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Comparative Study
. 2012 Sep;18(9):CR543-9.
doi: 10.12659/msm.883349.

Surgical sentinel lymph node biopsy in early breast cancer. Could it be avoided by performing a preoperative staging procedure? A pilot study

Alberto Testori  1 , Stefano Meroni, Oana Codrina Moscovici, Paola Magnoni, Paolo Malerba, Arturo Chiti, Daoud Rahal, Roberto Travaglini, Umberto Cariboni, Marco Alloisio, Sergio Orefice
Affiliations
Comparative Study

Surgical sentinel lymph node biopsy in early breast cancer. Could it be avoided by performing a preoperative staging procedure? A pilot study

Alberto Testori et al. Med Sci Monit. 2012 Sep.

Abstract

Background: The aim of this pilot trial was to study the feasibility of sentinel node percutaneous preoperative gamma probe-guided biopsy as a valid preoperative method of assessment of nodal status compared to surgical sentinel lymph node biopsy.

Material/methods: This prospective study enrolled 10 consecutive patients without evidence of axillary lymph node metastases at preoperative imaging. All patients underwent sentinel node occult lesion localization (SNOLL) using radiotracer intradermic injection that detected a "hot spot" corresponding to the sentinel node in all cases. Gamma probe over the skin detection with subsequent ultrasonographically guided needle biopsy of the sentinel node were performed. The percutaneous needle core histopathological diagnosis was compared to the results of the surgical biopsy.

Results: Preoperative sentinel node identification was successful in all patients.

Conclusions: The combination of preoperative gamma probe sentinel node detection and ultrasound-guided biopsy could represent a valid alternative to intraoperative sentinel node biopsy in clinically and ultrasonographically negative axillary nodes, resulting in shorter duration of surgery and lower intraoperative risks.

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Figures

Figure 1
Figure 1
Algorithm of the pilot study: new pre-operative diagnostic approach using US and gamma camera probe over the skin to evaluate the axillary sentinel node.
Figure 2
Figure 2
Flow chart representing axillary US, results of needle core biopsy and results of final pathological sentinel lymph node mnbiopsy (SLNB).
See this image and copyright information in PMC

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