Journal ArticleDOI
Lymphatic mapping and sentinel node biopsy in the patient with breast cancer
J. Albertini,Gary H. Lyman,Charles E. Cox,Tim Yeatman,Ludovico Balducci,N. N. K. Ku,Steve Shivers,Claudia Berman,Wells Ke,Rapaport D,Alan R. Shons,John R. Horton,Harvey Greenberg,Santo V. Nicosia,Robert A. Clark,Alan B. Cantor,Douglas S. Reintgen +16 more
TLDR
This study confirms that lymphatic mapping is technically possible in the patient with breast cancer and that the Histologic characteristics of the SLN probably reflect the histologic characteristicsof the rest of the axillary lymph nodes.Abstract:
Objective. —To identify the sentinel lymph node(s) (SLN[s]) (the first node[s] draining the primary tumor in the regional lymphatic basin) in patients with invasive breast cancer and to test the hypothesis that the histologic characteristics of the SLN predict the histologic characteristics of the remaining lymph nodes in the axilla. Design. —A prospective trial. Participants. —Sixty-two patients with newly diagnosed invasive breast cancers. Intervention. —Patients underwent intraoperative lymphatic mapping using a combination of a vital blue dye and filtered technetium-labeled sulfur colloid. The SLN was identified and removed, followed by a definitive cancer operation, including a complete axillary node dissection. Main Outcome Measure. —The metastatic distribution in the axilla was determined in patients with occult nodal disease. Results. —The SLN was successfully identified in 57 (92%) of 62 patients using the 2 lymphatic mapping procedures. After localization, 18 patients (32%) were found to have metastatic disease, and the SLN tested positive in all 18 patients. There were no "skip" metastases, defined as an SLN that tested negative with higher nodes that tested positive. In 12 (67%) of 18 patients with metastatic disease, the SLN was the only site of disease. The metastatic distribution significantly favored SLN involvement. Among subjects with discordant nodal involvement, the probability of observing the distribution of SLN involvement by chance is very small (P Conclusions. —This study confirms that lymphatic mapping is technically possible in the patient with breast cancer and that the histologic characteristics of the SLN probably reflect the histologic characteristics of the rest of the axillary lymph nodes. The procedure also allows the pathologist to focus the histologic examination on 1 or 2 nodes, potentially increasing the yield of positive dissections and the accuracy of staging.read more
Citations
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Journal ArticleDOI
Pathological prognostic factors in breast cancer.
Journal ArticleDOI
A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer.
Umberto Veronesi,Giovanni Paganelli,Giuseppe Viale,Alberto Luini,Stefano Zurrida,Viviana Galimberti,Mattia Intra,Paolo Veronesi,Chris Robertson,Patrick Maisonneuve,Giuseppe Renne,Concetta De Cicco,Francesca De Lucia,R. Gennari +13 more
TL;DR: Sentinel-node biopsy is a safe and accurate method of screening the axillary nodes for metastasis in women with a small breast cancer.
Journal ArticleDOI
Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes.
Umberto Veronesi,Giovanni Paganelli,Viviana Galimberti,Giuseppe Viale,Stefano Zurrida,Marilia Bedoni,Alberto Costa,Concetta De Cicco,James Geraghty,Alberto Luini,Virgilio Sacchini,Paolo Veronesi +11 more
TL;DR: Patients without clinical involvement of the axilla should undergo sentinel-node biopsy routinely, and may be spared complete axillary dissection when the sentinel node is disease-free, and thereby provide important information about the status of axillary nodes.
A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer
Umberto Veronesi,Giovanni Paganelli,Giuseppe Viale,Alberto Luini,S. Zurrida,Viviana Galimberti,Mattia Intra,Paolo Veronesi,Chris Robertson,Patrick Maisonneuve,Giuseppe Renne,C. De Cicco,F. De Lucia,R. Gennari +13 more
Journal ArticleDOI
American Society of Clinical Oncology Guideline Recommendations for Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer
Gary H. Lyman,Armando E. Giuliano,Mark R. Somerfield,Al B. Benson,Diane C. Bodurka,Harold J. Burstein,Alistair J. Cochran,Hiram S. Cody,Stephen B. Edge,Sharon Galper,James A. Hayman,Theodore Y. Kim,Cheryl L. Perkins,Donald A. Podoloff,Visa Haran Sivasubramaniam,Roderick R. Turner,Richard L. Wahl,Donald L. Weaver,Antonio C. Wolff,Eric P. Winer +19 more
TL;DR: A review of the available evidence demonstrates that, when performed by experienced clinicians, SNB appears to be a safe and acceptably accurate method for identifying early-stage breast cancer without involvement of the axillary lymph nodes.
References
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Book
Nonparametric Statistical Methods
Myles Hollander,Douglas A. Wolfe +1 more
TL;DR: An ideal text for an upper-level undergraduate or first-year graduate course, Nonparametric Statistical Methods, Second Edition is also an invaluable source for professionals who want to keep abreast of the latest developments within this dynamic branch of modern statistics.
Journal ArticleDOI
Technical details of intraoperative lymphatic mapping for early stage melanoma.
Donald L. Morton,D. R. Wen,Jan H. Wong,James S. Economou,Leslie A. Cagle,F K Storm,Leland J. Foshag,Alistair J. Cochran +7 more
TL;DR: Patients with early stage melanoma who have nodal metastases and are likely to benefit from radical lymphadenectomy are identified, with a high degree of accuracy, by a new procedure developed using vital dyes.
Journal ArticleDOI
Lymphatic Mapping and Sentinel Lymphadenectomy for Breast Cancer
TL;DR: The authors report the feasibility and accuracy of intraoperative lymphatic mapping with sentinel lymphadenectomy in patients with breast cancer.
Journal ArticleDOI
Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe
TL;DR: A pilot study of breast cancer patients concludes that radiolocalization and selective resection of sentinel lymph nodes is possible; and the sent Sentinel lymph node appears to predict correctly the status of the remaining axilla.
Journal ArticleDOI
The orderly progression of melanoma nodal metastases.
Douglas S. Reintgen,Cruse Cw,Wells Ke,Claudia Berman,Neil A. Fenske,Frank Glass,Schroer Kr,Richard Heller,Merrick I. Ross,Gary H. Lyman,Charles E. Cox,David P. Rappaport,Hilliard F. Seigler,Charles M. Balch +13 more
TL;DR: The null hypothesis tested was whether nodal metastases from malignant melanoma occurred in equal proportions among sentinel and nonsentinel nodes, and the probability that all seven unpaired observations would demonstrate that involvement of the sentinel node is 0.008.