Subareolar injection for sentinel lymph node location in breast cancer

Zavagno, G.; Meggiolaro, F.; Róssi, Carlo; Casara, Dario; Pescarini, Luigi; Marchet, Alberto; Denetto, V.; Baratella, Paola; Lise, Mario

doi:10.1053/ejso.2002.1340

Cited by 22 publications

(10 citation statements)

References 15 publications

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“…The rationale for periareolar injections is based on observations that suggest the lymphatic route to the axillary regional nodes may be the same for all breast sites. Even if this question remains debatable, several studies [7][8][9][10] showed similar results between sub-areoral or periareoral and peritumoural injections. However, one drawback of this technique could be the underestimation of an extraaxillay pathway, where therapeutic consequences are not evidence based [11].…”

Section: Discussionmentioning

confidence: 98%

Intra-individual comparison of sentinel lymph node scintigraphy on the day of injection and on the following day in breast cancer

Gutman¹,

Sanson²,

Piquenot³

et al. 2006

Nuclear Medicine Communications

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Section: Discussionmentioning

confidence: 98%

Intra-individual comparison of sentinel lymph node scintigraphy on the day of injection and on the following day in breast cancer

Gutman¹,

Sanson²,

Piquenot³

et al. 2006

Nuclear Medicine Communications

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“…Some studies have used methylene blue dye to identify the SLN and found the same rate of identification as for isosulfan blue dye [32,33]. In most studies, the rate of SLN identification was the same for subareolar, intradermal, or peritumoral blue dye injection sites [34,35]. Patent (isosulfan) blue dye injections may have side effects.…”

Section: Discussionmentioning

confidence: 99%

“…However, for isosulfan blue dye alone to become widely accepted in the management of breast cancer; it needs to identify SLNs reliably by reaching a rate of identification better than 80% and by having a lower cost than the combined techniques [18,[31][32][33][34][35]. Giuliano et al reported a study of a series of 100 patients in which they found the rate of detection of the SLN using the isosulfan blue dye technique was 93% [31].…”

Section: Discussionmentioning

confidence: 99%

Rate of sentinel lymph node identification using isosulfan blue dye in breast cancer patients at Charoenkrung Pracharak Hospital, Thailand

et al. 2014

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Background:The sentinel lymph node (SLN) is the first lymph node to receive lymphatic drainage from a primary breast tumor. If the SLN contains no metastatic tumor, then it is unlikely other lymph nodes will contain breast cancer metastasis. When the SLN does contains metastasis, an axillary lymph node dissection (ALND) is recommended to further stage the axilla and to maintain locoregional control. SLNs can be identified by using a dye, radioisotope, or combined techniques. Objective: To determine the rate of SLN identification using isosulfan blue dye in breast cancer patients at Charoenkrung Pracharak Hospital, Thailand, and factors that affect it. Methods: This prospective study of 106 consecutive cases breast cancer enrolled 105 women (1 bilateral breast cancer case) between October 2011 and October 2013 at Charoenkrung Pracharak Hospital. Clinical and pathological features were analyzed for the effectiveness of SLN identification using isosulfan blue dye. Results: The rate of SLN identification using isosulfan blue dye in breast cancer patients at Charoenkrung Pracharak Hospital was 92%. The method was safe and well tolerated in early-stage breast cancer patients. Conclusion:The effectiveness of sentinel node identification using isosulfan blue dye in breast cancer patients at Charoenkrung Pracharak Hospital is consistent with that shown in studies from other countries.

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“…Concordance rates between the peritumoral and central techniques ranged from 75.0%, in a small study 18 of 8 patients with multicentric tumors, to 95.4%. [9][10][11][12][13][14]17,20,21 These studies, although adding to the evidence supporting the use of central injection techniques in SLN biopsy, are all relatively small, single-institutional studies. Only 150 patients have previously been studied with concomitant axillary dissection to establish the falsenegative rates for subareolar and periareolar injection.…”

Section: Commentmentioning

confidence: 99%

Validation of Subareolar and Periareolar Injection Techniques for Breast Sentinel Lymph Node Biopsy

et al. 2004

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Subareolar or periareolar injection of radioactive technetium sulfur colloid is equivalent to other injection techniques for breast cancer sentinel lymph node (SLN) biopsy.Design and Setting: Prospective, multicenter clinical trial.Patients: A total of 3961 individuals with clinical stage I and II breast cancer.Interventions: All patients underwent attempted SLN biopsy followed by completion axillary dissection. Injection technique was determined by the preference of each participating surgeon. Most surgeons had little or no experience with SLN biopsy before participation in this study. Main Outcome Measures:The SLN identification and false-negative rates.Results: An SLN biopsy was performed in 3961 patients using blue dye alone or radioactive colloid plus blue dye.Subareolar and periareolar radioactive colloid injection techniques were associated with SLN identification rates of 99.3% and 95.6%, respectively, with false-negative rates of 8.3% and 8.9%, respectively. The identification rates were significantly higher for these 2 techniques than for peritumoral injection of radioactive colloid (91.1%) or the use of blue dye alone (88.5%) (PϽ.001). The false-negative rates were similar for all techniques.Conclusions: Although many medical centers have adopted subareolar and periareolar radioactive colloid injections because of their simplicity and convenience, a paucity of data from a few single-institutional studies has existed to substantiate the false-negative rates associated with these techniques. The results of this multicenter study establish the validity of subareolar and periareolar radioactive colloid injections and support the hypothesis that the lymphatic drainage of the entire breast is to the same few SLNs.

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Subareolar injection for sentinel lymph node location in breast cancer

Cited by 22 publications

References 15 publications

Intra-individual comparison of sentinel lymph node scintigraphy on the day of injection and on the following day in breast cancer

Intra-individual comparison of sentinel lymph node scintigraphy on the day of injection and on the following day in breast cancer

Rate of sentinel lymph node identification using isosulfan blue dye in breast cancer patients at Charoenkrung Pracharak Hospital, Thailand

Validation of Subareolar and Periareolar Injection Techniques for Breast Sentinel Lymph Node Biopsy

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