[Sentinel lymph node detection and clinical applications].
BACKGROUND
The sentinel lymph node (SLN) procedure consists of finding the first lymph node encountered by lymphatic vessels draining a tumor. This technique identifies the SLN histological status, which is representative of all the other draining area lymph nodes' status.


METHODS
SLN identification requires the injection of a lymphatic tracer, which could be either a blue dye or radiolabeled particles, or both. Performing a lymphoscintigraphy, which identifies and quantitates SLNs is a possibility provided by the use of radiolabeled particles before a gamma probe guided search is performed intraoperatively. Finally, a specific histopathological methodology involving serial sections of the entire SLN and immunohistochemistry is also required.


CONCLUSIONS
This technique is applicable to melanoma in which the SLN status might be a stronger prognostic factor than Breslow's thickness; to breast cancer in order to avoid full axillary lymph node dissection in patients with small tumors; and potentially to other carcinomas.
Brard
P-Y
PY
Service de biophysique et médecine nucléaire, CHU Albert-Michallon, BP 217, 38043 Grenoble cedex 09, France. pybrard@chu-grenoble.fr
D001943:Breast Neoplasms / Q000473:pathology*; D004396:Coloring Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008545:Melanoma / Q000473:pathology*; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*
D004396:Coloring Agents; D019275:Radiopharmaceuticals