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Sentinel Node Biopsy Detects Spread of Breast Cancer

By HospiMedica staff writers
Posted on 15 Jul 2002
A large study has confirmed that sentinel lymph node (SLN) biopsy can detect the spread of breast cancer significantly better than the standard approach of axillary lymph node dissection. More...
The study was presented at the annual meeting of the Society of Nuclear Medicine in Los Angeles (SNM, CA, USA).

Working with data from 814 breast cancer patients, researchers compared the SLN detection rate using several methods, including scintigraphy. They found that the highest detection rate (89.6%) of SLN was achieved by using a combined localization with blue dye and scintigraphy. The overall sensitivity in detecting lymph node metastases was 91.3%. The study was conducted by researchers at University Hospital (Ulm, Germany).

SLN scintigraphy uses a nuclear medicine imaging technique and an injected radiotracer to identify the first lymph node into which a tumor drains and the first place to which cancer cells are most likely to spread. After the SLN has been identified, only one or a few nodes are removed for laboratory analysis. If negative, no further invasive procedures are necessary. If positive, scintigraphy has already identified the local extent of the disease, and treatment can begin. This technique is appropriate for women with unifocal breast cancers less than 3 cm, who have negative clinical exams by palpation and ultrasound of the axilla, and who have not had previous surgery, since the detection rate is lower in patients who have had lumpectomies.

The standard approach, in contrast, is axillary lymph node dissection, a surgical procedure that carries a risk of lymphedema, loss of sensation, and general disruption of the lymphatic structures and nerves. Moreover, 70% of tumors less than 3 cm in diameter are found to be negative, showing the cancer has not spread.




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