[Sentinel node detection applied to breast cancer: 2007 update].
The technique of detection and resection of the sentinel lymph node applied to early breast cancer management aims to spare the patient with a low risk of lymph node involvement an unnecessary axillary lymphadenectomy. This innovating technique lies on the double hypothesis of an accuracy to predict non sentinel lymph node status and to induce a lower morbidity when compared with axillary lymphadenectomy. This multidisciplinary technique depends on surgeons, nuclear physicians and pathologists. In practice sentinel lymph nodes are detected thanks to two types of tracers, the Blue and the colloids marked with technetium, harvested by the surgeon guided by the blue lymphatic channel and the use of a gamma probe detection, analyzed by the pathologist according to a particular procedure with the concept of serial slices, and possibly immuno histo chemistry. The objectives of this review are to specify the state of knowledge concerning the different steps: detection, surgical resection and the pathological analysis of the sentinels lymph nodes and to focus on validated and controversial indications, and on the main ongoing trials.
Classe
J-M
JM
Service chirurgie oncologique, centre régional de lutte contre le cancer René-Gauducheau, site Hôpital-Nord, 44805 Nantes-Saint Herblain, France. jm-classe@nantes.fnclcc.fr
Houvenaeghel
G
G
Sagan
C
C
Leveque
J
J
Ferron
G
G
Dravet
F
F
Pioud
R
R
Catala
L
L
Rousseau
C
C
Curtet
C
C
Descamps
P
P
D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008197:Lymph Node Excision; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods / Q000639:trends