Top

Published in:

01-07-2005

The Impact of Nonvisualization of Sentinel Nodes on Lymphoscintigraphy in Breast Cancer

Authors: C. Rousseau, MD, J. M. Classe, MD, L. Campion, MD, C. Curtet, PhD, F. Dravet, MD, R. Pioud, MD, C. Sagan, MD, B. Bridji, MD, I. Resche, MD

Published in: Annals of Surgical Oncology | Issue 7/2005

Abstract

Background

This study aimed at evaluating the relationship between the nonvisualization of sentinel nodes (SNs) at lymphoscintigraphy and the intraoperative detection rate, radioactive counts in vivo, and histological status of SNs.

Methods

Two hundred eighty patients with infiltrating breast carcinoma (T0, T₁/T₂) underwent preoperative lymphoscintigraphy before gamma probe–guided SN biopsy.

Results

The surgical identification rate with a gamma probe was 84.6% (56 of 280) in lymphoscintigraphy-negative patients and 93.2% (224 of 280) in lymphoscintigraphy-positive patients (P < .05) after two subdermal periareolar injections. The average number of SNs per patient was 1.7 in lymphoscintigraphy-negative patients and 2.2 in lymphoscintigraphy-positive patients (P < .01), as assessed by gamma detection. The mean age of lymphoscintigraphy-negative patients was 62 ± 10 years, versus 55 ± 13 years for lymphoscintigraphy-positive patients (P < .001). The median radioactive count in dissected SNs identified by gamma detection was 204 cps (range, 4–618 cps) in lymphoscintigraphy-negative patients, versus 606 cps (range, 43–16,928 cps) in lymphoscintigraphy-positive patients (P < .001). The rate of macrometastatic SNs was 40% in lymphoscintigraphy-negative patients, versus 30% in lymphoscintigraphy-positive patients (not significant), whereas the size of involved SNs was 16.6 mm in lymphoscintigraphy-negative patients, versus 13.1 in lymphoscintigraphy-positive patients (P < .05). The micrometastasis detection rate in SNs from lymphoscintigraphy-negative patients was 6.25%, versus 23.3% in lymphoscintigraphy-positive patients (P < .01).

Conclusions

Negative lymphoscintigraphy was observed in 20% of patients and was more frequent in elderly patients. Negative lymphoscintigraphy was predictive of a lower surgical identification rate and fewer detected SNs. These SNs had fewer micrometastases, were fairly large, and tended to harbor metastases.

Veronesi, U, Paganelli, G, Viale, G, et al. 1999Sentinel lymph node biopsy and axillary dissection in breast cancer: results in a large seriesJ Natl Cancer Inst9136873CrossRefPubMed

Nieweg, OE, Jansen, L, Valdes Olmos, RA, et al. 1999Lymphatic mapping and sentinel lymph node biopsy in breast cancerEur J Nucl Med26S116CrossRefPubMed

Jeffrey, SS, Jones, SB, Smith, K 2000Controversies in sentinel lymph node biopsy for breast cancerCancer Biother Radiopharm1522333CrossRefPubMed

Mascarel, I, Bonichon, F, Coindre, JM, et al. 1992Prognostic significance of breast cancer axillary lymph node micrometastases assessed by two special techniques: reevaluation with longer follow-upBr J Cancer665237PubMed

Brenot-Rossi, I, Houvenaeghel, G, Jacquemier, J, et al. 2003Nonvisualization of axillary sentinel node during lymphoscintigraphy: is there a pathologic significance in breast cancer?J Nucl Med4412327PubMed

Mariani, G, Moresco, L, Viale, G, et al. 2001Radioguided sentinel lymph node biopsy in breast cancer surgeryJ Nucl Med421198215PubMed

Wilhem, AJ, Mijnhout, GS, Franssen, EJF 1999Radiopharmaceuticals in sentinel lymph node detection—an overviewEur J Nucl Med26S3642PubMed

Maza, S, Valencia, R, Geworski, L, et al. 2003Peritumoural versus subareolar administration of technetium-99m nanocolloid for sentinel lymph node detection in breast cancer: preliminary results of a prospective intra-individual comparative studyEur J Nucl Med306516

Smith, LF, Cross, MJ, Klimberg, VS 2000Subareolar injection is a better technique for sentinel lymph node biopsyAm J Surg1804348PubMed

10.

Chagpar, A, Martin, RC, Chao, C, et al. 2004Validation of subareolar and periareolar injection techniques for breast sentinel lymph node biopsyArch Surg13961420PubMed

11.

Mc Masters, KM, Wong, SL, Tuttle, TM, et al. 2000Preoperative lymphoscintigraphy for breast cancer does not improve the ability to identify axillary sentinel lymph nodesAnn Surg23172431CrossRefPubMed

12.

Valdes Olmos, RA, Tanis, PJ, Hoefnagel, CA, et al. 2001Improved sentinel node visualization in breast cancer by optimizing the colloid particle concentration and tracer dosageNucl Med Commun2257986PubMed

13.

Birdwell, RL, Smith, KL, Betts, BJ, et al. 2001Breast cancer: variables affecting sentinel lymph node visualization at preoperative lymphoscintigraphyRadiology2204753PubMed

14.

Alazraki, NP, Styblo, T, Grant, SF, et al. 2000Sentinel node staging of early breast cancer using lymphoscintigraphy and the intraoperative gamma-detecting probeSemin Nucl Med305664PubMed

15.

DeCicco, C, Cremonesi, M, Luini, A, et al. 1998Lymphoscintigraphy and radioguided biopsy of sentinel axillary node in breast cancerJ Nucl Med3920804PubMed

16.

Mariani, G, Erba, P, Villa, G, et al. 2004Lymphoscintigraphic and intraoperative detection of the sentinel lymph node in breast cancer patients: the nuclear medicine perspectiveJ Surg Oncol8511222PubMed

17.

Classe, JMC, Curtet, C, Campion, L, et al. 2003Learning curve for the detection of axillary sentinel lymph node in breast cancer implies a twofold axillary surgical procedure: prospective evaluation of the results and morbidity on a consecutive series of 200 patientsEur J Surg Oncol2942633CrossRefPubMed

18.

Valdes Olmos, RA, Jansen, L, Hoefnagel, CA, et al. 2000Evaluation of mammary lymphoscintigraphy by single intratumoral injection for sentinel node identificationJ Nucl Med4115006PubMed

19.

Heuser, T, Rink, T, Weller, E, et al. 2001Impact of axillary nodal status on sentinel node mapping in breast cancer and its relevance for technical proceedingBreast Cancer Res Treat6712532PubMed

20.

Gajdos, C, Tartter, PI, Bleiweiss, IJ, et al. 1999Lymphatic invasion, tumor size, and age are independent predictors of axillary lymph node metastases in women with T1 breast cancersAnn Surg472851

21.

Cox, CE, Dupont, E, Whitehead, GF, et al. 2002Age and body mass index may increase the chance of failure in sentinel lymph node biopsy for women with breast cancerBreast J8 8891

22.

Krausz, Y, Ykeda, DM, Jadvar, H, et al. 2001Non visualization of sentinel lymph node in patients with breast cancerNucl Med Commun222532CrossRefPubMed

Title: The Impact of Nonvisualization of Sentinel Nodes on Lymphoscintigraphy in Breast Cancer
Authors: C. Rousseau, MD
J. M. Classe, MD
L. Campion, MD
C. Curtet, PhD
F. Dravet, MD
R. Pioud, MD
C. Sagan, MD
B. Bridji, MD
I. Resche, MD
Publication date: 01-07-2005
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 7/2005
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/ASO.2005.07.014

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Impact of Nonvisualization of Sentinel Nodes on Lymphoscintigraphy in Breast Cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 7/2005

The Outcome of Surgical Resection Versus Assignment to the Liver Transplant Waiting List for Hepatocellular Carcinoma

Comparative Study of Surgical Margins in Oncoplastic Surgery and Quadrantectomy in Breast Cancer

Primary Hyperparathyroidism: Can Parathyroid Carcinoma Be Anticipated on Clinical and Biochemical Grounds? Report of Nine Cases and Review of the Literature

Predicting the Presence of Parathyroid Carcinoma

External Jugular Vein Cutdown Approach, as a Useful Alternative, Supports the Choice of the Cephalic Vein for Totally Implantable Access Device Placement

A Tat Fusion Protein–Based Tumor Vaccine for Breast Cancer