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Related Experiment Videos

Sentinel node detection in pre-operative axillary staging.

Giuseppe Trifirò1, Giuseppe Viale, Oreste Gentilini

  • 1Division of Nuclear Medicine, European Institute of Oncology, Milan, Italy.

European Journal of Nuclear Medicine and Molecular Imaging
|April 23, 2004
PubMed
Summary
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Sentinel lymph node biopsy is a minimally invasive breast cancer staging procedure. It accurately identifies metastatic disease, potentially replacing axillary node dissection and reducing patient morbidity.

Area of Science:

  • Oncology
  • Surgical Pathology
  • Nuclear Medicine

Background:

  • Breast cancer staging relies on axillary lymph node assessment.
  • Complete axillary dissection offers no prognostic benefit and causes significant morbidity.
  • Sentinel lymph node biopsy (SLNB) is a less invasive alternative for staging.

Purpose of the Study:

  • To evaluate SLNB as a replacement for axillary node dissection in clinically N0 breast cancer patients.
  • To highlight the advantages of SLNB in minimizing surgical morbidity.
  • To detail the optimal radiotracer and techniques for SLNB.

Main Methods:

  • Subdermal or peritumoural injection of (99m)Tc-labelled colloids (100-200 nm).
  • Radioguided localization of the sentinel lymph node.

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  • Intraoperative frozen section examination of the entire sentinel node using histopathology and cytokeratin immunostaining.

    • Main Results:

    • SLNB success rate for sentinel lymph node localization is approximately 97%.
    • Lymphoscintigraphy demonstrates a 100% success rate in sentinel node detection.
    • Approximately 70% of patients are found to be free of metastatic disease, avoiding unnecessary axillary dissection.

    Conclusions:

    • Sentinel lymph node biopsy is a highly effective and minimally invasive procedure for breast cancer staging.
    • SLNB accurately stages the axilla in clinically N0 patients, reducing morbidity.
    • Radioguided SLNB with lymphoscintigraphy is a valuable tool in breast cancer management.