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Sentinel Node Breast Biopsy

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2401. Sentinel lymph node biopsy in early breast cancer: the first 100 cases performed in a teaching institute. (Abstract)

Sentinel lymph node biopsy in early breast cancer: the first 100 cases performed in a teaching institute. The histologic status of axillary lymph nodes is one of the most important prognostic factors in breast cancer and influences the management of these patients. Axillary lymph node dissection was traditionally performed in all patients to obtain this information but this procedure carries a considerable rate of complications. Recently, sentinel lymph node biopsy has emerged as an accurate (...) the operations in all patients. All operations were performed by surgical residents under the supervision of senior surgeons.The overall rate of identification of sentinel lymph nodes was 92%. The accuracy of SLN biopsy in reflecting the axillary nodal status was 96% with a false negative rate of 5.7%.Sentinel lymph node biopsy is an accurate method for the evaluation and staging of regional lymph nodes in breast cancer patients. A dedicated instruction program for surgical residents may increase

2003 The Israel Medical Association journal : IMAJ Controlled trial quality: uncertain

2402. Sentinel lymph node biopsy in breast cancer patients: subdermal versus peritumoural radiocolloid injection. (Abstract)

Sentinel lymph node biopsy in breast cancer patients: subdermal versus peritumoural radiocolloid injection. Sentinel lymph node (SLN) biopsy has been widely used in the management of melanoma and breast cancer. The aims of this study were (1) to compare the results obtained with the two main injection techniques, the peritumoural and subdermal; and (2) to determine the reliability of SLN to predict the regional lymph node status.We prospectively studied 80 women (mean age 56 years) with breast (...) to reach the SLN. All nodes harvested were analysed by classic pathology techniques.Overall, lymphoscintigraphy allowed the detection of SLN in 75/80 patients (94%). All subdermal lymphoscintigraphies were positive (36/36) compared with 89% of peritumoural (39/44). Blue dye detected SLN in 23/31 patients (74%) after subdermal injection and in 24/34 patients (71%) after peritumoural injection. The sensitivity to localize the SLN with lymphoscintigraphy+blue dye+gamma probe was 92% (33/36) within

2001 Nuclear medicine communications Controlled trial quality: uncertain

2403. Sentinel node biopsy in breast cancer: ALMANAC trial. (Abstract)

Sentinel node biopsy in breast cancer: ALMANAC trial. Sentinel node biopsy of breast cancer is becoming an increasingly popular topic. The concept of the sentinel node being the first lymph node to contain metastatic cancer within a tumor's lymphatic basin was introduced by Cabanas, a South American surgeon, following his work on carcinoma of the penis. Morton and his colleagues then applied this principle to malignant melanomas, and more recently this concept has gained popularity (...) for carcinoma of the breast. In breast cancer patients, the fact that a sentinel node can be localized and the suggestion that the sentinel node is representative of the axillary nodal status has been confirmed by a number of studies across the world. Most authors writing on this subject, however, end with a caution that the results of randomized trials are needed before this new surgical technique can be accepted as part of routine breast cancer management. The Medical Research Council of the United

2001 World Journal of Surgery

2404. Should internal mammary chain (IMC) sentinel node biopsy be performed? Outcome in 90 consecutive non-biopsied patients with a positive IMC scintigraphy. (Abstract)

Should internal mammary chain (IMC) sentinel node biopsy be performed? Outcome in 90 consecutive non-biopsied patients with a positive IMC scintigraphy. Although the status of the regional lymph nodes is an important determinant of prognosis in breast cancer, harvesting sentinel nodes (SN) detected in the internal mammary chain (IMC) is still controversial.To determine in how many patients a positive IMC-SN might change the systemic or locoregional adjuvant therapy, with a possible benefit (...) in outcome.During 6 1/2 years data of T1-2 breast cancer patients, having an SN procedure, were prospectively collected. Our policy was not to explore the IMC even if it was the only localization of an SN.In 86 of 571 patients lymphoscintigraphy showed an IMC-SN. In 64 of these, the axillary SN was negative and only 25 of these patients did not have an indication for adjuvant systemic treatment based on their tumor characteristics. In the literature, IMC metastases are found in 0-10% of axillary negative

2008 Breast

2405. Internal mammary node drainage and its role in sentinel lymph node biopsy: the initial ALMANAC experience. (Abstract)

Internal mammary node drainage and its role in sentinel lymph node biopsy: the initial ALMANAC experience. This study was designed to identify the frequency of internal mammary drainage in patients undergoing sentinel lymph node (SLN) lymphoscintigraphy in a controlled clinical trial. The practicability and relevance of internal mammary SLN biopsy as a method to improve nodal staging and treatment in breast cancer were investigated. A total of 707 evaluable patients with invasive breast cancer (...) underwent SLN biopsy based on lymphoscintigraphy, intraoperative g probe detection, and blue dye mapping using technetium Tc 99m albumin colloid and Patent Blue V injected peritumorally. This was followed by standard axillary treatment in the same operation in all patients. Lymphoscintigraphy showed internal mammary sentinel nodes in 62 patients (9%), and internal mammary drainage was identified perioperatively in an additional 7 patients (1%) using g probe detection. Sampling of the internal mammary

2005 Clinical breast cancer Controlled trial quality: uncertain

2406. Incidence of internal mammary node metastases after a sentinel lymph node technique in breast cancer and its implication in the radiotherapy plan. (Abstract)

Incidence of internal mammary node metastases after a sentinel lymph node technique in breast cancer and its implication in the radiotherapy plan. To analyze the frequency in determining pathologically proven metastatic involvement of internal mammary nodes (IMN) after sentinel lymph node (SLN) technique in breast cancer and to evaluate the implications for radiotherapy (RT) management of patients.Two hundred and twenty-five patients who underwent lymphatic mapping for early breast cancer (...) treated with breast-conserving surgery and radiation (80%) or mastectomy (20%) were evaluated. There were two phases in the study: the validation phase (105 patients, 52 T1, 53 T2 < or = 4 cm), and the application phase (120 patients, 70 T1, 50 T2 < or = 2.5 cm). In the validation, if a drainage pathway to the IMN was identified, no biopsy was performed in this phase. In the application, if the study showed metastases in the IMNs, biopsy was performed. When histologically proven IMN metastases were

2004 Biology and Physics

2407. A prospective study of the value of axillary node sampling in addition to sentinel lymph node biopsy in patients with breast cancer. (Abstract)

A prospective study of the value of axillary node sampling in addition to sentinel lymph node biopsy in patients with breast cancer. Limitations of sentinel lymph node biopsy (SLNB) include the occurrence of false negative (FN) results and the need to further treat SLNB positive axillae. The aims of this study were to: (1) compare the accuracy of SLNB alone to a combined SLNB and axillary sampling procedure (SLNB+AS). (2) evaluate if the additional AS could identify those SLNB positive cases (...) with no further disease in the axilla.Sixty-seven combined SLNB+AS procedures were performed prospectively in 66 patients, followed by Level II axillary dissection. Additionally sampled nodes were recorded if they were clinically suspicious or not at intra-operative palpation.The FN rate for SLNB alone was 14.3%, whilst that for SLNB+AS was reduced to 3.6%. However, the benefit of additional sampling was only seen in those cases with tumours >/=3 cm and clinically suspicious nodes (n=12). Of 12 cases

2003 European Journal of Surgical Oncology

2408. Short-term morbidity of the upper limb after sentinel lymph node biopsy or axillary lymph node dissection for Stage I or II breast carcinoma. Full Text available with Trip Pro

Short-term morbidity of the upper limb after sentinel lymph node biopsy or axillary lymph node dissection for Stage I or II breast carcinoma. The goals of sentinel lymph node biopsy (SLNB) are to improve axillary staging and reduce unnecessary axillary lymph node dissections (ALND), thereby reducing treatment-related upper-limb morbidity. In the current prospective study, short-term upper-limb morbidity was assessed after SLNB and/or ALND.The study comprised 204 patients with Stage I/II breast

2003 Cancer

2409. Sentinel node biopsy as a practical alternative to axillary lymph node dissection in breast cancer patients: an approach to its validity. (Abstract)

Sentinel node biopsy as a practical alternative to axillary lymph node dissection in breast cancer patients: an approach to its validity. Sentinel node biopsy (SNB) has been proposed as an alternative to axillary lymph-node dissection (ALND) in breast cancer. Before implementing SNB in our practice, we wished to test its validity by comparing it to the standard ALND, both in our hands and with other reported series.One hundred thirty-two patients were included prospectively. SNB and immediate

2001 Annals of oncology : official journal of the European Society for Medical Oncology / ESMO

2410. Practice patterns of lymph-node mapping and sentinel-node biopsy for breast cancer in British Columbia Full Text available with Trip Pro

Practice patterns of lymph-node mapping and sentinel-node biopsy for breast cancer in British Columbia Because there is no standardized technique for mapping of lymph nodes and no optimal technique for evaluating the sentinel node, we decided to evaluate practice patterns for sentinel-node biopsy (SNB) for breast cancer in British Columbia 5 years after its introduction in 1996.We carried out mail and telephone surveys of general surgeons performing at least 1 SNB (n = 28) or not performing SNB (...) performed fewer than 10 procedures. Five surgeons had abandoned routine axillary dissection. There was considerable variation regarding the indications for SNB, definition of a sentinel node and surgical techniques. All nuclear medicine departments had a written lymphatic mapping protocol, but each used a different volume and activity of radiotracer. Immunohistochemical evaluation of the sentinel nodes was performed at just 3 pathology laboratories. The survey response rate from surgeons not practising

2003 Canadian Journal of Surgery

2411. Sentinel Lymph Node Biopsy to Assess Axillary Lymph Nodes in Women With Stage I or Stage II Breast Cancer

Sentinel Lymph Node Biopsy to Assess Axillary Lymph Nodes in Women With Stage I or Stage II Breast Cancer Sentinel Lymph Node Biopsy to Assess Axillary Lymph Nodes in Women With Stage I or Stage II Breast Cancer - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100 (...) ). Please remove one or more studies before adding more. Sentinel Lymph Node Biopsy to Assess Axillary Lymph Nodes in Women With Stage I or Stage II Breast Cancer The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT00005821 Recruitment Status : Unknown Verified March 2003 by National Cancer Institute (NCI

2000 Clinical Trials

2412. Clinical and therapeutic importance of sentinel node biopsy of the internal mammary chain in patients with breast cancer: a single-center study with long-term follow-up. (Abstract)

Clinical and therapeutic importance of sentinel node biopsy of the internal mammary chain in patients with breast cancer: a single-center study with long-term follow-up. We evaluated the incidence of sentinel lymph nodes (SLNs) in the internal mammary chain, calculated the lymphoscintigraphy and surgical detection rates, and evaluated the clinical effect on staging and the therapeutic approach in patients with breast cancer.The study involved 741 women diagnosed with breast cancer eligible (...) with no complications. Of these 65 patients, 10 had a positive internal mammary chain SLN on final pathologic examination, whereas 55 patients had >or=1 negative SLNs on final pathologic analysis. Thirty-five (53%) of 65 patients had also an axillary SLN, but only 5 patients (8%) had a positive SLN on pathologic analysis.Evaluation of the SLNs in the internal mammary chain may provide more accurate staging in breast cancer patients. If an internal mammary sampling is not performed, patients may be understaged

2006 Annals of Surgical Oncology

2413. Internal mammary lymph drainage and sentinel node biopsy in breast cancer - A study on 1008 patients. (Abstract)

Internal mammary lymph drainage and sentinel node biopsy in breast cancer - A study on 1008 patients. Nowadays, axillary sentinel node (SN) biopsy is a standard procedure in the staging of breast cancer. Although the internal mammary (IM) lymph node status is a major independent prognostic factor in breast cancer patients, sampling of IM sentinel nodes (IMSNs) is not performed routinely. The aim of this study was to determine the likelihood of finding IM lymph node metastases in case of IM (...) hotspots on lymphoscintigraphy and evaluate the relevance of IMSN biopsy as a method to improve staging.Between April 1997 and May 2006, a total of 1008 consecutive patients with clinically node-negative operable primary breast cancer were enrolled in a prospective study on SN biopsy. Both axillary and IMSNs were sampled, based on lymphoscintigraphy, intraoperative gamma probe detection and blue dye mapping, using 10 mCi (370 MBq) (99m)Tc-nanocolloid injected peritumorally, and 0.5-1.0 ml Patent Blue V

2008 European Journal of Surgical Oncology

2414. Sentinel lymph node biopsy alone without axillary lymph node dissection--follow up of sentinel lymph node negative breast cancer patients. (Abstract)

Sentinel lymph node biopsy alone without axillary lymph node dissection--follow up of sentinel lymph node negative breast cancer patients. To evaluate the rate of axillary recurrences in sentinel lymph node (SLN) negative breast cancer patients after sentinel lymph node biopsy (SLNB) alone without further axillary lymph node dissection (ALND).Between May 1999 and February 2001 all patients who had primary invasive breast cancer and were SLN negative were eligible for this prospective study (...) . SLNB was performed by using the combined method with radioactive tracer and blue dye. SLNs were examined by frozen section, standard H/E staining and immunohistochemistry staining. SLN negative patients did not receive further ALND. Follow-up was done three-monthly with clinical controls, blood samples and ultrasound of the breast and axilla. An annual mammogram was performed.116 patients with T1 or T2 invasive breast cancer were included in this trial. All 116 patients had negative SLNs in frozen

2003 European Journal of Surgical Oncology

2415. Should the hunt for internal mammary chain sentinel nodes begin? An evaluation of 150 breast cancer patients. (Abstract)

Should the hunt for internal mammary chain sentinel nodes begin? An evaluation of 150 breast cancer patients. The aim of this study was to determine the visualization rate, identification rate, and clinical implications of biopsy of sentinel nodes in the internal mammary chain (IMC) in patients with breast cancer.From January 1999 to December 2002, 691 sentinel node procedures were performed. Preoperative lymphoscintigraphy was performed after injection of (99m)Tc-labeled nanocolloid (...) %). There was a change of management in 38 (29%) of the 130 patients: institution or omission of radiotherapy to the IMC, adjuvant systemic therapy, or omission of an axillary lymph node dissection.Pursuit of IMC sentinel nodes improves the staging of patients with breast cancer and enables treatment to be better adjusted to the needs of the individual patient.

2003 Annals of Surgical Oncology

2416. The impact on post-surgical treatment of sentinel lymph node biopsy of internal mammary lymph nodes in patients with breast cancer. Full Text available with Trip Pro

The impact on post-surgical treatment of sentinel lymph node biopsy of internal mammary lymph nodes in patients with breast cancer. Since the introduction of the sentinel lymph node (SLN) biopsy in breast cancer patients there is a renewed interest in lymphatic drainage to the internal mammary (IM) chain nodes. We evaluated the frequency of lymphatic drainage to the IM chain, the rate of SLNs that contain metastases and the clinical implications of IM LN metastases.Between June 1999 and April (...) 2005 506 consecutive patients underwent SLN biopsy as a staging procedure for clinically T1-2N0 breast cancer. In all patients preoperative lymphoscintigraphy was combined with the intraoperative use of a gammaprobe. In patients with IM SLNs visualized on lymphoscintigraphy, LNs were extirpated through an intercostal parasternal incision.SLNs were visualized by preoperative lymphoscintigraphy in 99% of all patients (502/506): axillary SLNs in 499 patients (99%), ipsilateral IM LNs in 109 patients

2007 Annals of Surgical Oncology

2417. Stage migration after biopsy of internal mammary chain lymph nodes in breast cancer patients. (Abstract)

Stage migration after biopsy of internal mammary chain lymph nodes in breast cancer patients. Involvement of the internal mammary chain lymph nodes (IMNs) is associated with worsened prognosis in breast cancer. Use of lymphoscintigraphy to visualize sentinel nodes reveals that IMNs often receive lymph from the area containing the tumor.We biopsied IMNs in 182 patients because there was radiouptake to the IMNs or because the tumor was located in the medial portion of the breast. After tumor (...) removal, pectoralis major fibers were divided to expose intercostal muscle. A portion of intercostal muscle adjacent to the sternum was removed. Lymph nodes and surrounding fatty tissue in the intercostal space were freed, removed, and analyzed histologically. The pleural cavity was breached in four cases (2.2%), with spontaneous resolution.IMNs were found in 160 (88%) of 182 patients; 146 (94.4%) were negative and 14 (8.8%) were positive. The latter received internal mammary chain radiotherapy

2002 Annals of Surgical Oncology

2418. A selection algorithm for internal mammary sentinel lymph node biopsy in breast cancer. (Abstract)

A selection algorithm for internal mammary sentinel lymph node biopsy in breast cancer. Internal mammary lymph-node (IMN) metastases in breast carcinomas have a major influence on survival, comparable with the influence of axillary lymph-node metastases (ALNM). Prospective, randomized trials have demonstrated that complete IMN dissection as part of extended radical mastectomy does not improve overall or disease-free survival. In the subset of patients with tumours 1cm or less in size (...) and no ALNM, information on IMN status would provide important information. In these cases, the presence of IMN metastases would change the staging from stage I to stage IIIB, according to the current tumour, node and metastasis classification. More importantly, it would influence these patients' adjuvant treatment. Lymphatic mapping for sentinel lymph-node (SLN) biopsy has demonstrated extra-axillary drainage in up to 35% of patients. Recent reports have demonstrated the feasibility of internal mammary

2002 European Journal of Surgical Oncology

2419. Halsted Revisited: Internal Mammary Sentinel Lymph Node Biopsy in Breast Cancer Full Text available with Trip Pro

Halsted Revisited: Internal Mammary Sentinel Lymph Node Biopsy in Breast Cancer To investigate the feasibility of internal mammary sentinel lymph node biopsy as a method to refine and thereby improve nodal staging in breast cancer.The internal mammary lymph node status is a major prognostic factor in breast cancer. If positive, prognosis is less favorable. However, staging this regional nodal basin is not performed routinely, thus discarding additional staging information.In a consecutive (...) series of 256 patients with primary breast cancer, sentinel node biopsy was performed based on lymphoscintigraphy, intraoperative gamma probe detection, and blue dye mapping using 10 mCi (370 MBq) (99m)Tc-nanocolloid injected peritumorally and 0.5 to 1.0 mL Patent Blue V injected intradermally. During surgery, whenever possible, both axillary and internal mammary sentinel nodes were sampled.Lymphoscintigraphy showed axillary sentinel nodes in 95% (243/256) and additional internal mammary sentinel

2001 Annals of Surgery

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