@article{7c6752306c41423db90ff687105156b2,
title = "Ultrasonographically guided injection improves localization of the radiolabeled sentinel lymph node in breast cancer",
abstract = "Background: Several reports have demonstrated the accurate prediction of axillary nodal status (ANS) with radiolocalization and selective resection of sentinel lymph nodes (SLN) in breast cancer. To date, no technique has proven to be superior in localizing the SLN. Methods: 1.0 mCi of clear unfiltered 99mtechnetium sulfur colloid was injected under ultrasonographic (US) guidance around the perimeter of the breast lesion (palpable and nonpalpable) or previous biopsy site. Resection of the radiolocalized nodes was performed, followed by complete axiliary lymph node dissection (AXLND). Results: Forty- two breast cancer patients underwent SLN biopsy after US-guided radiopharmaceutical injection. The SLN was localized in 41 patients (98%). The type of previously performed diagnostic biopsy did not influence the ability to localize the sentinel lymph node. Pathology revealed nodal metastasis in 7 of the 41 evaluable patients (17%). ANS was accurately predicted in 40 of 41 patients (98%). Conclusions: Early experience with radiolocalization and selective resection of SLN in breast cancer remains promising. Use of US-guided injection facilitates localization of the SLN, perhaps as a result of more accurate placement of the radionuclide marker. Use of this technique allowed for effective management of patients regardless of tumor size or the extent of prior biopsy, thereby expanding the potential number of eligible patients for SLN biopsy.",
keywords = "Breast cancer, Gamma probe, Lymph node, Technetium, Ultrasound",
author = "Miner, {Thomas J.} and Shriver, {Craig D.} and Jaques, {David P.} and Maniscalco-Theberge, {Mary E.} and Krag, {David N.}",
note = "Funding Information: Received October 14, 1997; accepted January 22, 1998. From the General Surgery Service, Walter Reed Army Medical Center, Washington, DC (TJM, CDS, DPJ, MEM-T), and The Vermont Cancer Center, Burlington, Vermont (DNK). The opinions and assertions herein are the private ones of the authors and are not to be construed as official policy or reflecting the views of the Department of Defense. Support for this work provided by the National Cancer Institute (grant U01 CA65121 --02). Address correspondence and reprint requests to: Craig D. Shriver, MD, Dept. of Surgery, Walter Reed Army Medical Center, Washington, DC 20307. Funding Information: All nonpregnant patients with biopsy-proven breast cancer were identified and offered entry into a study for the radiolocalization and resection of the sentinel lymph node approved by the institutional review board at the Walter Reed Army Medical Center in Washington, DC. The clinical protocol was sponsored by the National Cancer Institute through the University of Vermont. Each participant gave informed consent. Patients with multicentric breast cancer or noninvasive breast cancer were excluded from the study. No patient was excluded based on the type of biopsy that had been previously performed or whether the patient had a palpable lesion at the time of the procedure. The first five patients enrolled in the study were designed in the protocol to be learning cases and not to be included in the final data analysis.",
year = "1998",
month = jun,
doi = "10.1007/BF02303494",
language = "English",
volume = "5",
pages = "315--321",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
number = "4",
}