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Titolo:
Preoperative lymphoscintigraphy during lymphatic mapping for breast cancer: Improved sentinel node imaging using subareolar injection of technetium 99m sulfur colloid
Autore:
Kern, KA; Rosenberg, RJ;
Indirizzi:
Hartford Hosp, Dept Surg, Hartford, CT 06115 USA Hartford Hosp Hartford CT USA 06115 sp, Dept Surg, Hartford, CT 06115 USA Hartford Hosp, Dept Radiol, Hartford, CT 06115 USA Hartford Hosp HartfordCT USA 06115 , Dept Radiol, Hartford, CT 06115 USA Univ Connecticut, Sch Med, Hartford, CT 06112 USA Univ Connecticut Hartford CT USA 06112 t, Sch Med, Hartford, CT 06112 USA
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
fascicolo: 5, volume: 191, anno: 2000,
pagine: 479 - 489
SICI:
1072-7515(200011)191:5<479:PLDLMF>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
GAMMA-PROBE; AXILLARY LYMPHOSCINTIGRAPHY; MAMMARY LYMPHOSCINTIGRAPHY; BLUE-DYE; BIOPSY; IDENTIFICATION; GUIDELINES; METASTASES; EXPERIENCE; DIAGNOSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
45
Recensione:
Indirizzi per estratti:
Indirizzo: Kern, KA 85 Seymour St,Suite 1011, Hartford, CT 06106 USA 85 Seymour St,Suite 1011 Hartford CT USA 06106 ord, CT 06106 USA
Citazione:
K.A. Kern e R.J. Rosenberg, "Preoperative lymphoscintigraphy during lymphatic mapping for breast cancer: Improved sentinel node imaging using subareolar injection of technetium 99m sulfur colloid", J AM COLL S, 191(5), 2000, pp. 479-489

Abstract

Background: Preoperative lymphoscintigraphy has been recommended to confirm the successful uptake and direction of migration of radiotracer into sentinel nodes during lymphatic mapping for breast cancer. In addition, preoperative lymphatic mapping may provide a visually useful aid to the relative location of sentinel nodes within a nodal basin. One common method of breastlymphoscintigraphy involves injections of unfiltered technetium 99m sulfurcolloid (Tc-99m-SC) directly into parenchymal tissues surrounding a tumor or biopsy cavity (IP injection). Because of the many imaging failures and prolonged imaging times of IP lymphoscintigraphy, the procedure has fallen into disfavor by oncologic surgeons. The purpose of this study is to document the increased success rate of preoperative breast lymphoscintigraphy using a new anatomic site of injection, the subareolar lymphatic plexus (SA injection). Study Design: In the 12 months between December 1, 1998, and December 29, 1999, 42 women with stage I and II breast cancer underwent preoperative lymphoscintigraphy by either the IP (n = 12, December 1998 to May 1999) or SA (n = 30, May 1999 to December 1999) route of injection. Both groups were injected with 1 mCi (37 MBq) of unfiltered Tc-99m-SC followed immediately by external gamma-camera imaging. The success rate for preoperative sentinel node imaging and the total imaging time were recorded in both groups. Results: The success rate of identifying a sentinel node by SA lymphoscintigraphy was 90% (n = 27 df 30 patients), compared with 50% (n = 6 of 12 patients) for IP lymphoscintigraphy (p = 0.009). The imaging time in the SA injection group was 34 +/- 16 minutes, which was 59% shorter than the imagingtime in the IP injection group of 82 +/- 48 minutes (p < 0.001). No uptakeinto internal mammary nodes was seen in either group. Conclusions: Moving the site of injection of unfiltered Tc-99m-SC to the subareolar lymphatic plexus (SA injection) increased the success rate of preoperative lymphoscintigraphy to 90%, compared with 50% using IP injections. Preoperative SA lymphoscintigraphy resulted in the rapid visualization of axillary sentinel nodes within 30 minutes of SA injection, enabling a visual determination of the approximate number of sentinel nodes and their relative locations within the axilla. We conclude SA injection of unfiltered Tc-99m-SC is superior to IP injections when performing preoperative breast lymphoscintigraphy and is a visually useful aid to lymphatic mapping for breast cancer. (J Am Coll Surg 2000;191:479-489. (C) 2000 by the American College;of Surgeons).

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 11/07/20 alle ore 16:43:47