Sentinel lymph node biopsy in breast cancer: Unfiltered radioisotope is superior to filtered Journal Article
| Authors: | Linehan, D. C.; Hill, A. D. K.; Tran, K. N.; Yeung, H.; Yeh, S. D. J.; Borgen, P. I.; Cody, H. S. 3rd |
| Article Title: | Sentinel lymph node biopsy in breast cancer: Unfiltered radioisotope is superior to filtered |
| Abstract: | Background: The combination of gamma-probe radiolocalization and blue- dye mapping of sentinel lymph nodes (SLNs) has been advocated as the most accurate method for staging the clinically negative axilla in breast cancer patients, but the technical aspects of these procedures are not fully characterized in the literature. In this study, we compared the success of SLN localization in 134 consecutive breast cancer patients using blue dye plus two different preparations of radiocolloid. Study Design: A retrospective analysis of a prospectively maintained data base was performed to assess SLN localization in two cohorts of patients. Unfiltered technetium- 99m (Tc-99m) sulfur colloid (in 77 patients; group I) was compared with filtered Tc-99m sulfur colloid (in 57 patients; group II). All patients had a peritumoral injection of blue dye and isotope, followed immediately by lymphoscintigraphy to confirm radioactivity at the injection site and to image the SLN. Statistical analysis was performed using the Pearson chi- square test. Results: Unfiltered Tc-99m sulfur colloid was superior to the filtered radiocolloid in localizing the SLN (88% versus 73%; p = 0.03). SLN imaging by lymphoscintigraphy was also more successful in the unfiltered group. Using the combination of blue dye and radiolocalization, SLNs were identified in 94% of patients. Conclusions: For optimal localization of the SLN in breast cancer patients, surgeons should use the combined technique of blue-dye mapping and gamma-probe localization using unfiltered Tc-99m sulfur colloid. |
| Keywords: | controlled study; unclassified drug; major clinical study; cancer staging; lymph node metastasis; isosulfan blue; lymphoscintigraphy; preoperative evaluation; breast cancer; axillary lymph node; dye; radioisotope; cancer scintiscanning; lymph node biopsy; technetium sulfur colloid tc 99m; scintillation camera; human; priority journal; article |
| Journal Title: | Journal of the American College of Surgeons |
| Volume: | 188 |
| Issue: | 4 |
| ISSN: | 1072-7515 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 1999-04-01 |
| Start Page: | 377 |
| End Page: | 381 |
| Language: | English |
| DOI: | 10.1016/s1072-7515(98)00314-7 |
| PUBMED: | 10195721 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 16 August 2016 -- Source: Scopus |
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