PURPOSE: Sentinel lymph node (SLN) biopsy (SLNB) for patients with melanoma and breast carcinoma has been validated as an accurate method for assessing the status of lymph nodes. Although prophylactic modified radical neck dissection for patients with papillary thyroidcarcinoma is not performed routinely, central neck node dissection is currently considered to be part of the standard initial operation. Therefore, this study was conductedto determine the feasibility of SLNB for the evaluation of central neck lymph node status in patients with papillary thyroid carcinoma. METHODS: 116 patients (108 women, 8 men) preoperatively diagnosed with papillary thyroid carcinoma between 2004 and 2006 were prospectively studied. After 0.1 to 0.3 ml of 1.0% methylene blue dye was injected into the tumor, SLNB was performed, followed by total thyroidectomy and central neck node dissection. RESULTS: Preoperatively, in cases of papillary thyroid carcinoma without evidence of cervical lymph node metastasis, the identification rate of SLN in level 6 compartments was 93.1%. In addition, the overall accuracy of SLN at predicting the nodal status was 91.7%. Furthermore, the sensitivity, specificity, positive predictive value and negative predictive values were 85.7%, 100%, 100% and 83.3% respectively. CONCLUSION: The SLNB in the central compartment for papillary thyroid carcinoma is an acceptable and feasible technique for estimating the central neck lymph node status, therefore, it may be helpful in diagnosing metastases and avoiding unnecessary lymph node dissection in cases of papillary thyroid cancer. However further studies are necessary to improve the diagnostic accuracy prior to routine clinical use.
Biopsy ; Breast Neoplasms ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; Melanoma ; Methods ; Methylene Blue ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Prospective Studies ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

A treatment option for early stage breast cancer is nodal evaluation by axillary lymph node dissection (ALND). An alternative to ALND is sentinel lymph node (SLN) biopsy employing radionuclide SLN mapping. This study was designed to investigate the relationship between malignancy spread to the SLN and primary tumor size by reviewing the clinical profile of 20 female breast cancer patients who underwent radionuclide SLN mapping procedure, sentinel lymph node and primary tumor biopsy, as well as axillary lymph node dissection. The accuracy of radionuclide mapping in the identifying the sentinel node and determining the status of the axillary lymph nodes was reviewed. Among the mapped sentinel nodes, 15% were positive for metastatic lymphadenopathy and 85% without malignant spread. The malignant sentinel nodes had a mean size of 5.5 ± 0.87 cm and the negative sentinel nodes had a mean size of 2.95 ±2.2 cm. The SLN identified by radionuclide mapping truly represented the status of the rest of the axillary nodes for the presence or absence of metastatic lymphadenopathy. Primary tumor size is a prognostic factor for cancer spread to the sentinel node. However, the combination of primary tumor histology and tumor size may prove to be a stronger prognostic indicator malignancy spread to the sentinel lymph node.

Human ; Female ; Axilla ; Breast Neoplasms ; Lymph Node Excision ; Lymph Nodes ; Lymphadenopathy ; Prognosis ; Radioisotopes ; Sentinel Lymph Node ; Sentinel Lymph Node Biopsy

PURPOSE: This study was performed to find the adequate number of removed lymph nodes to achieve an acceptable false-negative rate when performing sentinel lymph node biopsy for breast cancer. METHODS: A total of 179 sentinel node biopsies combined with conventional axillary lymph node dissection for breast cancer were performed between November 2003 and June 2007. RESULTS: The overall identification rate of sentinel lymph node and the false negative rate of the biopsy were 95.0% and 8.1%, respectively. Yet the false negative rate of the biopsy was lowered as the number of the removed nodes was increased. Especially, the false negative rate was 0% when more than 4 lymph nodes were removed. CONCLUSION: We recommend that four lymph nodes should be removed to obtain accurate results in sentinel node biopsy for breast cancer.
Biopsy ; Breast ; Breast Neoplasms ; Lymph Node Excision ; Lymph Nodes ; Nitriles ; Pyrethrins ; Sentinel Lymph Node Biopsy

No abstract available.
Endometrial Neoplasms/*pathology ; Female ; Humans ; Lymph Node Excision/*methods ; *Sentinel Lymph Node Biopsy

No abstract available.
Endometrial Neoplasms/*pathology ; Female ; Humans ; Lymph Node Excision/*methods ; *Sentinel Lymph Node Biopsy

Sentinel lymph node biopsy has not gained popularity in the Philippines, perhaps the reason being the unavailability of resources. The use of methylene blue may change this situation.
OBJECTIVE: The authors intend to demonstrate that methylene blue may be used as an alternative dye in sentinel lymph node biopsy for breast cancer with satisfactory results.
METHODS: Twenty patients diagnosed with breast cancer underwent sentinel lymph node biopsy after injection with methylene blue dye, followed by complete axillary dissection. Histologic evaluation of the nodes was done using H&E stain.
RESULTS: The identification rate was 95%, with no false negatives.
CONCLUSION: Sentinel lymph node biopsy using methylene blue can be done with satisfactory results.

Human ; Sentinel Lymph Node Biopsy ; Methylene Blue ; Philippines ; Lymph Node Excision ; Breast Neoplasms ; Coloring Agents

PURPOSE: Radio-guided sentinel node biopsy has become a standard method for evaluating the axillary status. However, there is no guideline for the optimum extent of sentinel lymphadenectomy. The object of this study was to assess the probability of metastases according to the sequence of radioactivity in the sentinel nodes and to determine the accuracy of the methods for evaluating metastases. METHODS: 80 consenting patients underwent sentinel lymph node biopsy using 99mTc-phytate. All the lymph nodes that showed radioactivity higher than surroundings were excised and labeled as SN1 to SN5 according to the sequential radioactivity. All the excised sentinel nodes were evaluated by frozen sectioning (FS) and permanent sectioning (PS). The sensitivity, specificity, negative predictive value and accuracy of the procedure were then analyzed according to the evaluation method. RESULTS: All 80 patients showed a variable number of axillary sentinel node sites (SN1-SN5) and 19 patients (23.8%) had three or more sentinel node sites, with an average number of 1.98. The sensitivity, specificity, NPV and accuracy were higher on PS (94.4%, 100%, 98.4% and 98.8% respectively) than on FS (88.9%, 100%, 96.9% and 97.5% respectively). 20 patients were found to have metastatic breast cancer within the sentinel lymph nodes by IHC, but one case of a metastatic, non-sentinel node was found in the 60 patients with negative sentinel nodes, so that the final false negative rate was 4.8%. In 18 of the 20 sentinel node-positive patients(90.0%), the most radioactive lymph node (SN1) was a positive node. The removal of the most radioactive sentinel node and the 2nd most radioactive sentinel node accurately staged all 20 sentinel node-positive patients. CONCLUSION: Careful evaluation of the sentinel nodes with FS, PS and IHC study is essential to reduce the false negative results. In addition, excision of the highest and the 2nd highest lymph nodes is essential and the excision of the 3rd highest node if any, should also be considered for obtaining a better treatment results.
Biopsy* ; Breast Neoplasms* ; Breast* ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Radioactivity* ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy

PURPOSE: Isosulfan blue dye has been widely used for localizing sentinel lymph nodes (SLNs) in breast cancer patients. The use of methylene blue has recently been applied for localizing SLNs. We compared the use of each dye to investigate the effectiveness of methylene blue for the localization of SLNs. METHODS: From January to December of 2005, 326 patients underwent surgery for breast cancer at Samsung Medical Center. In 86 patients, only a blue dye was used for SLN localization. Isosulfan blue and methylene blue were randomly given. Each dye (5 mL) was given by subareolar or peritumoral injection. The injection site was gently massaged with a warm gauze for 5 min. A frozen biopsy was performed for all SLNs, and an axillary dissection was done for positive frozen biopsy cases or cases in which axillary metastasis was clinically suspected. RESULTS: Fifty-eight cases (61.1%) had been treated with isosulfan blue and 37 cases (38.9%) had been treated with methylene blue. Blue nodes were found in 96.6% of samples in the isosulfan blue group and 86.5% of samples in the methylene blue group. The mean number of SLNs was 2.10 in the isosulfan blue group and 2.27 in the methylene blue group (p>0.05). The frozen biopsy was positive for malignant cells in 16 of 56 cases in the isosulfan blue group and 4 of 32 cases in the methylene blue group. Axillary lymph node dissection was performed in 23 cases in the isosulfan blue group and 19 cases in the methylene blue group. CONCLUSION: There are no significant differences in the success rate, the mean number of SLNs found and the false negative rate between the use of isosulfan blue and methylene blue for localization of SLNs in breast cancer patients.
Biopsy ; Breast Neoplasms* ; Breast* ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Methylene Blue* ; Neoplasm Metastasis ; Sentinel Lymph Node Biopsy

Cervical cancer is a common gynecologic malignancy. Most patients with early-stage cervical cancer received unnecessary systemic pelvic lymphadenectomy, which increased the risk of surgical complications. At present, sentinel lymph node biopsy has been applied in the clinical practice of cervical cancer abroad, however it is still at the starting stage in China in need of application and promotion. The Obstetrics and Gynecology Committee of Chinese Research Hospital Association invited domestic experts in the field of gynecologic oncology to discuss the application value, patient evaluation, technical methods, operation steps, pathological examination and many other key points of sentinel lymph node biopsy based on the current research status, and reached the consensus of clinical application on sentinel lymph node biopsy in cervical cancer to guide the standardized application of the technique in China.
Consensus ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes/surgery* ; Lymphatic Metastasis ; Neoplasm Staging ; Sentinel Lymph Node/surgery* ; Sentinel Lymph Node Biopsy ; Uterine Cervical Neoplasms/surgery*

PURPOSE: Primary systemic therapy (PST) downstages up to 40% of initial documented axillary lymph node (ALN) metastases in breast cancer. The current surgical treatment after PST consists of breast tumor resection and axillary lymph node dissection (ALND). This strategy, however, does not eliminate unnecessary ALND in patients with complete remission of axillary metastases. The aim of this study was to examine the accuracy of sentinel lymph node biopsy (SLNB) after PST among patients with documented ALN metastasis at presentation and to identify the rate of pathologic complete-remission (CR) with ALN after PST. METHODS: We analyzed 66 patients with ALN metastasis that was pathologically proven preoperatively who underwent SLNB and concomitant ALND after PST. Axillary ultrasound (AUS) was used to evaluate the clinical response of initially documented ALN metastasis after PST. Intraoperative lymphatic mapping was performed using blue dye with or without radioisotope. RESULTS: After PST, 34.8% of patients had clinical CR of ALN on AUS and 28.8% patients had pathologic CR of ALN. The overall success rate of SLNB after PST was 87.9%, and the sentinel lymph node identification rate in patients with clinical CR was 95.7%. In patients with successful lymphatic mapping, 70.7% of patients had residual axillary metastases. The overall accuracy and false-negative rate were 87.9% and 17.1% in all patients: 95.5% and 10.0% in patients with clinical CR of ALN, and 83.3% and 19.4% in patients with residual axillary disease after PST. CONCLUSION: Our findings suggest that SLNB may be feasible in patients with initial documented ALN metastasis who have clinical CR for metastatic ALN after PST. Further investigation in a prospective setting should be performed to confirm our results.
Breast ; Breast Neoplasms ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Nitriles ; Pyrethrins ; Sentinel Lymph Node Biopsy