Identificazione del linfonodo sentinella in pazienti con carcinoma mammario

Translated title of the contribution: Sentinel lymph node identification in breast cancer patients

Rosa Fonti, Gennaro Limite, Antonio Sodano, Albina Riccardi, Pietro Forestieri, Giuliana De Cristofaro, Guido Pettinato, Marco Salvatore

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose. To evaluate the predictive value of sentinel lymph node biopsy versus axillary node dissection on lymph node status in patients with T1-T2 breast cancer. Material and methods. Twentynine patients with T1 and 12 with T2 breast carcinoma and clinically NO axillary lymph nodes, underwent lymphoscintigraphy following the administration of 99mTc-human albumin nanocolloids. The tracer was injected subdermally, over the tumor mass, in the 34 patients with palpable lesions and peritumorally (n=3) or intratumorally (n=4), under stereotactic or ultrasound guidance, in the 7 patients with non-palpable lesions. Anterior and lateral planar images were acquired 15 min after the injection of the tracer and repeated every 30 min up to 3 hr until identification of sentinel lymph node. At the end of the scintigraphic study, sentinel node skin projection was marked using a demographic pen. Eighteen hours after lymphoscintigraphy, sentinel lymph node was identified and removed during surgery by hand-held gamma probe, then, the remaining axillary lymph nodes were dissected. All surgical specimens underwent histologic examination. Sentinel lymph nodes free of metastasis at histology, underwent additional examination with immunohistochemistry using monoclonal antibodies against cytokeratin and EMA to search for micrometastases. Results. Sentinel lymph node was identified in the 34 patients injected subdermally and in the 3 patients injected peritumorally, while it remained undetected in the 4 patients injected intratumorally except for one case in which it was isolated by radioguided surgery but not scintigraphically. Sentinel nodes resulted free of metastases both at histology and immunohistochemistry in 32 cases and metastatic in 6. In the 32 patients with non-metastatic sentinel lymph nodes the other axillary nodes were also free of metastases. Among the 6 metastatic sentinel lymph nodes, in 3 cases they were the only metastatic nodes of the axilla while in the other 3 cases metastases were spread to other axillary nodes. Conclusions. In agreement with previous studies, our results showed that sentinel lymph node radioguided biopsy is a simple and reliable method for predicting axillary lymph nodes status and for avoiding axillary dissection in early breast cancer patients with sentinel node free of metastases.

Original languageItalian
Pages (from-to)370-377
Number of pages8
JournalRadiologia Medica
Volume103
Issue number4
Publication statusPublished - Apr 2002

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Breast Neoplasms
Neoplasm Metastasis
Lymphoscintigraphy
Sentinel Lymph Node Biopsy
Lymph Nodes
Lymph Node Excision
Histology
Immunohistochemistry
Sentinel Lymph Node
Neoplasm Micrometastasis
Axilla
Keratins
Dissection
Albumins
Hand
Monoclonal Antibodies
Demography
Skin
Injections
cyhalothrin

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Fonti, R., Limite, G., Sodano, A., Riccardi, A., Forestieri, P., De Cristofaro, G., ... Salvatore, M. (2002). Identificazione del linfonodo sentinella in pazienti con carcinoma mammario. Radiologia Medica, 103(4), 370-377.

Identificazione del linfonodo sentinella in pazienti con carcinoma mammario. / Fonti, Rosa; Limite, Gennaro; Sodano, Antonio; Riccardi, Albina; Forestieri, Pietro; De Cristofaro, Giuliana; Pettinato, Guido; Salvatore, Marco.

In: Radiologia Medica, Vol. 103, No. 4, 04.2002, p. 370-377.

Research output: Contribution to journalArticle

Fonti, R, Limite, G, Sodano, A, Riccardi, A, Forestieri, P, De Cristofaro, G, Pettinato, G & Salvatore, M 2002, 'Identificazione del linfonodo sentinella in pazienti con carcinoma mammario', Radiologia Medica, vol. 103, no. 4, pp. 370-377.
Fonti R, Limite G, Sodano A, Riccardi A, Forestieri P, De Cristofaro G et al. Identificazione del linfonodo sentinella in pazienti con carcinoma mammario. Radiologia Medica. 2002 Apr;103(4):370-377.
Fonti, Rosa ; Limite, Gennaro ; Sodano, Antonio ; Riccardi, Albina ; Forestieri, Pietro ; De Cristofaro, Giuliana ; Pettinato, Guido ; Salvatore, Marco. / Identificazione del linfonodo sentinella in pazienti con carcinoma mammario. In: Radiologia Medica. 2002 ; Vol. 103, No. 4. pp. 370-377.
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AU - Fonti, Rosa

AU - Limite, Gennaro

AU - Sodano, Antonio

AU - Riccardi, Albina

AU - Forestieri, Pietro

AU - De Cristofaro, Giuliana

AU - Pettinato, Guido

AU - Salvatore, Marco

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N2 - Purpose. To evaluate the predictive value of sentinel lymph node biopsy versus axillary node dissection on lymph node status in patients with T1-T2 breast cancer. Material and methods. Twentynine patients with T1 and 12 with T2 breast carcinoma and clinically NO axillary lymph nodes, underwent lymphoscintigraphy following the administration of 99mTc-human albumin nanocolloids. The tracer was injected subdermally, over the tumor mass, in the 34 patients with palpable lesions and peritumorally (n=3) or intratumorally (n=4), under stereotactic or ultrasound guidance, in the 7 patients with non-palpable lesions. Anterior and lateral planar images were acquired 15 min after the injection of the tracer and repeated every 30 min up to 3 hr until identification of sentinel lymph node. At the end of the scintigraphic study, sentinel node skin projection was marked using a demographic pen. Eighteen hours after lymphoscintigraphy, sentinel lymph node was identified and removed during surgery by hand-held gamma probe, then, the remaining axillary lymph nodes were dissected. All surgical specimens underwent histologic examination. Sentinel lymph nodes free of metastasis at histology, underwent additional examination with immunohistochemistry using monoclonal antibodies against cytokeratin and EMA to search for micrometastases. Results. Sentinel lymph node was identified in the 34 patients injected subdermally and in the 3 patients injected peritumorally, while it remained undetected in the 4 patients injected intratumorally except for one case in which it was isolated by radioguided surgery but not scintigraphically. Sentinel nodes resulted free of metastases both at histology and immunohistochemistry in 32 cases and metastatic in 6. In the 32 patients with non-metastatic sentinel lymph nodes the other axillary nodes were also free of metastases. Among the 6 metastatic sentinel lymph nodes, in 3 cases they were the only metastatic nodes of the axilla while in the other 3 cases metastases were spread to other axillary nodes. Conclusions. In agreement with previous studies, our results showed that sentinel lymph node radioguided biopsy is a simple and reliable method for predicting axillary lymph nodes status and for avoiding axillary dissection in early breast cancer patients with sentinel node free of metastases.

AB - Purpose. To evaluate the predictive value of sentinel lymph node biopsy versus axillary node dissection on lymph node status in patients with T1-T2 breast cancer. Material and methods. Twentynine patients with T1 and 12 with T2 breast carcinoma and clinically NO axillary lymph nodes, underwent lymphoscintigraphy following the administration of 99mTc-human albumin nanocolloids. The tracer was injected subdermally, over the tumor mass, in the 34 patients with palpable lesions and peritumorally (n=3) or intratumorally (n=4), under stereotactic or ultrasound guidance, in the 7 patients with non-palpable lesions. Anterior and lateral planar images were acquired 15 min after the injection of the tracer and repeated every 30 min up to 3 hr until identification of sentinel lymph node. At the end of the scintigraphic study, sentinel node skin projection was marked using a demographic pen. Eighteen hours after lymphoscintigraphy, sentinel lymph node was identified and removed during surgery by hand-held gamma probe, then, the remaining axillary lymph nodes were dissected. All surgical specimens underwent histologic examination. Sentinel lymph nodes free of metastasis at histology, underwent additional examination with immunohistochemistry using monoclonal antibodies against cytokeratin and EMA to search for micrometastases. Results. Sentinel lymph node was identified in the 34 patients injected subdermally and in the 3 patients injected peritumorally, while it remained undetected in the 4 patients injected intratumorally except for one case in which it was isolated by radioguided surgery but not scintigraphically. Sentinel nodes resulted free of metastases both at histology and immunohistochemistry in 32 cases and metastatic in 6. In the 32 patients with non-metastatic sentinel lymph nodes the other axillary nodes were also free of metastases. Among the 6 metastatic sentinel lymph nodes, in 3 cases they were the only metastatic nodes of the axilla while in the other 3 cases metastases were spread to other axillary nodes. Conclusions. In agreement with previous studies, our results showed that sentinel lymph node radioguided biopsy is a simple and reliable method for predicting axillary lymph nodes status and for avoiding axillary dissection in early breast cancer patients with sentinel node free of metastases.

KW - Breast cancer

KW - Lymphoscintigraphy

KW - Sentinel lymph node

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