Lymphatic Mapping and Sentinel Lymph Node Biopsy
Identifieur interne : 003716 ( Istex/Checkpoint ); précédent : 003715; suivant : 003717Lymphatic Mapping and Sentinel Lymph Node Biopsy
Auteurs : Siddharth S. Bass [États-Unis] ; Gary H. Lyman [États-Unis] ; Christa R. Mccann [États-Unis] ; Ni Ni Ku [États-Unis] ; Claudia Berman [États-Unis] ; Kara Durand [États-Unis] ; Monica Bolano [États-Unis] ; Sarah Cox [États-Unis] ; Christopher Salud [États-Unis] ; Douglas S. Reintgen [États-Unis] ; Charles E. Cox [États-Unis]Source :
- The Breast Journal [ 1075-122X ] ; 1999-09.
Abstract
▪ Abstract: The status of the regional nodal basin remains the most important prognostic indicator of survival. The current standard of care for the management of invasive breast cancer is the complete removal of the tumor, with documentation of negative margins by either mastectomy or lumpectomy, followed by complete axillary lymph node dissection. Data suggest that complete lymph node dissection (CLND) provides better local control of the disease and may actually offer a survival advantage. Lymphatic mapping and sentinel lymph node (SLN) biopsy are clearly changing this long‐held paradigm and have the potential to change the standard of surgical care of the breast cancer patient. The purpose of this report is to describe the lymphatic mapping experience at the H. Lee Moffitt Cancer Center and Research Institute. From April 1994 to January 1999, 1,147 consecutive breast cancer patients were enrolled in an institutional review board‐approved lymphatic mapping protocol. Lymphatic mapping was performed using Tc99m‐labeled sulfur colloid and isosulfan blue dye. An SLN was defined as any blue node and/or any hot node with ex vivo radioactivity counts 10 times an excised non‐SLN or in situ radioactivity counts 3 times the background counts. Lymphatic mapping was successful in identifying the SLN in 1,098 of 1,147 (95.7%) cases. In the first 186 patients, all of whom underwent CLND following SLN biopsy, one false‐negative biopsy was encountered for a false‐negative rate of 0.83%. The method of diagnosis (excisional versus minimally invasive) does not appear to impact on lymphatic mapping. Tumor size, however, is directly related to the probability of axillary lymph node involvement. Advances in technology and the development of minimally invasive surgical techniques have heralded a new era in surgery. Lymphatic mapping and SLN biopsy may actually prove to be a more accurate method of identifying metastases to the axilla by allowing a more focused pathologic examination of the axillary node(s) at highest risk for metastasis. With adequate training, this technique can be readily implemented as a valuable tool in the surgical treatment of breast cancer. ▪
Url:
DOI: 10.1046/j.1524-4741.1999.00001.x
Affiliations:
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Mccann</name></author><author><name sortKey="Ku, Ni Ni" sort="Ku, Ni Ni" uniqKey="Ku N" first="Ni Ni" last="Ku">Ni Ni Ku</name></author><author><name sortKey="Berman, Claudia" sort="Berman, Claudia" uniqKey="Berman C" first="Claudia" last="Berman">Claudia Berman</name></author><author><name sortKey="Durand, Kara" sort="Durand, Kara" uniqKey="Durand K" first="Kara" last="Durand">Kara Durand</name></author><author><name sortKey="Bolano, Monica" sort="Bolano, Monica" uniqKey="Bolano M" first="Monica" last="Bolano">Monica Bolano</name></author><author><name sortKey="Cox, Sarah" sort="Cox, Sarah" uniqKey="Cox S" first="Sarah" last="Cox">Sarah Cox</name></author><author><name sortKey="Salud, Christopher" sort="Salud, Christopher" uniqKey="Salud C" first="Christopher" last="Salud">Christopher Salud</name></author><author><name sortKey="Reintgen, Douglas S" sort="Reintgen, Douglas S" uniqKey="Reintgen D" first="Douglas S." last="Reintgen">Douglas S. 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Lee Moffitt Cancer Center and Research Institute, Tampa</wicri:cityArea></affiliation></author><author><name sortKey="Ku, Ni Ni" sort="Ku, Ni Ni" uniqKey="Ku N" first="Ni Ni" last="Ku">Ni Ni Ku</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>H. Lee Moffitt Cancer Center and Research Institute, Tampa</wicri:cityArea></affiliation></author><author><name sortKey="Berman, Claudia" sort="Berman, Claudia" uniqKey="Berman C" first="Claudia" last="Berman">Claudia Berman</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>H. Lee Moffitt Cancer Center and Research Institute, Tampa</wicri:cityArea></affiliation></author><author><name sortKey="Durand, Kara" sort="Durand, Kara" uniqKey="Durand K" first="Kara" last="Durand">Kara Durand</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>H. Lee Moffitt Cancer Center and Research Institute, Tampa</wicri:cityArea></affiliation></author><author><name sortKey="Bolano, Monica" sort="Bolano, Monica" uniqKey="Bolano M" first="Monica" last="Bolano">Monica Bolano</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>H. Lee Moffitt Cancer Center and Research Institute, Tampa</wicri:cityArea></affiliation></author><author><name sortKey="Cox, Sarah" sort="Cox, Sarah" uniqKey="Cox S" first="Sarah" last="Cox">Sarah Cox</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>H. Lee Moffitt Cancer Center and Research Institute, Tampa</wicri:cityArea></affiliation></author><author><name sortKey="Salud, Christopher" sort="Salud, Christopher" uniqKey="Salud C" first="Christopher" last="Salud">Christopher Salud</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>H. Lee Moffitt Cancer Center and Research Institute, Tampa</wicri:cityArea></affiliation></author><author><name sortKey="Reintgen, Douglas S" sort="Reintgen, Douglas S" uniqKey="Reintgen D" first="Douglas S." last="Reintgen">Douglas S. 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Lee Moffitt Cancer Center and Research Institute, Tampa</wicri:cityArea></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">The Breast Journal</title><title level="j" type="alt">BREAST JOURNAL</title><idno type="ISSN">1075-122X</idno><idno type="eISSN">1524-4741</idno><imprint><biblScope unit="vol">5</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="288">288</biblScope><biblScope unit="page" to="295">295</biblScope><biblScope unit="page-count">8</biblScope><publisher>Blackwell Science Inc</publisher><pubPlace>Boston, MA, USA</pubPlace><date type="published" when="1999-09">1999-09</date></imprint><idno type="ISSN">1075-122X</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1075-122X</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">▪ Abstract: The status of the regional nodal basin remains the most important prognostic indicator of survival. The current standard of care for the management of invasive breast cancer is the complete removal of the tumor, with documentation of negative margins by either mastectomy or lumpectomy, followed by complete axillary lymph node dissection. Data suggest that complete lymph node dissection (CLND) provides better local control of the disease and may actually offer a survival advantage. Lymphatic mapping and sentinel lymph node (SLN) biopsy are clearly changing this long‐held paradigm and have the potential to change the standard of surgical care of the breast cancer patient. The purpose of this report is to describe the lymphatic mapping experience at the H. Lee Moffitt Cancer Center and Research Institute. From April 1994 to January 1999, 1,147 consecutive breast cancer patients were enrolled in an institutional review board‐approved lymphatic mapping protocol. Lymphatic mapping was performed using Tc99m‐labeled sulfur colloid and isosulfan blue dye. An SLN was defined as any blue node and/or any hot node with ex vivo radioactivity counts 10 times an excised non‐SLN or in situ radioactivity counts 3 times the background counts. Lymphatic mapping was successful in identifying the SLN in 1,098 of 1,147 (95.7%) cases. In the first 186 patients, all of whom underwent CLND following SLN biopsy, one false‐negative biopsy was encountered for a false‐negative rate of 0.83%. The method of diagnosis (excisional versus minimally invasive) does not appear to impact on lymphatic mapping. Tumor size, however, is directly related to the probability of axillary lymph node involvement. Advances in technology and the development of minimally invasive surgical techniques have heralded a new era in surgery. Lymphatic mapping and SLN biopsy may actually prove to be a more accurate method of identifying metastases to the axilla by allowing a more focused pathologic examination of the axillary node(s) at highest risk for metastasis. With adequate training, this technique can be readily implemented as a valuable tool in the surgical treatment of breast cancer. ▪</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Floride</li></region></list><tree><country name="États-Unis"><region name="Floride"><name sortKey="Bass, Siddharth S" sort="Bass, Siddharth S" uniqKey="Bass S" first="Siddharth S." last="Bass">Siddharth S. Bass</name></region><name sortKey="Berman, Claudia" sort="Berman, Claudia" uniqKey="Berman C" first="Claudia" last="Berman">Claudia Berman</name><name sortKey="Bolano, Monica" sort="Bolano, Monica" uniqKey="Bolano M" first="Monica" last="Bolano">Monica Bolano</name><name sortKey="Cox, Charles E" sort="Cox, Charles E" uniqKey="Cox C" first="Charles E." last="Cox">Charles E. Cox</name><name sortKey="Cox, Sarah" sort="Cox, Sarah" uniqKey="Cox S" first="Sarah" last="Cox">Sarah Cox</name><name sortKey="Durand, Kara" sort="Durand, Kara" uniqKey="Durand K" first="Kara" last="Durand">Kara Durand</name><name sortKey="Ku, Ni Ni" sort="Ku, Ni Ni" uniqKey="Ku N" first="Ni Ni" last="Ku">Ni Ni Ku</name><name sortKey="Lyman, Gary H" sort="Lyman, Gary H" uniqKey="Lyman G" first="Gary H." last="Lyman">Gary H. Lyman</name><name sortKey="Mccann, Christa R" sort="Mccann, Christa R" uniqKey="Mccann C" first="Christa R." last="Mccann">Christa R. Mccann</name><name sortKey="Reintgen, Douglas S" sort="Reintgen, Douglas S" uniqKey="Reintgen D" first="Douglas S." last="Reintgen">Douglas S. Reintgen</name><name sortKey="Salud, Christopher" sort="Salud, Christopher" uniqKey="Salud C" first="Christopher" last="Salud">Christopher Salud</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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