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Sentinel Lymph Node Biopsy Efficacy in Breast Cancer: A 4-year Experience Report

Received: 3 December 2021    Accepted: 30 December 2021    Published: 9 April 2022
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Abstract

Sentinel lymph node biopsy has been one of the most important advances in oncologic surgery, especially in breast cancer, since it decreases the high morbidity associated with radical axillary dissection, and allows treatment personalization. The staging of axillary nodes in breast cancer is fundamental as it is a prognostic indicator and determines the need for adjuvant therapy. Sentinel lymph node is detected by injecting a radioisotope and dye through the periareolar area that consequently travels through mammary glands to axillary lymph nodes. We conducted a retrospective study that included 57 women with a histopathological diagnosis of breast cancer, and underwent sentinel node biopsy. Transoperative pathology analysis reported metastases in 24% of the patients, requiring radical axillary dissection. Sensitivity was 97%, and specificity was 85%, reflecting high efficacy of the sentinel lymph node biopsy, and thus benefitting patients by decreasing morbidity. Sentinel node biopsy is the standard procedure for correct staging of patients with early breast cancer, and no clinical evidence of lymph node involvement. Further, it decreases morbidity in these patients by preventing radical axillary dissection, a previously standard approach, without compromising the diagnosis and hence, the prognosis of the patients. We demonstrated that with the correct technique for sentinel lymph node biopsy, the prognosis for patients is much better than for those patients that undergo radical axillary dissection.

Published in Journal of Cancer Treatment and Research (Volume 10, Issue 1)
DOI 10.11648/j.jctr.20221001.12
Page(s) 8-12
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Sentinel Node Biopsy, Breast Cancer, Lymph Node Metastasis

References
[1] Gallegos-Hernández JF. El ganglio centinela. Rev Mex Anestesiol. 2007; 30, Supl. 1 abr-jun.
[2] Nielsen Moody A, Bull J, Culpan A.-M., Munyombwe T, Sharma N, Whitaker M, Wolstenhulme S. (2017). Preoperative sentinel lymph node identification, biopsy and localisation using contrast enhanced ultrasound (CEUS) in patients with breast cancer: a systematic review and meta-analysis. Clin Radiol, 2017; 72 (11): 959–971. doi: 10.1016/j.crad.2017.06.121.
[3] Bernet L, et al. Consenso sobre la biopsia selectiva del ganglio centinela en el cáncer de mama. Revisión 2013 de la Sociedad Española de Senología y Patología Mamaria. Rev Esp Patol. 2014. http://dx.doi.org/10.1016/j.patol.2013.11.001
[4] Manca G, Rubello D, Tardelli E, Giammarile F, Mazzarri S, Boni G, Colletti PM (2016). Sentinel Lymph Node Biopsy in Breast Cancer. Clin Nucl Med 2016; 41 (2): 126–133. doi: 10.1097/rlu.0000000000000985.
[5] Lyman GH, Somerfield MR, Bosserman LD, Perkins CL, Weaver DL, Giuliano AE. Sentinel Lymph Node Biopsy for Patients with Early-Stage Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol 2016; 35: 561-564.
[6] Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, Gennari R. A Randomized Comparison of Sentinel-Node Biopsy with Routine Axillary Dissection in Breast Cancer. N Engl J Med 2003; 349 (6), 546–553. doi: 10.1056/nejmoa012782.
[7] Giuliano AE, Ballman KV, McCall L, Beitsch PD, Brennan MB, Kelemen PR, Morrow M. Effect of Axillary Dissection vs No Axillary Dissection on 10-Year Overall Survival Among Women with Invasive Breast Cancer and Sentinel Node Metastasis. JAMA 2017; 318 (10), 918. doi: 10.1001/jama.2017.11470.
[8] Duraes M, Guillot E, Seror J, Pouget N, Rouzier R. Ganglion sentinelle et chimiothérapie néoadjuvante dans le cancer du sein. Bull Cancer 2017; 104 (10): 92–901. doi: 10.1016/j.bulcan.2017.08.003.
[9] Munck F, Clausen E W, Balslev E, Kroman N, Tvedskov TF, Holm-Rasmussen EV. Multicentre study of the risk of invasive cancer and use of sentinel node biopsy in women with a preoperative diagnosis of ductal carcinoma in situ. Br J Surg 2019 doi: 10.1002/bjs.11377.
[10] Morrow M, Jagsi R, McLeod M C, Shumway D, Katz S J. Surgeon Attitudes Toward the Omission of Axillary Dissection in Early Breast Cancer. JAMA Oncol, 2018. doi: 10.1001/jamaoncol.2018.1908.
[11] Giuliano A E. Axillary Dissection vs No Axillary Dissection in Women with Invasive Breast Cancer and Sentinel Node Metastasis. JAMA, 2011; 305 (6), 569. doi: 10.1001/jama.2011.90.
[12] NCCN Clinical Practice Guidelines in Oncology. Breast cancer. Septiembre 2019.
[13] Veronesi, P., & Corso, G. (2019). Standard and controversies in sentinel node in breast cancer patients. The Breast, 48, S53–S56. doi: 10.1016/s0960-9776(19)31124-5.
[14] Fan, B., Pardo, J. A., Serres, S., Alapati, A. C., Szewczyk, J., Mele, A., & James, T. A. (2020). Role of Sentinel Lymph Node Biopsy in Microinvasive Breast Cancer. Annals of Surgical Oncology. doi: 10.1245/s10434-020-08606-3.
[15] Garcia-Etienne, C. A., Ferrari, A., Della Valle, A., Lucioni, M., Ferraris, E., Di Giulio, G., … Sgarella, A. (2019). Management of the axilla in patients with breast cancer and positive sentinel lymph node biopsy: An evidence-based update in a European breast center. European Journal of Surgical Oncology. doi: 10.1016/j.ejso.2019.08.013.
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    Paola Iturralde-Rosas Priego, Javier Gomezpedroso-Rea, Miguel Angel Mancera-Resendiz, Daniela Stuht-Lopez, Manuel Ubiergo-Garcia. (2022). Sentinel Lymph Node Biopsy Efficacy in Breast Cancer: A 4-year Experience Report. Journal of Cancer Treatment and Research, 10(1), 8-12. https://doi.org/10.11648/j.jctr.20221001.12

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    ACS Style

    Paola Iturralde-Rosas Priego; Javier Gomezpedroso-Rea; Miguel Angel Mancera-Resendiz; Daniela Stuht-Lopez; Manuel Ubiergo-Garcia. Sentinel Lymph Node Biopsy Efficacy in Breast Cancer: A 4-year Experience Report. J. Cancer Treat. Res. 2022, 10(1), 8-12. doi: 10.11648/j.jctr.20221001.12

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    AMA Style

    Paola Iturralde-Rosas Priego, Javier Gomezpedroso-Rea, Miguel Angel Mancera-Resendiz, Daniela Stuht-Lopez, Manuel Ubiergo-Garcia. Sentinel Lymph Node Biopsy Efficacy in Breast Cancer: A 4-year Experience Report. J Cancer Treat Res. 2022;10(1):8-12. doi: 10.11648/j.jctr.20221001.12

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  • @article{10.11648/j.jctr.20221001.12,
      author = {Paola Iturralde-Rosas Priego and Javier Gomezpedroso-Rea and Miguel Angel Mancera-Resendiz and Daniela Stuht-Lopez and Manuel Ubiergo-Garcia},
      title = {Sentinel Lymph Node Biopsy Efficacy in Breast Cancer: A 4-year Experience Report},
      journal = {Journal of Cancer Treatment and Research},
      volume = {10},
      number = {1},
      pages = {8-12},
      doi = {10.11648/j.jctr.20221001.12},
      url = {https://doi.org/10.11648/j.jctr.20221001.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jctr.20221001.12},
      abstract = {Sentinel lymph node biopsy has been one of the most important advances in oncologic surgery, especially in breast cancer, since it decreases the high morbidity associated with radical axillary dissection, and allows treatment personalization. The staging of axillary nodes in breast cancer is fundamental as it is a prognostic indicator and determines the need for adjuvant therapy. Sentinel lymph node is detected by injecting a radioisotope and dye through the periareolar area that consequently travels through mammary glands to axillary lymph nodes. We conducted a retrospective study that included 57 women with a histopathological diagnosis of breast cancer, and underwent sentinel node biopsy. Transoperative pathology analysis reported metastases in 24% of the patients, requiring radical axillary dissection. Sensitivity was 97%, and specificity was 85%, reflecting high efficacy of the sentinel lymph node biopsy, and thus benefitting patients by decreasing morbidity. Sentinel node biopsy is the standard procedure for correct staging of patients with early breast cancer, and no clinical evidence of lymph node involvement. Further, it decreases morbidity in these patients by preventing radical axillary dissection, a previously standard approach, without compromising the diagnosis and hence, the prognosis of the patients. We demonstrated that with the correct technique for sentinel lymph node biopsy, the prognosis for patients is much better than for those patients that undergo radical axillary dissection.},
     year = {2022}
    }
    

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    T1  - Sentinel Lymph Node Biopsy Efficacy in Breast Cancer: A 4-year Experience Report
    AU  - Paola Iturralde-Rosas Priego
    AU  - Javier Gomezpedroso-Rea
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    T2  - Journal of Cancer Treatment and Research
    JF  - Journal of Cancer Treatment and Research
    JO  - Journal of Cancer Treatment and Research
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    EP  - 12
    PB  - Science Publishing Group
    SN  - 2376-7790
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    AB  - Sentinel lymph node biopsy has been one of the most important advances in oncologic surgery, especially in breast cancer, since it decreases the high morbidity associated with radical axillary dissection, and allows treatment personalization. The staging of axillary nodes in breast cancer is fundamental as it is a prognostic indicator and determines the need for adjuvant therapy. Sentinel lymph node is detected by injecting a radioisotope and dye through the periareolar area that consequently travels through mammary glands to axillary lymph nodes. We conducted a retrospective study that included 57 women with a histopathological diagnosis of breast cancer, and underwent sentinel node biopsy. Transoperative pathology analysis reported metastases in 24% of the patients, requiring radical axillary dissection. Sensitivity was 97%, and specificity was 85%, reflecting high efficacy of the sentinel lymph node biopsy, and thus benefitting patients by decreasing morbidity. Sentinel node biopsy is the standard procedure for correct staging of patients with early breast cancer, and no clinical evidence of lymph node involvement. Further, it decreases morbidity in these patients by preventing radical axillary dissection, a previously standard approach, without compromising the diagnosis and hence, the prognosis of the patients. We demonstrated that with the correct technique for sentinel lymph node biopsy, the prognosis for patients is much better than for those patients that undergo radical axillary dissection.
    VL  - 10
    IS  - 1
    ER  - 

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Author Information
  • Gynecologic and Breast Private Group, Hospital Angeles Pedregal, Mexico City, Mexico

  • Gynecologic and Breast Private Group, Hospital Angeles Pedregal, Mexico City, Mexico

  • Gynecologic and Breast Private Group, Hospital Angeles Pedregal, Mexico City, Mexico

  • Gynecologic and Breast Private Group, Hospital Angeles Pedregal, Mexico City, Mexico

  • Gynecologic and Breast Private Group, Hospital Angeles Pedregal, Mexico City, Mexico

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