Sentinel node biopsy

Cochran AJ, Roberts A, Wen DR, et al. Update on lymphatic mapping and sentinel node biopsy in the management of patients with melanocytic tumors. Pathology. 2004 36 478-484. 

Erumovitz M, Bodurka DC, Broaddus RR, et al. Lymphatic mapping and sentinel node biopsy in women with high-risk endometrial cancer. Gynecol Oncol. 2007 104 100-103. 

Lymphoscintigraphy and sentinel node biopsy is a minimally invasive technique that samples first echelon lymph nodes and predicts the need of more extensive neck dissection. The accuracy has been assessed on oral cancers undergoing preoperative PET/CT followed by sentinel node biopsy (Civantos et al. 2003). Gross tumour replacement of lymph nodes and redirection of lymphatic flow represented a significant technical issue in oral carcinomas (Civantos et al. 2006). 

Sentinel node biopsy, which has been extensively validated in breast cancer and melanoma, is being used increasingly in the evaluation of penile cancer. The concept of the sentinel node, the first lymph node to contain metastatic cancer within a tumor s lymphatic basin, was introduced by Cabanas in 1977 (Cabanas 1977). Anatomically, the sentinel lymph node was discovered to be part of the lymphatic system around the superficial inferior epigastric vein, and theoretically, skip metastases beyond this node were suppose to be a very rare event. Cabanas recommended bilateral sentinel node biopsy followed by inguino-femoral dissection only when biopsy of the sentinel node was positive. When the sentinel node is negative for metastatic disease, no further surgical treatment was recommended. The reliability of Cabana s approach was limited by its relatively poor localization technique, and therefore failed to gain widespread acceptance. 

Lont AP, Horenblas S, Tanis PJ et al (2003b) Management of clinically node negative penile carcinoma improved survival after the introduction of dynamic sentinel node biopsy. J Urol 170 783-786... 

Perdona S, Autorino R, Gallo L et al (2006) Role of dynamic sentinel node biopsy in penile cancer our experience. J Surg Oncol 93 181-185... 

Local therapy of early-stage breast cancer consists of modified radical mastectomy or lumpectomy plus external-beam radiation therapy. The surgical approach to the ipsilateral axilla may consist of a full level I/II axillary lymph node dissection or a lymph node mapping procedure with sentinel lymph node biopsy. 

Melanoma Thickness Margin of Excision Sentinel Lymph Node Biopsy... 

Axillary lymph nodes should be sampled for staging and prognostic information. Lymphatic mapping with sentinel lymph node biopsy is a new, less invasive alternative to axillary dissection however, the procedure is controversial because of the lack of long-term data. 

Sentinel" Lymph Node Biopsies for Metastatic Melanoma 196... 

SENTINEL LYMPH NODE BIOPSIES FOR METASTATIC MELANOMA ... 

Wick MR. Principles of evidence-based medicine as applied to sentinel lymph node biopsies. Pathol Case Rev. 2008 13 102-108. 

Medalie N, Ackerman AB. Sentinel lymph node biopsy has no benefit for patients with primary cutaneous melanoma an assertion based on comprehensive, critical analysis. 2nd ed. New York Ardor Scribendi Press 2004 1-95. 

Bass SS, Lyman GH, McGann GR, et al. Lymphatic mapping and sentinel lymph node biopsy. Breast J. 1999 5 288-295. 

Gzerniecki BJ, Scheff AM, Callans LS, et al. Immunohistochemistry with pancytokeratins improves the sensitivity of sentinel lymph node biopsy in patients with breast carcinoma. Cancer. 1999 85 1098-1103. 

Gutzmer, R., Kaspari, M., Broderson, (.P. et al. (2002) Specificity of tyrosinase and HMB45 PCR in the detection of melanoma metastases in sentinel lymph node biopsies. Histopathology, 41, 510-518. 

Marchiole P, Buenerd A, Scoazec JY, Dargent D, Mathevet P (2004) Sentinel lymph node biopsy is not accurate in predicting lymph node status for patients with cervical carcinoma. Cancer 100 2154-2159... 

Fig. 7.22 Chemical structures of dyes used for sentinel blue. The latter dye is not tilways approved for sentinel lymph node biopsies—the tiiarylmethane dyes, patent lymph node localization blue V and isosulfan blue, and the thiazine dye, methylene...

Studies in which isosulfan was used for sentinel lymph node biopsies in breast and melanoma patients showed allergic reactions in 1.42 % of patients. With regard to the severe allergic reactions (grade III), the figures were 0.44 % and 0.06 % for isosulfan blue and patent blue V, respectively. 

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