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Sentinel lymph node biopsy: validation technique at the medical centre of set bal-Portugal
P. Ferreira, Baía r., r. António Almeida, j., j. Simões Amaro, J.C., c. Quintana, l. Branco, M.V. Rigueira, m. Gonçalves Pereira, E.V., l. Mendonça-Ferreira
Objectives: To evaluate the accuracy of the Sentinel lymph node biopsy in breast cancer patients at this Institute, using combined sulphur colloid technetium-99 m (99mTc) and patent vital dye blue.
Methods: from March 2007 to July 2008, 50 patients with cancer, less than 3 cm with clinically negative axillary lymph nodes of Sentinel lymph node biopsy underwent (SLNB) followed by lymph node axillary dissection (ALND). Subareolar 99mTc sulphur presence injection was performed the day before surgery and patents vital dye blue was injected even subareolarly at least 5 minutes before surgery. Sentinel lymph node was identified during the surgical procedure using a probe of range and the direct sight.All Sentinel nodes immediately frozen section analysis. later haematoxylin & eosin immunohistochemical analysis were performed and colouring. Finally, SLNB was compared with standard ALND on his ability to accurately reflect the final pathological state of axillary nodes.
Results: The Sentinel lymph node (SLN) was identified in 48 50 patients (96%).The number of Sentinel Lymph nodes which ranged from 1-4 (means 1.48) and the Sentinel nodes not ranged from 7-27 (means 14.33).48 Patients with SLNs correctly identified, were positive histologically 29.17% (14/48). sensitivity of the .sln to predict the armpit was 93.75%;precision was 97.96%. The SLN has been falsely negative in a patient 6,25% (1/16).
Conclusions: this study validation proves the accuracy of SLNB and its reasonable rate of false negative. The SLNB represents a major step forward in surgical treatment of breast cancer as a minimally invasive procedure to provide for the State of axillary lymph nodes and now can be used as the standard method of staging in patients with early breast cancer to this institution.
Volume: 3 article number: 124 DOI: 10.3332/ecancer. 2008.124 received: 11/12/2008 published: 15/01/2009
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Management Training for administrators: Sentinel lymph node biopsy hospital under local anesthesia for breast cancer-organizational and economic impact
V. Galimberti, c. De Cicco, p. Veronesi, f. Landoni, s. Baraldi
Sentinel lymph node biopsy under local anesthesia for breast cancer: organisational and economic impact.
This study compares sentinel lymph node biopsy-made at the time of removal of primary breast cancer in general anesthesia, Sentinel lymph node biopsy performed under local anesthesia before main operation.
Compares the total cost of the two approaches, treatments in terms of average income and of their impact on subsequent operations scheduling and hence on waiting lists and income.
Volume: 2 article number: 74 DOI: 10.3332/eCMS. 2008 74 received: 01/08/2008 published: 15/02/2008
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Lymph node biopsy technique of lymphatic mapping and Sentinel during laparoscopic colon resection for cancer
P. White, b. Rottoli Andreoni, m., s. Celotti, r. Chiappa, m. Montorsi
Background: The Mapper lymphnode to improve staging colon cancer is still under evaluation. Laparoscopic Colectomy for colon cancer was validated in multi-centre trials. This study evaluated the feasibility and the technical aspects of lymphnode mapping in laparoscopic colectomy for colon cancer. Methods. Forty-four patients with histologically proven colon cancer were studied from January 2006 to September 2007. Exclusion criteria include: advanced disease (clinical phase III), rectal cancer, colon resection and contraindication for laparoscopy. Lymphnodal status has been evaluated preoperative scanning tomography (CT) and intraoperative with the help of laparoscopic ultrasound. Before resection, 2-3 ml dye Patent blue V was injected subserosally around the tumor. Lymphnodes colored were marked as Sentinel (SN) with metal clips or laparoscopic colectomy with suture and lymphadenectomy completed as normal. In case of failure of intraoperative procedure ex vivo SN biopsy was performed the sample colectomy after resection. Results. Total number of 904 lymphnodes have been examined, with a median number of 22 lymphnodes collected per patient. SN detection rate was 100%, an ex vivo lymphnode mapping was necessary in 4 patients. Eleven (26.2%) patients had lymphnodal metastasis and 5 (45.5%) of these patients, SN was the only positive lymphnode. There were two false negative SN (18.2%). In three cases (7.1%) with aberrant, lymphatic drainage was extended lymphadenectomy. The accuracy of the mapping SN was 95.2% and negative predictive value was 93.9%. Conclusions: lymphatic Mapping and SN laparoscopic removal is feasible in laparoscopic colectomy for colon cancer.The ex vivo technique is useful as a technique of saving in case of failure of intraoperative procedure. prospective studies are warranted to determine the accuracy true and the false negative rate of technique.
Volume: 1 article number: 60 DOI: 10.3332/ecancer. 2008.60 received: 01/10/2007 published: 15/11/2007
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cancer3 