Relevant bibliographies by topics / Sentinel lymph node

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Academic literature on the topic 'Sentinel lymph node'

Author: Grafiati
Published: 4 June 2021
Last updated: 13 June 2025

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Journal articles on the topic "Sentinel lymph node"

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Harold, J. A., D. Uyar, J. S. Rader, et al. "Adipose-only sentinel lymph nodes: a finding during the adaptation of a sentinel lymph node mapping algorithm with indocyanine green in women with endometrial cancer." International Journal of Gynecologic Cancer 29, no. 1 (2019): 53–59. http://dx.doi.org/10.1136/ijgc-2018-000008.

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ObjectiveTo identify factors that affect successful adaptation of sentinel lymph node mapping and those that lead to unintended adipose-only sentinel lymph node identification.MethodsSurgical and pathological data were prospectively collected on patients with endometrial cancer who underwent sentinel lymph node mapping with indocyanine green with or without pelvic and/or para-aortic lymph node dissection between November 2013 and April 2017. All mapping cases were performed with the robotic system. Adipose-only specimens were defined as a sentinel lymph node without a pathologically identified lymph node after ultrastaging.ResultsA total of 202 patients were included: 83% had endometrioid pathology, 12% serous, 3% carcinosarcoma, and 2% clear cell, with mixed pathology noted in 2%. The bilateral sentinel lymph node detection rate was 66%, and the rate of mapping at least a unilateral sentinel lymph node was 86%. Neither the bilateral nor the unilateral sentinel lymph node mapping rate changed with increased surgeon experience. The rate of adipose-only sentinel lymph node identification was more frequent when comparing the first 10 cases (37%), cases 11 – 30 (28%), and > 30 cases (9%) (P = 0.006). Body mass index > 30 kg/m2, uterine fibroids, The International Federation of Gynecology and Obstetrics (FIGO) grade, and histology were not found to have a statistically significant impact on either sentinel lymph node identification or adipose-only sentinel lymph node identification. Adipose-only sentinel lymph nodes were more likely with increased time from cervical injection to identification of the sentinel lymph node in the right hemipelvis. The median range was 28 min (14–73) for true sentinel lymph node identification vs 33 min (23–74) for adipose-only sentinel lymph node identification (P = 0.02).ConclusionPatient and surgeon factors did not impact the identification of sentinel lymph nodes over time. Adipose-only sentinel lymph nodes were more frequently identified in the initial cases and represent a potential complication to adapting sentinel lymph node biopsy without lymphadenectomy. The increase in adipose-only sentinel lymph node identification that was associated with time from cervical injection may represent delayed or disrupted uptake of indocyanine green.
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Vogt, H., R. Bares, W. Brenner, et al. "Verfahrensanweisung für die nuklear medizinische Wächter-Lymphknoten-Diagnostik." Nuklearmedizin 49, no. 04 (2010): 167–72. http://dx.doi.org/10.3413/nukmed-321.

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SummaryThe authors present a procedure guideline for scintigraphic detection of sentinel lymph nodes in malignant melanoma and other skin tumours, in breast cancer, in head and neck cancer, and in prostate and penile carcinoma. Important goals of sentinel lymph node scintigraphy comprise reduction of the extent of surgery, lower postoperative morbidity and optimization of histopathological examination focussing on relevant lymph nodes. Sentinel lymph node scintigraphy itself does not diagnose tumorous lymph node involvement and is not indicated when lymph node metastases have been definitely diagnosed before sentinel lymph node scintigraphy. Procedures are compiled with the aim to reliably localise sentinel lymph nodes with a high detection rate typically in early tumour stages. Radiation exposure is low so that pregnancy is not a contraindication for sentinel lymph node scintigraphy. Even with high volumes of scintigraphic sentinel lymph node procedures surgeons, theatre staff and pathologists receive a radiation exposure < 1 mSv/year so that they do not require occupational radiation surveillance.
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de Hullu, J. A., H. Hollema, D. A. Piers, et al. "Sentinel Lymph Node Procedure Is Highly Accurate in Squamous Cell Carcinoma of the Vulva." Journal of Clinical Oncology 18, no. 15 (2000): 2811–16. http://dx.doi.org/10.1200/jco.2000.18.15.2811.

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PURPOSE: To determine the diagnostic accuracy of the sentinel lymph node procedure in patients with squamous cell carcinoma of the vulva and to investigate whether step sectioning and immunohistochemistry of sentinel lymph nodes increase the sensitivity for detection of metastases. PATIENTS AND METHODS: Between July 1996 and July 1999, 59 patients with primary vulvar cancer were entered onto a two-center prospective study. All patients underwent sentinel lymph node procedure with the combined technique (preoperative lymphoscintigraphy with technetium-99m–labeled nanocolloid and intraoperative blue dye). Radical excision of the primary tumor with uni- or bilateral inguinofemoral lymphadenectomy was performed subsequently. Sentinel lymph nodes and lymphadenectomy specimens were sent for histopathologic examination separately. Sentinel lymph nodes, negative at the time of routine pathologic examination, were re-examined with step sectioning and immunohistochemistry. RESULTS: In 59 patients, 107 inguinofemoral lymphadenectomies were performed (11 unilateral and 48 bilateral). All sentinel lymph nodes, as observed on preoperative lymphoscintigram, were identified successfully intraoperatively. Routine histopathologic examination showed lymph node metastases in 27 groins, all of which were detected by the sentinel lymph node procedure. The negative predictive value for a negative sentinel lymph node was 100% (97.5% confidence interval [CI], 95% to 100%). Step sectioning and immunohistochemistry showed four additional metastases in 102 sentinel lymph nodes (4%; 95% CI, 1% to 9%) that were negative at the time of routine histopathologic examination. CONCLUSION: Sentinel lymph node procedure with the combined technique is highly accurate in predicting the inguinofemoral lymph node status in patients with early-stage vulvar cancer. Future trials should focus on the safe clinical implementation of the sentinel lymph node procedure in these patients. Step sectioning and immunohistochemistry slightly increase the sensitivity of detecting metastases in sentinel lymph nodes and should be included in these trials.
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Maguire, Aoife, and Edi Brogi. "Sentinel Lymph Nodes for Breast Carcinoma: A Paradigm Shift." Archives of Pathology & Laboratory Medicine 140, no. 8 (2016): 791–98. http://dx.doi.org/10.5858/arpa.2015-0140-ra.

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Context.—Sentinel lymph node biopsy has been established as the new standard of care for axillary staging in most patients with invasive breast carcinoma. Historically, all patients with a positive sentinel lymph node biopsy result underwent axillary lymph node dissection. Recent trials show that axillary lymph node dissection can be safely omitted in women with clinically node negative, T1 or T2 invasive breast cancer treated with breast-conserving surgery and whole-breast radiotherapy. This change in practice also has implications on the pathologic examination and reporting of sentinel lymph nodes.Objective.—To review recent clinical and pathologic studies of sentinel lymph nodes and explore how these findings influence the pathologic evaluation of sentinel lymph nodes.Data Sources.—Sources were published articles from peer-reviewed journals in PubMed (US National Library of Medicine) and published guidelines from the American Joint Committee on Cancer, the Union for International Cancer Control, the American Society of Clinical Oncology, and the National Comprehensive Cancer Network.Conclusions.—The main goal of sentinel lymph node examination should be to detect all macrometastases (>2 mm). Grossly sectioning sentinel lymph nodes at 2-mm intervals and evaluation of one hematoxylin-eosin–stained section from each block is the preferred method of pathologic evaluation. Axillary lymph node dissection can be safely omitted in clinically node-negative patients with negative sentinel lymph nodes, as well as in a selected group of patients with limited sentinel lymph node involvement. The pathologic features of the primary carcinoma and its sentinel lymph node metastases contribute to estimate the extent of non–sentinel lymph node involvement. This information is important to decide on further axillary treatment.
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Dewar, D. J., B. Newell, M. A. Green, A. P. Topping, B. W. E. M. Powell, and M. G. Cook. "The Microanatomic Location of Metastatic Melanoma in Sentinel Lymph Nodes Predicts Nonsentinel Lymph Node Involvement." Journal of Clinical Oncology 22, no. 16 (2004): 3345–49. http://dx.doi.org/10.1200/jco.2004.12.177.

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Purpose Sentinel node biopsy is now widely accepted as the most accurate prognostic indicator in melanoma, and is important in guiding management of patients with clinical stage I or II disease. Patients with a positive sentinel node have conventionally undergone completion lymphadenectomy (CLND) of the involved basin, but only 20% have involvement beyond the sentinel node, suggesting that CLND may be unnecessary for the other 80% of patients. This study seeks to identify criteria that might be used to be more restrictive in selecting those who should undergo CLND. Methods A total of 146 patients were identified who had had a positive sentinel node biopsy for malignant melanoma. Their sentinel nodes and lymphadenectomy specimens were re-evaluated pathologically. The metastatic melanoma in each sentinel node was assessed according to its microanatomic location within the node (subcapsular, combined subcapsular and parenchymal, parenchymal, multifocal, or extensive), and this was correlated with the presence of involved nonsentinel nodes in the CLND. The depth of the metastases from the sentinel node capsule was also recorded. Results The metastatic deposits in the sentinel node were subcapsular in 26.0% of patients. None of these patients had any nonsentinel nodes involved on CLND. In the patients whose sentinel node metastases had a different microanatomic location, the rate of nonsentinel node involvement was 22.2% overall. Conclusion The microanatomic location of metastases within sentinel nodes predicts nonsentinel lymph node involvement. In patients with only subcapsular deposits in the sentinel node, it is possible that CLND could safely be avoided.
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Lin, Y. S., C. C. Tzeng, K. F. Huang, C. Y. Kang, C. C. Chia, and J. F. Hsieh. "Sentinel node detection with radiocolloid lymphatic mapping in early invasive cervical cancer." International Journal of Gynecologic Cancer 15, no. 2 (2005): 273–77. http://dx.doi.org/10.1136/ijgc-00009577-200503000-00014.

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We assessed the feasibility of sentinel lymph node detection using technicium-99 radiocolloid lymphatic mapping for predicting lymph node metastases in early invasive cervical cancer. Thirty patients with cervical cancer (stages IA2–IIA) underwent preoperative lymphoscintigraphy using technicium-99 intracervical injection and intraoperative lymphatic mapping with a handheld gamma probe. After dissection of the sentinel nodes, the standard procedure of pelvic lymph node dissection and radical hysterectomy was performed as usual. The sentinel node detection rate was 100% (30/30). There were seven (23.3%) cases of microscopic lymph node metastases on pathologic analysis. All of them had sentinel node involvement. Therefore, the sensitivity of sentinel node identification for prediction of lymph node metastases was 100%, and no false negative was found. Preoperative lymphoscintigraphy, coupled with intraoperative lymphatic mapping, located the sentinel nodes accurately in our study patients. This sentinel node detection method appears to be feasible for predicting lymph node metastases
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Chiu, Wan Kam, Shuk Tak Kwok, Yaokai Wang, Hiu Mei Luk, Aaron Hei Yin Chan, and Ka Yu Tse. "Applications and Safety of Sentinel Lymph Node Biopsy in Endometrial Cancer." Journal of Clinical Medicine 11, no. 21 (2022): 6462. http://dx.doi.org/10.3390/jcm11216462.

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Lymph node status is important in predicting the prognosis and guiding adjuvant treatment in endometrial cancer. However, previous studies showed that systematic lymphadenectomy conferred no therapeutic values in clinically early-stage endometrial cancer but might lead to substantial morbidity and impact on the quality of life of the patients. The sentinel lymph node is the first lymph node that tumor cells drain to, and sentinel lymph node biopsy has emerged as an acceptable alternative to full lymphadenectomy in both low-risk and high-risk endometrial cancer. Evidence has demonstrated a high detection rate, sensitivity and negative predictive value of sentinel lymph node biopsy. It can also reduce surgical morbidity and improve the detection of lymph node metastases compared with systematic lymphadenectomy. This review summarizes the current techniques of sentinel lymph node mapping, the applications and oncological outcomes of sentinel lymph node biopsy in low-risk and high-risk endometrial cancer, and the management of isolated tumor cells in sentinel lymph nodes. We also illustrate a revised sentinel lymph node biopsy algorithm and advocate to repeat the tracer injection and explore the presacral and paraaortic areas if sentinel lymph nodes are not found in the hemipelvis.
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Pargaonkar, Anjali S., Robert S. Beissner, Samuel Snyder, and V. O. Speights. "Evaluation of Immunohistochemistry and Multiple-Level Sectioning in Sentinel Lymph Nodes From Patients With Breast Cancer." Archives of Pathology & Laboratory Medicine 127, no. 6 (2003): 701–5. http://dx.doi.org/10.5858/2003-127-701-eoiams.

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Abstract Context.—Previous investigations on sentinel lymph node biopsies have demonstrated their importance in nodal staging of patients with breast cancer. However, sentinel node biopsy in breast cancer is currently a controversial procedure and continues to provoke debate. Objectives.—We designed our study to determine the usefulness of a standard protocol for evaluating sentinel lymph node metastases and to assess the value of sentinel node biopsy as the only procedure in nodal staging in breast cancer patients. Materials and Methods.—A retrospective analysis of 84 breast cancer patients with sentinel node biopsies, who also underwent axillary dissection, was conducted using a standard protocol (3 levels of immunohistochemical stains for keratin and 2 levels of hematoxylin-eosin (HE) stains on the first 3 negative lymph nodes). Results.—Hematoxylin-eosin staining identified 20 patients (23.8%) with sentinel node metastases. The remaining 64 negative patients (76.1%) were tumor free on sentinel lymph nodes at level 1 HE. Additional immunohistochemical stains for keratin and HE stains on specimens from these 64 patients showed an additional 5 patients (7.8%) to be positive for lymph node micrometastases (<2 mm). The total percentage of cases with sentinel lymph node metastases detected by HE staining and immunohistochemistry was 29.7%. Of the remaining 59 cases that were negative on HE and immunohistochemistry, axillary dissection revealed 3 cases that had metastases in the axillary lymph nodes. The false-negative rate was 10.7%. The concordance rate between sentinel lymph nodes and axillary lymph nodes was 96.4%. The sensitivity was 89% and specificity was 100%. Conclusion.—Immunohistochemistry and multiple-level sectioning increased detection of metastases by 7.8% in sentinel lymph nodes. Caution should be used in accepting sentinel node biopsy alone as the only procedure for staging due to a high false-negative rate (10.7%). A predictive value of 96.4% confirms that sentinel lymph node biopsy is most likely to contain metastatic carcinoma. Sentinel lymph node examination with the protocol we describe, combined with axillary dissection, increased the yield of metastatic disease by identifying 8 additional cases of nodal metastatic disease (an increase of 28%), as compared to standard axillary nodal dissection and single-section sentinel lymph node examination alone.
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Oliveira, Andrea Fernandes de, Ivan Dunshee de Abranches Oliveira Santos, Thaís Cardoso de Mello Tucunduva, et al. "Sentinel lymph node biopsy in cutaneous melanoma." Acta Cirurgica Brasileira 22, no. 5 (2007): 332–36. http://dx.doi.org/10.1590/s0102-86502007000500002.

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PURPOSE: To assess the importance of sentinel lymph node biopsy in patients with cutaneous melanoma. METHODS: Ninety consecutive non-randomized patients with stages I and II melanoma who underwent sentinel lymph node biopsy were followed up prospectively for six years. RESULTS: Patients were followed up for a mean period of 30 months. Their mean age was 53.3 years, ranging from 12 to 83 years. Thirty patients were male (37.5%) and 50, female (62.5%). Sentinel lymph node was positive in 32.5% and negative in 67.5%. It was found that the thicker the tumor, the greater the incidence of positive sentinel lymph nodes. In the group of patients with positive sentinel lymph nodes, recurrence occurred in 43.5%, but in those with negative sentinel lymph nodes, in only 7%, what points out to the association of tumor recurrence and positive sentinel lymph nodes. There were no major postoperative complications. CONCLUSION: Sentinel lymph node biopsy was demonstrated to be a safe method for selecting patients who need therapeutic lymphadenectomy.
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Togami, Shinichi, Takashi Ushiwaka, Mika Fukuda, et al. "Comparison of radio-isotope method with 99m technetium and near-infrared fluorescent imaging with indocyanine green for sentinel lymph node detection in endometrial cancer." Japanese Journal of Clinical Oncology 52, no. 1 (2021): 24–28. http://dx.doi.org/10.1093/jjco/hyab172.

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Abstract Background We aimed to compare the detection rate of pelvic sentinel lymph node between the radio-isotope with 99m technetium (99mTc)-labeled phytate and near-infrared fluorescent imaging with indocyanine green in patients with endometrial cancer. Methods This study included 122 patients who had undergone sentinel lymph node mapping using 99mTc and indocyanine green. In the radio-isotope method, sentinel lymph nodes were detected using uterine cervix 99mTc injections the day before surgery. Following injection, the number and locations of the sentinel lymph nodes were evaluated by lymphoscintigraphy. In addition, indocyanine green was injected into the cervix immediately before surgery. Results The overall pelvic sentinel lymph node detection rate (at least one pelvic sentinel lymph node detected) was not significantly different between 99mTc (95.9% [117/122]) and indocyanine green (94.3% [115/122]). Similarly, the bilateral sentinel lymph node detection rate was not significantly different between 99mTc (87.7% [107/122]) and indocyanine green (79.5% [97/122]). More than two sentinel lymph nodes per unilateral pelvic lymph node were found in 12.3% (15/122) and 27% (33/122) of cases with 99mTc and indocyanine green, respectively, in the right pelvic side, and 11.5% (14/122) and 32.8% (40/122) of cases with 99mTc and indocyanine green, respectively, in the left pelvic side. indocyanine green showed that there were significantly more than two sentinel lymph nodes in either the left or right pelvic sentinel lymph nodes (P < 0.0001). There was a significant difference in the mean number of total pelvic sentinel lymph nodes between 99mTc (2.2) and indocyanine green (2.5) (P = 0.028) methods. Conclusion Although indocyanine green is useful for sentinel lymph node identification, we believe it is better to use it in combination with 99mTc until the surgeon is accustomed to it.
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Dissertations / Theses on the topic "Sentinel lymph node"

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Richardson, Keith. "Sentinel lymph node biopsy for papillary thyroid cancer." Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=114194.

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Objective: To prospectively evaluate the role of sentinel lymph node (SLN) biopsy in the management of well differentiated thyroid carcinoma (WDTC)Methods: I designed and implemented a SLN biopsy protocol and subsequently performed it on consecutive patients undergoing thyroid surgery. Thyroid nodules were injected with methylene blue dye. A central compartment neck dissection (CCND) was performed. Frozen section analysis of the SLNs was performed.Results: 157 patients are included in this study. 94 patients had WDTC. Sevently three percent (69/94) of WDTC patients were found to have detectable SLNs. Twenty percent (14/69) of patients with SLNs were found to have central compartment metastases. The sensitivity, specificity, positive predictive value and negative predictive value of our SLN biopsy technique to remove all disease from the central compartment was 92.9%, 100%, 100% and 98.8% respectively (p < 0.0001). Conclusion: This data series suggests that if a patient has SLNs deemed as negative for malignancy on frozen section, the rest of the central compartment is unlikely to have lymph node metastasis.<br>Contexte: Notre objectif est d'évaluer prospectivement le rôle du biopsy ganglion sentinelle dans la gestion du cancer de la thyroïde bien différencié Méthodes: Nous avons conçu et mis en place un protocole de biopsie du ganglion sentinelle et par la suite effectuées notre protocol sur des patients consécutifs subissant une thyroïdectomie. Les nodules ont été injectés avec du bleu de méthylène. Un dissection du cou central a été effectuée. Examen intra-operatoire des ganglion a été réalisée.Résultats: 157 patients sont inclus dans cette étude. 94 patients avaient un dissection central du cou. 73% (69/94) des patients ont été trouvés à avoir ganglion détectable. 20% (14/69) des patients atteints de ganglion ont été trouvés à avoir des métastases compartiment central. La sensibilité, spécificité, valeur prédictive positive et valeur prédictive négative de notre technique de biopsie du ganglion sentinelle pour enlever toutes les maladies à partir du compartiment central était de 92,9%, 100%, 100% et 98,8% respectivement (p <0,0001).Conclusion: Cette série de données volumineux suggère que si un patient a jugé comme négatif intra-operatoire de malignité sur la section gelée, un dissection central peut être preventire.
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Peres, Gabriel. "Biópsia de linfonodo sentinela na recidiva locorregional do melanoma maligno revisão sistemática /." Botucatu, 2020. http://hdl.handle.net/11449/191662.

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Orientador: Antônio José Maria Cataneo<br>Resumo: Introdução: No melanoma primário, a aplicabilidade da biópsia de linfonodo sentinela (BLS), seguida ou não de esvazimento linfonodal (EL) é conhecida. Na recidiva locorregional (RL) de melanoma, alguns serviços tendem a indicá-la, buscando estadiamento mais acurado para embasar condutas individualizadas aos pacientes, ainda que as evidências sejam insuficientes. Objetivo: Avaliar o sucesso da BLS no encontro do linfonodo sentinela (LNS) e sua positividade na RL. Comparar a sobrevida entre os pacientes com LNS positivo e negativo. Verificar diferença na sobrevida pós EL. Métodos: Revisão sistemática, através das bases MEDLINE via PUBMED, LILACS, SCOPUS, EMBASE e CENTRAL, buscando estudos experimentais e observacionais sobre BLS na RL de melanoma. Desfechos avaliados: sucesso na BLS pelo encontro do LNS, positividade para melanoma no LNS; sobrevida no subgrupo LNS positivo comparado com o negativo; sobrevida livre de doença no subgrupo LNS positivo comparada com o negativo; sobrevida dos pacientes submetidos ao EL. Para metanálises, utilizaram-se RevMan 5.3 e StatsDirect 3.0.121. Resultados: Foram identificados 1872 estudos, destes, seis estudos observacionais foram incluídos, totalizando 449 pacientes. O LNS foi encontrado em 98% das BLS (IC 95-100%, I2=53,7% - seis estudos). LNS com 32% de positividade para melanoma (IC 19-47%, I2= 84,6% - seis estudos). A chance de sobrevida global em cinco anos foi 2,49 vezes maior no subgrupo com LNS negativo (IC 95% 1,41-4,38, I2=0% - qua... (Resumo completo, clicar acesso eletrônico abaixo)<br>Abstract: Background: In primary melanoma, the applicability of sentinel lymph node biopsy (SLB), followed or not by complete lymph node dissection (CLND) is known. In locoregional recurrence (LR) of melanoma, some groups may indicate it for more accurate staging to support individualized management, even with scarce evidence. Objective: To evaluate success in SLB and its positivity in LR. Compare survival between patients with positive and negative sentinel lymph node (SLN). Check for survival modification after CLND. Methods: Systematic review through databases such as MEDLINE via PUBMED, LILACS, SCOPUS, EMBASE and CENTRAL, searching for experimental and observational studies on SLB in melanoma LR. Outcomes assessed: success in SLB by finding the SLN, positivity for melanoma in the SLN; survival in the positive SLN subgroup compared to the negative one; disease-free survival in the positive versus negative SLN subgroup; survival of patients undergoing CLND. For meta-analyzes, RevMan 5.3 and StatsDirect 3.0.121 were used. Results: The total number of patients in six observational studies was 449, over 1872 studies indentified. The SNL was found in 98% of SLB (95-100% CI, I2 = 53.7%, 6 studies). SLB detected 32% positivity for melanoma on SNL (CI 19-47%, I2 = 84.6%, 6 studies). The chance of five year overall survival was 2,49 higher in the negative SNL subgroup (95% CI 1.41-4.38, I2 = 0%, 4 studies). Meta-analyzes were not performed due to lack of objective data for disease-free survi... (Complete abstract click electronic access below)<br>Doutor
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Wahed, Shajahan. "Minimally invasive sentinel lymph node biopsy in oesophageal adenocarcinoma." Thesis, University of Newcastle upon Tyne, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.720011.

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Introduction and Aims Sentinel lymph nodes are the first nodes draining a primary tumour and the most likely sites of early metastases. A minimally invasive technique of identifying sentinel nodes in oesophageal adenocarcinoma could revolutionise management by determining whether patients with submucosal disease can be treated solely by endoscopic resection and whether other patients are suitable for a less radical lymphadenectomy. We evaluated a laparoscopic technique of identifying abdominal sentinel lymph nodes in patients with oesophageal adenocarcinoma and assessed whether these nodes could predict overall lymph node status. Methods This trial recruited patients with lower-third oesophageal adenocarcinoma planned for two-stage oesophagectomy with two-field lymphadenectomy. Sentinel node identification occurred immediately before resection, following endoscopic submucosal injection of 99mTechnetium-nanocol!oid. A laparoscopic gamma probe measured radioactivity from all nodal stations at laparoscopy, from the open abdomen, from the mediastinum following thoracotomy and ex vivo following removal of the specimen. Sentinel nodes had in vivo radioactivity greater than twice and ex vivo greater than 10 times background. Specimens were examined using haematoxylin and eosin and immunohistochemistry. Results A total of 1297 lymph nodes were examined from 40 patients (median 31 nodes). The median age and BMI were 65.5years and 26.5kg/m2 re s pectively. The overall sentinel node detection rate was 85% and sensitivity 88%. The laparoscopic abdominal sentinel node detection rate was 58% (23/40). Lymph node metastases were identified in 13 of these 23 patients, in whom laparoscopic abdominal sentinel nodes were positive in 10 but negative in three (sensitivity 77%). Two of these negative patients had mediastinal sentinel node micrometastases. Eleven patients had only mediastinal sentinel nodes. Five patients had no sentinel nodes. Adhesions prevented laparoscopy in one patient. Conclusions Laparoscopic identification of abdominal sentinel lymph using 99mTechnetium in patients with oesophageal adenocarcinoma was safe and technically feasible but not sensitive enough to predict overall nodal status.
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Doting, Meintje Hylkje Edwina. "Sentinel lymph node biopsy in breast cancer and melanoma." [S.l. : [Groningen : s.n.] ; University Library Groningen] [Host], 2007. http://irs.ub.rug.nl/ppn/300326254.

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MANFREDI, MARTINA. "IMAGING THE SENTINEL LYMPH NODE IN SMALL ANIMAL ONCOLOGY." Doctoral thesis, Università degli Studi di Milano, 2021. http://hdl.handle.net/2434/829131.

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Sentinel lymph node (SLN) biopsy has become the cornerstone for tumor staging in patients affected by different solid tumors. To identify the first lymph node draining the tumor site, several mapping modalities have been investigated in human medicine and applied in veterinary oncology, either as experimental models or in clinical setting. In this dissertation, after an extensive literature review, we investigate the principal SLN imaging techniques, such as lymphoscintigraphy, which is considered the gold standard in human oncology, the use of blue dye and computed tomography (CT)-indirect lymphography for SLN mapping in canine patients with spontaneous malignant tumors. The feasibility of Single Proton Emission Computed Tomography (SPECT)/CT images fusion is described for the first time in clinical veterinary oncology. The results of these studies reinforce the paramount importance of SLN mapping incorporation in veterinary practice, supporting the use of combined techniques to increase the SLN detection rate.
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Korowlay, Nisaar Ahmed. "The use of lymphoscintigraphy to localise the sentinel lymph node." Master's thesis, University of Cape Town, 2005. http://hdl.handle.net/11427/2802.

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Includes bibliographical references (leaves 72-90).<br>Sentinel lymph node (SLN) biopsy is being used increasingly for staging early breast carcinoma in place of complete axillary lymph node dissection. The optimal method to identify the SLN and has not been clearly elucidated in the literature. A number of techniques have been proposed for identifying SLN/s. The main debate centres on whether to use a blue dye or radiopharmaceutical method either singly or in combination.
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Uren, Roger. "Lymphatic mapping of the skin and breast: locating the sentinel node." Thesis, University of Sydney, 1999. https://hdl.handle.net/2123/27546.

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Lymphoscintigraphy has been used for many years to study the physiology of the lymphatic drainage of the skin. Following the intradermal injection of 99mTc antimony sulphide colloid images can be obtained using a gamma camera which display the pattern of lymphatic drainage from the injection site. When we first started performing the lymphatic mapping studies for patients of the Sydney Melanoma Unit we were using the study to clarify flow patterns in patients who had melanomas in skin sites which were considered on clinical grounds to have ambiguous lymphatic drainage. These were sites close to the midline of the trunk where drainage could occur to either axilla or sites close to a line drawn around the waist at the level of the umbilicus when drainage might occur to the axilla or groin. Sites on the head and neck were also included as drainage could occur to several different node fields. These clinical judgements were made based on the teachings of Sappey, a French physicians who had produced an elaborate atlas of the lymphatic drainage of the skin late in the 19th century. The imaging in each patient involved standard protocols which has been determined many years previously. In appropriate patients when lymphoscintigraphy had designed the pattern of lymphatic drainage an elective dissection of the node field was performed as part of the treatment of the patients melanoma. Our practice changed dramatically following the description of the sentinel node concept by Morton and colleagues.
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Johnson, Laura. "Magnetic nanoparticles for sentinel lymph node imaging and biopsy in breast cancer." Thesis, King's College London (University of London), 2012. https://kclpure.kcl.ac.uk/portal/en/theses/magnetic-nanoparticles-for-sentinel-lymph-node-imaging-and-biopsy-in-breast-cancer(978692de-a495-4df1-ac0f-303227bed0dd).html.

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Background Axillary nodal status is the single most important prognostic factor in breast cancer diagnosis. If cancerous cells are present, the sentinel lymph node (SLN) is the axillary lymph node that is most likely to contain metastatic disease. In early stage breast cancer, the SLN is localised (then surgically removed for pathological analysis) using a radioisotope and/or a blue dye injected into the breast Super-paramagnetic iron oxide (SPIO) nanoparticles are novel agents that, when injected, could potentially both localise and characterise the SLN using MRI such that surgical SLN biopsy is no longer required. Aims To evaluate axillary SLN localisation after SPIO injection with, pre-operatively, axillary MRI and, intra-operatively, with a hand held magnetometer and to characterise SLN SPIO uptake using ex-vivo MRI. Methods From November 2009 - March 2011, 51 patients with early stage breast cancer underwent SLN biopsy following a subcutaneous injection of SPIO in addition to the standard injection of radioisotope (Tc99M) and blue dye. SPIO injection technique was refined during the trial with an initial dose of 2mls and then 4mls in 8 and then 43 women respectively. Pre-operative axillary in vivo MRI (1.5T) was carried out on 14 women and ex vivo high resolution MRI (9.4T) on 36 nodes. During surgery, an SLN was defined as either "hot", "blue", "palpable" or "SPIO detected". Axillary clearance was carried out for SLN-positive disease. Results In total, 11 of the 51 patients had positive SLNs. On pre-operative axillary MRI, SPIO uptake was noted in at least one node in all 14 patients. A total of 35 nodes were identified. Uptake of SPIO in the SLN was seen at a minimum of 12mins post injection. Involved SLNs were not differentiated from normal SLNs following morphological characterisation or based on loss of T2 signal within the individual SLN. At SLN biopsy, 134 hot, blue, palpable or SPIO-containing nodes were identified in 51 patients. The magnometer identified 92 SPIO-containing nodes in 51 (84%) patients. One node in one patient was not identified using the combined technique but was found to contain SPIO. Of the 16 hot, blue or palpable involved nodes in 11 patients, 9 contained SPIO. In summary, the SPIO SLN localisation rate and FNR in patients was 84% and 16% respectively. Ex vivo SLN MRI demonstrated SPIO uptake in all 35 SLNs preferential to the sinuses and sub-capsular spaces. Of the 3 involved nodes, areas of metastasis did not take up SPIO, whereas in normal areas of the node, SPIO was positively identified. Conclusion In our study, subcutaneous SPIO, a novel SLN-localising agent, was taken up by axillary nodes and identified on pre-operative axillary MRI. Node positive SLNs were identified on ex vivo MRI, but SPIO did not demonstrate sufficient accuracy at SLN localisation for routine clinical use.
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O'Sullivan, Jack Denis. "Imaging through a scanner, darkly : spectral imaging for sentinel lymph node biopsies." Thesis, University of Southampton, 2012. https://eprints.soton.ac.uk/339772/.

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Breast cancer is the single most prevalent form of cancer in the UK today, accounting for around 16% of all diagnoses, and around 31% of diagnoses in women. The survival rates are good, however the prognosis is heavily dependent on the stage to which the cancer has progressed at diagnosis. In order to help accurately determine this stage, the sentinel lymph node of patients undergoing tumour resection surgery is removed and examined cytologically for the presence of cancerous cells. This examination of the lymph node is currently the rate-limiting step in the operation as a whole. There is evidence in the literature to suggest that cancerous tissue has a measurably different infrared spectrum from healthy tissue owing to chemical and morphological differences in the tissue. There is further evidence to suggest that in the visible and near infrared region, the spectra of healthy lymph node tissue is different from that of cancerous tissue. This thesis details a project, performed in collaboration with a surgical team at St Mary's Hospital, Newport, Isle of Wight, to analyse spectral images taken in the visible and near infrared, of biopsied lymph node tissue. In the course of the project, an unsupervised classificaton technique, based on an extension to the well establised 'spectral angle', was developed to analyse the spectral images. Psoriasis affects 2-3% of the UK population causing itchy and/or painful plaques on the skin. One of the main treatments for psoriasis is UV phototherapy, exposure to which is a risk factor for burning and the development of cancers. This thesis details an investigation into the possibility of developing a targeted UV phototherapy system based on spectral imaging to delineate the plaques and a proposed new UV laser for treatment.
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Karlsson, Mona. "Sentinel node based immunotherapy of cancer /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-203-3/.

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Books on the topic "Sentinel lymph node"

1

S, Cody Hiram, ed. Sentinel lymph node biopsy. Martin Dunitz, 2002.

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Keshtgar, M. R. S. 1962- and Barneveld P. C, eds. The sentinel node in surgical oncology. Springer, 1999.

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International Symposium on "The Sentinel Lymph Node Concept in Oncology" (2000 : Berlin, Germany), ed. The sentinel lymph node concept in oncology: Facts and fiction. Zuckschwerdt, 2001.

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Leong, Stanley P. L. Atlas of Selective Sentinel Lymphadenectomy for Melanoma, Breast Cancer and Colon Cancer. Kluwer Academic Publishers, 2003.

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L, Leong Stanley P., ed. Atlas of selective sentinel lymphadenectomy for melanoma, breast cancer, and colon cancer. Kluwer Academic Publishers, 2002.

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L, Leong Stanley P., and Wong Jan H, eds. Sentinel lymph nodes in human solid cancer. W.B. Saunders, 2000.

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Branagan, Graham. Comparison between histological and molecular biological methods of detecting breast cancer metastases in sentinel and non-sentinel lymph nodes. University of Portsmouth, 2002.

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Harrison, Jones undifferentiated, Barry M. Kinzbrunner, et al. Sentinel Lymph Node Biopsy. Informa Healthcare, 2001.

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Cody, Hiram S. Sentinel Lymph Node Biopsy. Taylor & Francis Group, 2003.

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Hiram, Cody. Sentinel Lymph Node Biopsy. Taylor & Francis Group, 2001.

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Book chapters on the topic "Sentinel lymph node"

1

Jensen, Lindsay G., Loren K. Mell, Christin A. Knowlton, et al. "Sentinel Lymph Node." In Encyclopedia of Radiation Oncology. Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-540-85516-3_535.

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Nieweg, Omgo E. "Sentinel Lymph Node." In Encyclopedia of Cancer. Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-642-27841-9_5242-4.

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Persichetti, Paolo, Stefania Tenna, Beniamino Brunetti, and Stefano Campa. "Sentinel Lymph Node." In Skin Cancer. Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4614-7357-2_32.

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Clark, Jonathan R., and Douglas Shaw. "Sentinel Lymph Node." In Encyclopedia of Otolaryngology, Head and Neck Surgery. Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-642-23499-6_200158.

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Nieweg, Omgo E. "Sentinel Lymph Node." In Encyclopedia of Cancer. Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-662-46875-3_5242.

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van der Ploeg, Iris M. C., Bin B. R. Kroon, Omgo E. Nieweg, and Maartje C. van Rijk. "Sentinel Lymph Node." In Encyclopedia of Cancer. Springer Berlin Heidelberg, 2011. http://dx.doi.org/10.1007/978-3-642-16483-5_5242.

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Weldon, Christopher. "Sentinel Lymph Node Biopsy." In Pediatric Head and Neck Tumors. Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4614-8755-5_6.

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Perrins, Steven, Savannah Moon, and Cassann Blake. "Sentinel Lymph Node Biopsy." In Mental Conditioning to Perform Common Operations in General Surgery Training. Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-319-91164-9_7.

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Takada, Masahiro, and Masakazu Toi. "Sentinel Lymph Node Mapping." In Video Atlas of Intraoperative Applications of Near Infrared Fluorescence Imaging. Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-38092-2_25.

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Frumovitz, Michael, Robert L. Coleman, and Charles M. Levenback. "Sentinel lymph node biopsy." In An Atlas of Gynecologic Oncology. CRC Press, 2018. http://dx.doi.org/10.1201/9781351141680-18.

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Conference papers on the topic "Sentinel lymph node"

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Rosenscheg, Marceen, Leonardo Dequech Gavarrete, and Adriane Lenhard Vidal. "USE OF NEOADJUVANT CHEMOTHERAPY AND DISSECTION OF THE POSITIVE SENTINEL LYMPH NODES IN THE TREATMENT OF BREAST CANCER ONLY ON STAGES T1 TO T2." In XXIV Congresso Brasileiro de Mastologia. Mastology, 2022. http://dx.doi.org/10.29289/259453942022v32s1082.

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Objective: Breast cancer is the most common cancer that occurs in women. Its treatment is based on mastectomy, which can be radical or quadrantectomy. Surgery is performed with axillary lymph node dissection (ALND) or sentinel lymph node dissection (SLND), in addition to the prior or subsequent use of radiotherapy and chemotherapy. This article aims, in this sense, to evaluate the displacement of surgery with positive sentinel in patients undergoing neoadjuvant chemotherapy (NAC) and radiotherapy compared to standard treatment of ALND in positive or expectant sentinel in patients with negative lymph nodes associated with NAC. Methods: This is a retrospective study based on an analysis of medical records from the Hospital São Vicente de Paulo (HSVP) in Guarapuava, PR, from 2011 to 2020. Patients are selected for breast cancer at an early stage, with maximum stage IIIA, quadrantectomy, NAC, and lymph node sentinel biopsy based on the patent blue application being the inclusion criteria for all groups. Results: The results showed recurrence in two patients in the control group (7%) and in one patient in the study group (17%), which resulted in posterior death. Conclusion: Standard breast cancer patients, who are in intermediate stage, post menopause and positive lymph node in biopsy, had a better treatment response when compared with other patients. Furthermore, in this study, young patients had a worse response than the others. However, more studies with diversification and longer follow-up time are needed to have more solid conclusions.
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Jaishuen, Atthapon, Pisutt Srichaikul, and Khemanat Khemworapong. "Sentinel lymph node mapping in endometrial cancer." In The 7th Biennial Meeting of Asian Society of Gynecologic Oncology. Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology; Japan Society of Gynecologic Oncology, 2021. http://dx.doi.org/10.3802/jgo.2021.32.s1.e30.

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Andrade, Danúbia Ariana de, Filomena Marino Carvalho, Fernando Nalesso Aguiar, Alfredo Luiz Jacomo, and Alfredo Carlos Simões Dornellas de Barros. "SIZE OF METASTATIC INFILTRATION IN THE SENTINEL NODE AS A PREDICTOR OF NON‑SENTINEL NODES INVOLVEMENT." In Scientifc papers of XXIII Brazilian Breast Congress - 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s1065.

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Introduction: The broad acceptance of sentinel lymph node biopsy (SLNB) led to an analysis for finding out the anatomopathological characteristics that can help predict the involvement of other axillary lymph nodes (LN) in positive sentinel lymph node (SLN) cases. Currently, it is very appropriate to investigate the cases that enable the omission of complete axillary dissection (CAD), even considering the involvement of the SLN. Some important studies on this theme were published, e.g., ACOSOG Z0011, and AMAROS. However, their results were not accepted uniformly enough because of methodological inconsistencies. Objectives: We aimed at providing a complementary basis for a pragmatic analysis of CAD after a positive SLNB in breast cancer. Methods: This is a cross-sectional study. Clinical and anatomopathological data were collected in patients with early-infiltrating breast cancer that were treated with SLNB, followed by CAD. Statistical analyses were performed using binary logistic regression and multiple logistic regression. Results: Out of 129 patients evaluated, compromise of non-sentinel additional lymph nodes was observed in 47 (36.4%) patients. According to an univariate analysis, the parameters related to non-SLN compromise were the tumor size in anatomopathological exam, histological grade III, the presence of peritumoral vascular embolism in focal area, compromise of more than one SLN, LN compromise rate of 100%, the presence of extracapsular neoplastic extension, perilymphnodal vascular involvement, perilymphatic fat compromise, and twenty or more dissected non-SNLs. The variables that increased the chance of compromise of non-SNL in the multivariate analysis were presented in following table with an accuracy of 81% (Figure). Conclusions: The tumor size on a clinical examination of the T2 category, the presence of two or more neoplastic foci in the SNL, and the size of the metastasis &gt; 4.0 mm are the parameters that favor complete axillary lymphadenectomy.
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Reitsamer, R., S. Glueck, C. Menzel, and F. Peintinger. "Non-Sentinel Lymph Node Status of Patients with T1/T2 Breast Cancer and Micrometastasis in the Sentinel Lymph Node." In Abstracts: Thirty-Second Annual CTRC‐AACR San Antonio Breast Cancer Symposium‐‐ Dec 10‐13, 2009; San Antonio, TX. American Association for Cancer Research, 2009. http://dx.doi.org/10.1158/0008-5472.sabcs-09-1034.

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Irakleidis, Foivos, Ashutosh Tondare, Hisham Hamed, and Ashutosh Kothari. "MANAGEMENT OF THE AXILLA IN PATIENTS WITH BREAST CANCER AND ONE OUT OF ONE POSITIVE SENTINEL LYMPH NODE. CAN WE OMIT AXILLARY LYMPH NODE CLEARANCE?" In Abstracts from the Brazilian Breast Cancer Symposium - BBCS 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s2063.

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Background: Over the past three decades, the treatment of the axilla in breast cancer management continues to change. Current treatment strategies aim to achieve regional nodal control associated with reduced incidence of lymphedema and other long-term complications. In this study, we analyzed our tertiary center’s database of patients who had a single retrieved sentinel node (SN) that was positive for macrometastatic disease. We focused on AMAROS trial outcomes and the future view of treating this cohort of patients with axillary radiotherapy (RT) instead of axillary node clearance (ANC). Methods: Both the literature review and the 5-year retrospective analysis of our database were performed, focusing on the management of the axilla in patients with breast cancer with one-in-one positive SN. Results: A total of 24 patients who had surgery as primary treatment had one-in-one positive SN. All patients had the clinical and radiological assessment of their axilla prior to their sentinel lymph node biopsy (SNB). In all, 92% of these patients had a complete ANC, 50% of them had zero additional positive nodes, 21% had only one additional positive node, and a further 21% had more than one additional positive node. One patient was planned for ANC but died from chemotherapy-related complications and one more patient had alternative axillary RT instead of ANC. Of note, 80% of patients who had three or more positive axillary lymph nodes following ANC had indeed evidence of advanced locoregional disease and thus would not be eligible for alternative axillary RT, as compared with one patient who had a multifocal disease, could have axillary RT but had a heavy axillary burden on ANC. Finally, 71% of patients could have been offered alternative axillary RT but had ANC instead. Fourteen patients from this group had chest wall and supraclavicular fossa RT after their initial surgery, and thus, the addition of axillary RT instead of ANC could have been offered. Conclusion: In patients with early breast cancer and clinically node-negative axilla, disease burden in non-SN is limited and ANC may entail overtreatment. In view of low recurrence and complication rates seen in the AMAROS trial, axillary irradiation appears to be a valid and safe alternative when compared with ANC in patients with one-in-one positive SN.
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Huang, J., X. Chen, K. Shen, et al. "Abstract P3-01-13: Risk factors of non-sentinel lymph node metastasis in breast cancer patients with metastatic sentinel lymph node." In Abstracts: Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium; December 8-12, 2015; San Antonio, TX. American Association for Cancer Research, 2016. http://dx.doi.org/10.1158/1538-7445.sabcs15-p3-01-13.

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Liu, Yang, Adam Q. Bauer, Walter Akers, et al. "Compact intraoperative imaging device for sentinel lymph node mapping." In SPIE BiOS, edited by Samuel Achilefu and Ramesh Raghavachari. SPIE, 2011. http://dx.doi.org/10.1117/12.886226.

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Waanders, S., M. Ahmed, B. Anninga, et al. "SPIO requirements for in vivo sentinel lymph node localization." In 2015 5th International Workshop on Magnetic Particle Imaging (IWMPI). IEEE, 2015. http://dx.doi.org/10.1109/iwmpi.2015.7107000.

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Gur, SA, B. Unal, R. Johnson, G. Ahrendt, M. Bonaventura, and A. Soran. "The predictive probability of four different breast cancer nomograms for non-sentinel axillary lymph node metastasis in positive sentinel lymph node biopsy." In CTRC-AACR San Antonio Breast Cancer Symposium: 2008 Abstracts. American Association for Cancer Research, 2009. http://dx.doi.org/10.1158/0008-5472.sabcs-204.

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Tanaka, S., N. Sato, H. Fujioka, Y. Takahashi, K. Kimura, and M. Iwamoto. "P3-07-35: Validation of Online Calculators To Predict Non-Sentinel Lymph Node Status in Sentinel Lymph Node-Positive Breast Cancer Patients." In Abstracts: Thirty-Fourth Annual CTRC‐AACR San Antonio Breast Cancer Symposium‐‐ Dec 6‐10, 2011; San Antonio, TX. American Association for Cancer Research, 2011. http://dx.doi.org/10.1158/0008-5472.sabcs11-p3-07-35.

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Reports on the topic "Sentinel lymph node"

1

Sutton, Richard. Sentinel Lymph Node Biopsy. Touch Surgery Simulations, 2014. http://dx.doi.org/10.18556/touchsurgery/2014.s0033.

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Goodwin, Andrew P. Multifunctional Polymer Microbubbles for Advanced Sentinel Lymph Node Imaging and Mapping. Defense Technical Information Center, 2012. http://dx.doi.org/10.21236/ada583372.

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Goodwin, Andrew P. Multifunctional Polymer Microbubbles for Advanced Sentinel Lymph Node Imaging and Mapping. Defense Technical Information Center, 2012. http://dx.doi.org/10.21236/ada591061.

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Hassett, Mary. Outcomes by Ethnicity: Sentinel Lymph Node Status in Women with Breast Cancer. Defense Technical Information Center, 2007. http://dx.doi.org/10.21236/ada495304.

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Cavalli, Luciane R. Detection of Genetic Alterations in Breast Sentinel Lymph Node by Array-CGH. Defense Technical Information Center, 2005. http://dx.doi.org/10.21236/ada444833.

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Cavalli, Luciane R. Detection of Genetic Alterations in Breast Sentinel Lymph Node by Array-CGH. Defense Technical Information Center, 2006. http://dx.doi.org/10.21236/ada460808.

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Wang, Shi-Yi, Peiyin Hung, Brigid Killelea, et al. Comparing Treatment for Ductal Carcinoma In Situ (DCIS) With or Without Sentinel Lymph Node Biopsy. Patient-Centered Outcomes Research Institute® (PCORI), 2020. http://dx.doi.org/10.25302/06.2020.cer.150731630.

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Wen, Zhenhua. Efficacy of sentinel lymph node biopsy versus standard axillary care for operable breast cancer: a systematic-review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, 2022. http://dx.doi.org/10.37766/inplasy2022.8.0032.

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Liu, Hongjin, Mingshuai Sun, Liyuan Liu, et al. The Using of Methylene Blue Dye combined with Other Tracer in Sentinel Lymph Node Biopsy of Early Breast Cancer: A Meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, 2021. http://dx.doi.org/10.37766/inplasy2021.5.0107.

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Cao, Siyang, Xia Liu, Zijian Yang, et al. Feasibility of sentinel lymph node biopsy in breast cancer patients with positive axillary nodes at initial diagnosis after neoadjuvant chemotherapy: An updated meta-analysis involving 3,450 patients. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, 2020. http://dx.doi.org/10.37766/inplasy2020.11.0019.

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