title: Novel techniques for sentinel lymph node biopsy in breast cancer: a systematic review.
abstract: The existing standard for axillary lymph node staging in breast cancer patients with a clinically and radiologically normal axilla is sentinel lymph node biopsy with a radioisotope and blue dye (dual technique). The dependence on radioisotopes means that uptake of the procedure is limited to only about 60% of eligible patients in developed countries and is negligible elsewhere. We did a systematic review to assess three techniques for sentinel lymph node biopsy that are not radioisotope dependent or that refine the existing method: indocyanine green fluorescence, contrast-enhanced ultrasound using microbubbles, and superparamagnetic iron oxide nanoparticles. Our systematic review suggested that these new methods for sentinel lymph node biopsy have clinical potential but give high levels of false-negative results. We could not identify any technique that challenged the existing standard procedure. Further assessment of these techniques against the standard dual technique in randomised trials is needed.
authors.affiliation: Department of Research Oncology, King's College London, London, UK; Oncology and Haematology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Muneer
authors.initials: M
authors.lastname: Ahmed
authors.affiliation: Department of Research Oncology, King's College London, London, UK; Oncology and Haematology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Arnie D
authors.initials: AD
authors.lastname: Purushotham
authors.affiliation: Department of Research Oncology, King's College London, London, UK; Oncology and Haematology, Guy's and St Thomas' NHS Foundation Trust, London, UK. Electronic address: michael.douek@kcl.ac.uk.
authors.forename: Michael
authors.initials: M
authors.lastname: Douek
mesh_terms: D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D004396:Coloring Agents; D003287:Contrast Media; D005260:Female; D005453:Fluorescence; D006801:Humans; D007208:Indocyanine Green; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D058185:Magnetite Nanoparticles; D045423:Microbubbles; D009367:Neoplasm Staging; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D014463:Ultrasonography
chemical_list: D004396:Coloring Agents; D003287:Contrast Media; D058185:Magnetite Nanoparticles; D007208:Indocyanine Green