 |
|
Validation of Subareolar and Periareolar Injection Techniques for Breast Sentinel Lymph Node Biopsy
Anees Chagpar, MD, MSc;
Robert C. Martin III, MD;
Celia Chao, MD;
Sandra L. Wong, MD;
Michael J. Edwards, MD;
Todd Tuttle, MD;
Kelly M. McMasters, MD, PhD; for the University of Louisville Breast Cancer Sentinel Lymph Node Study Group
Arch Surg. 2004;139:614-620.
Hypothesis Subareolar or periareolar injection of radioactive technetium sulfur colloid is equivalent to other injection techniques for breast cancer sentinel lymph node (SLN) biopsy.
Design and Setting Prospective, multicenter clinical trial.
Patients A total of 3961 individuals with clinical stage I and II breast cancer.
Interventions All patients underwent attempted SLN biopsy followed by completion axillary dissection. Injection technique was determined by the preference of each participating surgeon. Most surgeons had little or no experience with SLN biopsy before participation in this study.
Main Outcome Measures The SLN identification and false-negative rates.
Results An SLN biopsy was performed in 3961 patients using blue dye alone or radioactive colloid plus blue dye. Subareolar and periareolar radioactive colloid injection techniques were associated with SLN identification rates of 99.3% and 95.6%, respectively, with false-negative rates of 8.3% and 8.9%, respectively. The identification rates were significantly higher for these 2 techniques than for peritumoral injection of radioactive colloid (91.1%) or the use of blue dye alone (88.5%) (P<.001). The false-negative rates were similar for all techniques.
Conclusions Although many medical centers have adopted subareolar and periareolar radioactive colloid injections because of their simplicity and convenience, a paucity of data from a few single-institutional studies has existed to substantiate the false-negative rates associated with these techniques. The results of this multicenter study establish the validity of subareolar and periareolar radioactive colloid injections and support the hypothesis that the lymphatic drainage of the entire breast is to the same few SLNs.
From the Department of Surgery, Division of Surgical Oncology, University of Louisville, Louisville, Ky (Drs Chagpar, Martin, and McMasters); Department of Surgery, The University of Texas at Galveston (Dr Chao); Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (Dr Wong); Department of Surgery, University of Arkansas, Little Rock (Dr Edwards); and Department of Surgery, University of Minnesota, Minneapolis (Dr Tuttle). A complete list of the members of the University of Louisville Breast Cancer Sentinel Lymph Node Study Group was published previously (Am J Surg. 2002;184:498).
RELATED ARTICLE
This Month in Archives of Surgery
Arch Surg. 2004;139(6):583.
FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Detection of the sentinel lymph node in breast cancer
Somasundaram et al.
Br Med Bull 2008;0:ldm032v1-15.
ABSTRACT
| FULL TEXT
Prospective Multicentric Randomized Study Comparing Periareolar and Peritumoral Injection of Radiotracer and Blue Dye for the Detection of Sentinel Lymph Node in Breast Sparing Procedures: FRANSENODE Trial
Rodier et al.
JCO 2007;25:3664-3669.
ABSTRACT
| FULL TEXT
Reliability of Lymphatic Mapping After Wide Local Excision of Cutaneous Melanoma
Ariyan et al.
Ann. Surg. Oncol. 2007;14:2377-2383.
ABSTRACT
| FULL TEXT
Pro: SLNB in DCIS
Fuhrman
Ann. Surg. Oncol. 2007;14:1005-1006.
FULL TEXT
A Further Validation of Subareolar Injection Technique for Breast Sentinel Lymph Node Biopsy
D'Eredita et al.
Ann. Surg. Oncol. 2006;13:701-707.
ABSTRACT
| FULL TEXT
The Impact of Nonvisualization of Sentinel Nodes on Lymphoscintigraphy in Breast Cancer
Rousseau et al.
Ann. Surg. Oncol. 2005;12:533-538.
ABSTRACT
| FULL TEXT
|
