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Related Experiment Video

Updated: Oct 10, 2025

Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy
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Does failed mapping predict sentinel lymph node metastasis in cN0 breast cancer?

Francesca Magnoni1, Giovanni Corso1,2, Laura Gilardi3

  • 1Breast Cancer Surgery Division, European Institute of Oncology, IRCCS, Milan, 20141, Italy.

Future Oncology (London, England)
|December 9, 2021
PubMed
Summary

Nonvisualized sentinel lymph nodes (non-vSLNs) occur in 1.7% of procedures. Despite this, most are identified during surgery, reducing unnecessary axillary dissection and managing metastasis risk.

Keywords:
axillary dissectionbreast cancerlymph node metastaseslymphoscintigraphy failurenonvisualized sentinel lymph nodessentinel lymph node biopsy

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Area of Science:

  • Oncology
  • Surgical Pathology
  • Nuclear Medicine

Background:

  • The clinical significance of nonvisualized sentinel lymph nodes (non-vSLNs) after lymphoscintigraphy is not well-established.
  • Sentinel lymph node (SLN) biopsy is a standard procedure for staging breast cancer and melanoma.

Purpose of the Study:

  • To determine the incidence of non-vSLNs on lymphoscintigraphy.
  • To assess the intraoperative identification rate of non-vSLNs.
  • To identify factors associated with non-vSLNs and their impact on axillary management.

Main Methods:

  • Retrospective analysis of 30,508 consecutive SLN procedures from 2000 to 2017.
  • Evaluation of associations between clinicopathological factors and SLN identification during surgery.

Main Results:

  • Non-vSLNs were identified in 1.7% (525/30,508) of procedures.
  • Intraoperative identification of at least one SLN was achieved in 73.3% of non-vSLN cases.
  • Nodal involvement was significantly associated with SLN nonidentification (p < 0.001).

Conclusions:

  • Patients with non-vSLNs have an elevated risk of SLN metastasis.
  • Consistent intraoperative detection rates for non-vSLNs help minimize unnecessary axillary dissections.