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European Journal of Nuclear Medicine and Molecular Imaging

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01-06-2004

Sentinel node detection in pre-operative axillary staging

Authors: Giuseppe Trifirò, Giuseppe Viale, Oreste Gentilini, Laura Lavinia Travaini, Giovanni Paganelli

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Special Issue 1/2004

Abstract

The concept of sentinel lymph node biopsy in breast cancer surgery is based on the fact that the tumour drains in a logical way via the lymphatic system, from the first to upper levels. Since axillary node dissection does not improve the prognosis of patients with breast cancer, sentinel lymph node biopsy might replace complete axillary dissection for staging of the axilla in clinically N0 patients. Sentinel lymph node biopsy would represent a significant advantage as a minimally invasive procedure, considering that about 70% of patients are found to be free from metastatic disease, yet axillary node dissection can lead to significant morbidity. Subdermal or peritumoural injection of small aliquots (and very low activity) of radiotracer is preferred to intratumoural administration, and ^99mTc-labelled colloids with most of the particles in the 100–200 nm size range would be ideal for radioguided sentinel node biopsy in breast cancer. The success rate of radioguidance in localising the sentinel lymph node in breast cancer surgery is about 97% in institutions where a high number of procedures are performed, and the success rate of lymphoscintigraphy in sentinel node detection is about 100%. The sentinel lymph node should be processed for intraoperative frozen section examination in its entirety, based on conventional histopathology and, when necessary, immune staining with anti-cytokeratin antibody. Nowadays, lymphoscintigraphy is a useful procedure in patients with different clinical evidence of breast cancer.

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Title: Sentinel node detection in pre-operative axillary staging
Authors: Giuseppe Trifirò
Giuseppe Viale
Oreste Gentilini
Laura Lavinia Travaini
Giovanni Paganelli
Publication date: 01-06-2004
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue Special Issue 1/2004
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-004-1526-9

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Sentinel node detection in pre-operative axillary staging

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