Sentinel node localization in breast cancer patients using intradermal dye injection.
In a series of 161 consecutive breast cancer operations, intradermal injection of Patent Blue was used to localize the sentinel node (SN). The surgical localization rate was 60%. Including the blue lymph nodes found by the pathologist, localization rate was 70%. After the first 103 operations, the surgical procedure was changed, resulting in a localization rate of 83%. Ten surgeons participated, but only one had previous experience with SN dissection. The others experienced a steep learning curve. Metastasis was found in 42 of 97 SNs (43%). In 15 cases (36%) metastasis was recognized only after step-sectioning and immunohistochemical staining for cytokeratin. In one case a benign epithelial inclusion was found. The sentinel node was false negative in 9.1% of cases. The consensus from the literature is that the best results are achieved using a combination of dye and isotopic techniques.
Ilum
L
L
Department of Surgery, Odense University Hospital, Denmark.
Bak
M
M
Olsen
K E
KE
Kryh
D
D
Berg
V
V
Axelsson
C K
CK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001706:Biopsy; D001943:Breast Neoplasms / Q000473:pathology*; D004396:Coloring Agents; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007271:Injections, Intradermal; D007633:Keratins / Q000032:analysis; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011237:Predictive Value of Tests; D011361:Professional Competence
D004396:Coloring Agents; D007633:Keratins