 31 Radiotracer was injected in the afternoon, a day before surgery, if the patient was scheduled as first case next day morning. A gamma-detecting probe was used intra-operatively to identify radioactivity positive nodes.…”

Section: Identification and Excision Of Sentinel Lymph Nodementioning

confidence: 99%

<p>Proteomics of Sentinel Lymph Nodes in Early Breast Cancer for Identification of Thymidylate Synthase as a Potential Biomarker to Flag Metastasis: A Preliminary Study</p>

Pathania

Khan

Kumar

et al. 2020

CMAR

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Introduction: Breast cancer is the second most common cancer in women across the world. Some of the patients who present in the early stage of disease are affected by metastasis to the axillary group of lymph nodes. The first among this group that is affected is called as sentinel lymph node, and its diagnosis is crucial for the staging of cancer thereby dictating the type of surgical therapy. Therefore, the sentinel lymph node status provides the most relevant information to the surgeon and patient prognosis. The expanded utilization of breast conservation surgery has declined the morbidity associated with mastectomy and axillary lymph node surgery. Recent interest is, therefore, centered on techniques that allow accurate assessment of the sentinel lymph node metastasis. A current procedure such as sentinel lymph node biopsy (SLNB) that is used to assess axillary lymph node metastasis is neither specific nor sensitive, and besides, it is time-consuming. Objective: To compare the protein profiles between metastatic and non-metastatic lymph nodes to identify a biomarker that can flag lymph node metastasis. Materials and Methods: Women with early breast cancer were screened using mammography imaging and recruited to the study. Surgical resection was done to remove the breast tissue, and sentinel lymph node was identified using fluorescein and methylene blue tracer. Lymph node was sliced, and one set was sent for histopathology, which was considered the gold standard to assess the metastatic status of the lymph node. One set of slices was taken for proteomic experiments. Proteins were labelled with fluorescent cyanine tags and were subjected to difference gel electrophoresis experiment. Differentially expressed spots that had at least a twofold relative ratio and consistent pattern across three sets of biological replicate experiments were marked. Gel spots were trypsin digested and identified on mass spectrometry machine. Validation study was done by Western blot experiment on the same set of samples. Results: Thymidylate synthase has a twofold higher expression in the metastatic sentinel lymph nodes as compared to non-metastatic lymph nodes in early breast cancer patients. Conclusion: Differential in gel expression proteomics is an ideal platform for the identification of potential protein biomarker candidates that can differentiate metastatic from nonmetastatic lymph nodes in early breast cancer. The identification of thymidylate synthase offers a scope to develop an on-table diagnostic kit to assess the status of sentinel lymph nodes during mastectomy procedure to guide surgical management of axillary lymph nodes in early breast cancer.

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Sentinel lymph node mapping in early breast cancer — Our experience

Cited by 4 publications

References 24 publications

Sentinel Lymph Node Biopsy Using a Single-Dye Technique in a Cancer Center of North-East India

Sentinel Lymph Node Biopsy Using a Single-Dye Technique in a Cancer Center of North-East India

Sentinel Lymph Node Detection Using Carbon Nanoparticles in Patients with Early Breast Cancer

<p>Proteomics of Sentinel Lymph Nodes in Early Breast Cancer for Identification of Thymidylate Synthase as a Potential Biomarker to Flag Metastasis: A Preliminary Study</p>

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