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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-05-2009 | Original Article

Can the sentinel lymph node technique affect decisions to offer internal mammary chain irradiation?

Authors: Jean-Cyril Bourre, Raoul Payan, Delphine Collomb, Céline Gallazzini-Crepin, Alex Calizzano, Marie-Dominique Desruet, Dominique Pasquier, Michel Bolla, Daniel Fagret, Jean-Philippe Vuillez

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 5/2009

Abstract

Purpose

Identification of the sentinel lymph node (SLN) for small mammary tumours (cT1N0) sometimes leads to detection of internal mammary chain (IMC) drainage. This information is often ignored by physicians. The present study sought to determine the frequency with which an internal mammary SLN was identified by peritumoral injection of radioactive tracer, and then to determine the patients in whom identification of an internal mammary SLN could have an impact on the radiation treatment plan.

Materials

Between March 2002 and March 2008, 622 SLN biopsies performed in a cohort of 608 patients were analysed. Technetium-labelled nanocolloids were administered via three peritumoral injections, completed by a deep prepectoral injection, with the entire procedure performed under echographic guidance.

Results

The SLN was identified in 607 of the 622 patients, including 174 (28.7%) in the IMC. A total of 161 successful internal mammary biopsies were performed. Of the 622 patients, 18 showed SLN involvement in the IMC. In 7 of these patients, only the internal mammary SLN was affected. Prophylactic irradiation of the IMC was indicated in 376 patients, but only in 18 (4.8%) of these patients was there effectively IMC involvement; internal mammary SLN biopsy failed in 7 patients (1.9%).

Conclusion

SLN detection by peritumoral injection, combined with the systematic removal of the internal mammary SLN, enabled the involvement of this region to be found in a nonnegligible number of patients. Such information should make it possible to personalize treatment for patients with stage cT1 mammary cancer and thereby avoid needless internal mammary radiation therapy in a large number of patients (93.4% in our study).

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Title: Can the sentinel lymph node technique affect decisions to offer internal mammary chain irradiation?
Authors: Jean-Cyril Bourre
Raoul Payan
Delphine Collomb
Céline Gallazzini-Crepin
Alex Calizzano
Marie-Dominique Desruet
Dominique Pasquier
Michel Bolla
Daniel Fagret
Jean-Philippe Vuillez
Publication date: 01-05-2009
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 5/2009
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-008-1034-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Can the sentinel lymph node technique affect decisions to offer internal mammary chain irradiation?

Abstract

Purpose

Materials

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials

Results

Conclusion

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