title: [Sentinel node in melanoma and breast cancer. Current considerations].
abstract: The main objectives of sentinel node (SN) biopsy is to avoid unnecessary lymphadenectomies and to identify the 20-25% of patients with occult regional metastatic involvement. This technique reduces the associated morbidity from lymphadenectomy and increases the occult lymphatic metastases identification rate by offering the pathologist the or those lymph nodes with the highest probability of containing metastatic cells. Pre-surgical lymphoscintigraphy is considered a "road map" to guide the surgeon towards the sentinel nodes and to localize unpredictable lymphatic drainage patterns. The SPECT/CT advantages include a better SN detection rate than planar images, the ability to detect SNs in difficult to interpret studies, better SN depiction, especially in sites closer to the injection site and better anatomic localization. These advantages may result in a change in the patient's clinical management both in melanoma and breast cancer. The correct SN evaluation by pathology implies a tumoral load stratification and further prognostic implication. The use of intraoperative imaging devices allows the surgeon a better surgical approach and precise SN localization. Several studies reports the added value of such devices for more sentinel nodes excision and a complete monitoring of the whole procedure. New techniques, by using fluorescent or hybrid tracers, are currently being developed.
authors.affiliation: Servei de Medicina Nuclear, Centre de Diagnòstic per la Imatge (CDI), Hospital Clínic, Barcelona, España. Electronic address: svidal@clinic.ub.es.
authors.forename: S
authors.initials: S
authors.lastname: Vidal-Sicart
authors.affiliation: Servei de Dermatologia. Institut Clínic de Medicina i Dermatologia (ICMiD), Hospital Clínic, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Vilalta Solsona
authors.affiliation: Servei de Ginecologia, Institut Clínic de Ginecologia, Obstetricia i Neonatologia (ICGON), Hospital Clínic, Barcelona, España.
authors.forename: M I
authors.initials: MI
authors.lastname: Alonso Vargas
mesh_terms: D001706:Biopsy / Q000379:methods; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D061305:Lymphoscintigraphy / Q000379:methods*; D008297:Male; D008408:Mastectomy / Q000379:methods; D008545:Melanoma / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D009367:Neoplasm Staging / Q000379:methods; D000071036:Sentinel Lymph Node / Q000000981:diagnostic imaging* / Q000473:pathology; D021701:Sentinel Lymph Node Biopsy; D000072098:Single Photon Emission Computed Tomography Computed Tomography / Q000379:methods*; D012878:Skin Neoplasms / Q000601:surgery; D025321:Surgery, Computer-Assisted; D047368:Tumor Burden; D014463:Ultrasonography / Q000379:methods; D019564:Unnecessary Procedures
keywords: Breast cancer; Cáncer de mama; Ganglio centinela; Imagen intraoperatoria; Intraoperative imaging; Melanoma; SPECT/CT; SPECT/TC; Sentinel node