γ-probe-guided resection of the sentinel lymph node in breast cancer

James A. Crossin, A. Cedric Johnson, Paul B. Stewart, William W. Turner

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

Regional lymph node metastases in patients with breast cancer have fundamental staging, prognostic, and treatment implications. Classically, axillary lymph node sampling requires a dissection under general anesthesia. The concept that a primary, or sentinel, lymph node is the first node to receive drainage from a tumor has been established in patients with malignant melanomas using radiolabeled tracers and vital dyes. This study proposed two hypotheses: (1) radiolabeled sentinel lymph nodes can be identified in most patients with breast cancer, and (2) radiolabeled sentinel lymph node biopsy accurately predicts axillary lymph node metastases in those patients. Patients with operable breast cancer had Tc-99 sulphur colloid injected around their breast tumors 1-6 hours preoperatively. Patients underwent γ probe identification of sentinel lymph nodes that were biopsied. All patients underwent axillary lymphadenectomy in conjunction with lumpectomy or mastectomy. Fifty female patients ages 26 to 90 years underwent lumpectomies with axillary dissections (40 patients) or modified radical mastectomies (10 patients). Sentinel lymph nodes were identified in 42 of 50 patients (84%). Eight patients (16%) had metastases to the axillary lymph nodes. In 7 patients, sentinel lymph nodes correctly predicted the status of the axillary nodes. There was one false negative result. A total of 550 lymph nodes were resected for an average of 11.2 nodes per patient. Sentinel lymph node scintigraphy and biopsy accurately predicted the axillary lymph node status in 41 of 42 patients (98%). Scintigraphy can identify sentinel lymph nodes in a large majority of patients. Sentinel lymph node biopsy is an accurate predictor of axillary lymphatic metastases.

Original languageEnglish (US)
Pages (from-to)666-669
Number of pages4
JournalAmerican Surgeon
Volume64
Issue number7
StatePublished - 1998

Fingerprint

Breast Neoplasms
Lymph Nodes
Sentinel Lymph Node Biopsy
Segmental Mastectomy
Sentinel Lymph Node
Neoplasm Metastasis
Radionuclide Imaging
Dissection
Modified Radical Mastectomy
Lymphatic Metastasis
Mastectomy
Colloids
Lymph Node Excision
Sulfur
General Anesthesia
Drainage
Melanoma
Coloring Agents

ASJC Scopus subject areas

  • Surgery

Cite this

Crossin, J. A., Cedric Johnson, A., Stewart, P. B., & Turner, W. W. (1998). γ-probe-guided resection of the sentinel lymph node in breast cancer. American Surgeon, 64(7), 666-669.

γ-probe-guided resection of the sentinel lymph node in breast cancer. / Crossin, James A.; Cedric Johnson, A.; Stewart, Paul B.; Turner, William W.

In: American Surgeon, Vol. 64, No. 7, 1998, p. 666-669.

Research output: Contribution to journalArticle

Crossin, JA, Cedric Johnson, A, Stewart, PB & Turner, WW 1998, 'γ-probe-guided resection of the sentinel lymph node in breast cancer', American Surgeon, vol. 64, no. 7, pp. 666-669.
Crossin JA, Cedric Johnson A, Stewart PB, Turner WW. γ-probe-guided resection of the sentinel lymph node in breast cancer. American Surgeon. 1998;64(7):666-669.
Crossin, James A. ; Cedric Johnson, A. ; Stewart, Paul B. ; Turner, William W. / γ-probe-guided resection of the sentinel lymph node in breast cancer. In: American Surgeon. 1998 ; Vol. 64, No. 7. pp. 666-669.
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