sentinel lymph node biopsy


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sentinel lymph node biopsy

A procedure, performed most often for breast cancer and less commonly for melanomas, in which a dye (Patent Blue V) and/or radioactive substance (99mTc-labelled colloid) is injected near a tumour; it flows into the sentinel lymph node (the first lymph node that cancer spreads to from a primary cancer). In the breast, 90% of the sentinel nodes are in the axilla, 10% in the internal mammary chain. The sentinel lymph is identified by a dye or a handheld gamma probe, removed and sent to pathology. If the sentinel node is negative for cancer (about 5% of cases are false negative), then it is likely that the tumour has not spread to the nodes and the considerable morbidity associated with removing the lymph nodes (e.g., marked lymphoedema with compromised quality of life, restricted shoulder movement, sensory loss, seroma formation, longer hospital stay and future risk of angiosarcoma) can be avoided.

Sentinel positivity
Macrometastasis: 50% risk of non-sentinel lymph node involvement.
Micrometastasis: Breast, 20% risk of non-sentinel lymph node involvement.

Micrometastasis
Melanoma
Predictors of poor prognosis
• Presence of infiltration of the sentinel node capsule;
• Tumour penetrative depth of > 2 mm;
• Largest tumour deposit of 30 cells.
Metastasis detected by immunocytochemistry, 9% risk of non-sentinel lymph node involvement.
References in periodicals archive ?
The Central-European SentiMag study: sentinel lymph node biopsy with superparamagnetic iron oxide (SPIO) vs radioisotope.
Atypical anaphylactic reaction to patent blue during sentinel lymph node biopsy for breast cancer.
Sentinel lymph node biopsy for evaluation and treatment of patients with Merkel cell carcinoma: the Dana-Farber experience and meta-analysis of the literature.
A sentinel lymph node biopsy is used to identify, remove and examine lymph nodes to determine whether cancer cells are present.
If early-stage breast cancer is present, sentinel lymph node biopsy is used as an alternative to traditional lymph node dissection.
Sentinel lymph node biopsy is considered to have minimal surgical risk and avoids axillary lymphadenectomy if an occult carcinoma is found [10, 11].
The panel heard evidence from Alrawi's colleagues praising his "excellent skills as a doctor" and his specialist work in sentinel lymph node biopsy and melanoma treatment.
[1] These shifts include the transition from routine axillary lymph node dissection (ALND) to sentinel lymph node biopsy (SLNB) in node-negative patients, and the transition from routine mastectomy to breast-conserving therapy.
A comparison of sentinel lymph node biopsy to lymphadenectomy for endometrial cancer staging (FIRES trial): a multicentre, prospective, cohort study.
Axilla lymph node dissection (ALND) is slowly replaced by sentinel lymph node biopsy (SLNB) as standard procedure of breast cancer treatment.
The authors found no difference in clinical data and prognosis between patients who underwent WLE or amputation and recommended consideration of WLE with or without sentinel lymph node biopsy instead of amputation in cases of long standing ADPA without metastasis or bony invasion.