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Query: UMLS:C0006142 (breast cancer)
 160,383 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Limiting morbidity without sacrificing outcome remains paramount for patients with minimally invasive breast cancer, particularly regarding diagnosis, local disease control, limiting axillary dissection, and identifying the optimal timing for surgery. Stereotactic biopsy is evolving as a viable alternative to surgical biopsy, but it awaits confirmation in a randomized prospective study before its adoption on a routine basis. Breast-conserving therapy continues to offer local control rates similar to mastectomy, except for lesions with positive-excision margins, an extensive intraductal component, and perhaps in young patients and those with either lobular carcinoma or multifocal disease. Factors that provide prognostic information currently obtained by axillary dissection have not been identified, and hence axillary dissection remains a mainstay of treatment. Sentinel node biopsy requires further refinements and confirmation before its universal acceptance. Premenopausal patients undergoing surgery during the follicular phase of the menstrual cycle appear to fare poorly, thereby requiring further investigation.
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PMID:Surgery for early and minimally invasive breast cancer. 854 97

Sentinel node (SN) biopsy technique has been reported to be a very accurate staging procedure in patients with stage I/II melanoma. Whether it is as accurate in patients with breast cancer has to be studied more extensively. Eighty-three patients with clinically T1-T2 N0M0 breast cancer were peri-tumorally injected with 99m-Tc colloidal-albumin. Lymphoscintigraphy was performed either 4 or 18 h after the injection. Using a gamma probe the SN were located in vivo, removed from the axillary specimen and sent for histological examination. No focal accumulation was seen on the lymphoscintigraphy in 17 patients. Two patients had parasternal SN locations only and in seven patients the localization of the SN failed. Of the remaining 57 patients, 23 had positive axillary basins, of which 22 were correctly predicted by one or more positive SN. There was one false-negative biopsy (sensitivity=96%). In 12 of the 22 positive axillary basins, SN was the only positive node. We conclude that the SN biopsy technique is a promising and feasible procedure in about three-quarters of patients with clinically T1-T2 N0M0 breast cancer. However, more data are needed to establish the actual sensitivity of this procedure.
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PMID:Lymphoscintigraphy and feasibility of sentinel node biopsy in 83 patients with primary breast cancer. 948 18

Sentinel node biopsy is a less invasive technique for staging breast cancer than complete axillary lymph-node dissection and may be as accurate. In the case of a 71-year-old woman with a T1 breast cancer, sentinel node biopsy improved staging. Metastases were discovered in sentinel nodes outside the axilla while the axillary nodes were tumour-free.
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PMID:Improved staging of breast cancer through lymphatic mapping and sentinel node biopsy. 980 Sep 78

Sentinel node biopsy may be useful in the staging of breast cancer. In experienced hands presence or absence of metastasis in the sentinel node accurately predicts the nodal status and in patients with a negative sentinel node biopsy axillary dissection may be avoided. The technique, however, shows a clear learning curve and hasty introduction may lead to an unacceptable rate of false negative biopsies. Moreover, the introduction of the technique in general practice should be well coordinated in order to prevent large differences between hospitals in the staging and treatment of breast cancer patients. On the initiative of NABON (Nationaal Borstkanker Overleg Nederland; 'national breast cancer consultation') and the Nederlandse Vereniging voor Chirurgische Oncologie (Netherlands Association for Surgical Oncology) a study group was formed to co-ordinate the introduction of the sentinel node biopsy in breast cancer patients in the Netherlands. Important topics are central registration of all procedures in order to evaluate its applicability and technical variations, the performance in each centre of at least 50 procedures together with axillary node dissection to evaluate the results before clinical application is considered, and nationwide co-ordination to find the best therapy for patients with positive sentinel nodes.
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PMID:[The sentinel node biopsy in patients with breast cancer: recommendations for the introduction of this procedure. Dutch Working Group Sentinel Node Biopsy in Breast Cancer]. 1006 64

Sentinel node (SN) detection is a reliable method to detect lymph node metastases in breast cancer patients. While blue dye allows to follow the lympatic stream towards the sentinel node the use of radioactive marked protein allows a preoperative identification of the SN (e.g. internal mammary artery). Detection rate and predictive value depend on the tumor size, tumors of a diameter greater than 30 mm show a poor detection rate and a lower predictive value. With regard of the increased rate of detected micrometastases the SN principle has a higher predictive value for the nodal status then the axillary clearance. Since no long term results are available yet the advantage for the patients remain unclear.
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PMID:[Sentinel node detection in breast carcinoma]. 993 46

The status of the axillary nodes is the strongest known prognostic variable in patients with early breast cancer, and is routinely used in planning postoperative therapy. Conventional axillary lymph node dissection is limited by sampling error and potential morbidity. Sentinel node techniques have revolutionized the management of axillary nodes. Accurate identification and focused histologic evaluation of the sentinel node allow accurate prediction of the tumor status of other axillary nodes, thereby avoiding the morbidity and expense of a complete axillary dissection in node-negative patients. Radiotracer techniques play an important role in the preoperative and intraoperative localization of the sentinel nodes. Optimal localization of the sentinel node requires the use of both preoperative lymphoscintigraphy and intraoperative radiosensitive probes. Lymphoscintigraphy also identifies patients with lymphatic drainage to sites other than the axilla, thereby allowing more appropriate treatment and follow-up in this subset of patients. Procedures for localizing sentinel nodes require an understanding of the kinetics of the radiopharmaceuticals or other tracers used and the detection devices employed in each institution. Both surgical and nuclear medicine personnel should understand these principles, and close cooperation between surgeons, nuclear medicine physicians, and pathologists is essential for the application of sentinel node techniques.
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PMID:Sentinel node localization in breast cancer. 999 Jun 84

Sentinel node detection enables the definition of the most relevant draining lymph node of a tumor. We analysed 123 patients with breast cancer according to this method. A preoperative lymphoscintigraphy was performed 17 hours after a peritumoral application of 0.5 ml 99mTC-Nanokoll. The sentinel node was identified by means of a gammaprobe in 75 of 89 patients with pT1- and pT2-tumors and in 11 of 17 patients with pT3-4 tumors respectively. The results of histological investigation of the sentinel node in comparison to all other axillary nodes following dissection were correlated. In the pT1-2 group the accuracy of correlative findings was rather high (96%). In patients with pT3- and pT4-tumors the lymph node status was predictable only in 7 patients. Therefore sentinel node biopsy may serve as a tool for individualization of axillary dissection especially in pT1-2 breast cancer patients.
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PMID:[Sentinel lymph node detection in patients with breast carcinoma]. 1006 79

The sentinel node is the first lymph node that drains a primary tumour. If this lymphatic drainage occurs in a step-wise fashion, this lymph node reflects the pathological status of the remaining lymph node basin. The day before the operation, a total dose of 60 MBq 99mTc nanocolloid is injected around the primary tumour for lymphoscintigraphy. On the day of surgery, 1 ml of blue dye is injected around the primary tumour to facilitate sentinel lymph node detection. After making a small incision over the regional lymph node region, the sentinel node can be detected using a hand-held gamma ray detection probe; the sentinel lymph node and the afferent lymphatic vessels will be stained blue. Sentinel node biopsy has proved useful for malignant melanoma, breast cancer, penile cancer, vulvar cancer, Merkel cell carcinoma and thyroid cancer. New studies are described on breast cancer and malignant melanoma. Gamma-probe-guided localization of radiolabelled lymph nodes can direct the surgeon non-invasively to the exact location of the sentinel node. Once localized with a gamma probe, it is quick and easy to remove the sentinel node through a small incision. Discriminating the node from other tissue can be aided by blue dye which stains the lymph node. It appears that both radioactivity and blue dye are complementary for locating the sentinel node.
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PMID:Sentinel node biopsy as a surgical staging method for solid cancers. 1038 10

Sentinel node biopsy is currently considered to be an outstanding advance in surgical oncology and represents significant evolution toward minimally invasive breast cancer surgery. Detected by blue dye, radiopharmaceutical or combined techniques, the sentinel lymph node can be selectively used for the detection of micrometastasis through extensive histopathologic analysis. Nevertheless, before considering the sentinel lymph node concept as a new standard of care, the standardization of both detection methods and histopathological protocols is of critical importance. The future of this attractive technique is strictly dependent on the quality of teaching, training and evaluation in prospective controlled multicentric studies.
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PMID:Sentinel lymph node procedure--a valid selection criterion? 1054 19

Sentinel node biopsy (SNB) in breast cancer is a promising surgical technique that avoids unnecessary axillary lymph node dissection. To optimize lymphatic mapping with radiopharmaceuticals, mammary lymphoscintigraphy with 30-50 MBq of technetium-99m-diethylenetriamine pentaacetic acid human serum albumin (99mTc-HSAD), technetium-99m-human serum albumin (99mTc-HSA), or technetium-99m-tin colloid (99mTc-TC) were investigated in 69 cases of primary breast cancer. Dynamic early images were obtained during the first 30 or 40 minutes, and static delayed images were obtained 6 hours after tracer injection. Hot spots as sentinel lymph nodes (SLNs) appeared in 51 of 69 cases (74%): in early images in 27 cases and in delayed images in 24 cases. SLNs were visualized more frequently in 23 of the 26 cases (88%) treated with 99mTc-HSAD and in 21 of the 24 cases (88%) treated with 99mTc-HSA than in only 7 of the 19 cases (37%) treated with 99mTc-TC. In 26 of the 51 cases, SLNs were identified as faint spots in delayed images. There was a significant difference in the first appearance of SLNs on the lymphoscintiscan between 43 cases of dense breast parenchyma and 26 cases of fatty breast parenchyma. These results suggest that 99mTc-HSAD or 99mTc-HSA is acceptable for lymphatic mapping, but in cases which have faint spots in delayed images or fatty breast parenchyma, gamma probe-guided SNB may result in failure or misleading false-negative SLNs.
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PMID:Mammary lymphoscintigraphy with various radiopharmaceuticals in breast cancer. 1058 2


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