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The concept of the sentinel lymph node is important because of the advent of the sentinel lymph node biopsy technique, also known as a sentinel node procedure. This technique is used in the staging of certain types of cancer to see if they have spread to any lymph nodes, since lymph node metastasis is one of the most important prognostic signs .
The sentinel lymph node biopsy (SLNB) is the standard of care for detecting nodal metastases in cutaneous melanoma patients and has been the most informative prognostic factor to guide subsequent treatment. However, ~85% of patients undergoing this procedure have no evidence of nodal metastasis.
Giuliano authored the results of the Z0011 trial which showed that for women with T1 or T2 primary invasive breast cancer, without palpable axillary lymphadenopathy, and one or two nodes positive for malignancy, the ten-year survival for patients treated with sentinel lymph node biopsy alone was non-inferior to overall survival of patients ...
The sentinel lymph node is the first node that drains the tumor, and subsequent SLN mapping can save 65–70% of patients with breast cancer from having a complete lymph node dissection for what could turn out to be a negative nodal basin.
Although surgeons are able to remove parts of a single lymph node from the body to screen, it is impossible to remove every lymph node and other organs (lungs, liver, bones, etc.) to look for spread. [2] Doctors must assume that the tumor cells have likely spread to other regions of the body if micrometastases are present in one of the lymph nodes.
Lymph node biopsy is a test in which a lymph node or a piece of a lymph node is removed for examination under a microscope (see: biopsy). The lymphatic system is made up of several lymph nodes connected by lymph vessels. The nodes produce white blood cells (lymphocytes) that fight infections. When an infection is present, the lymph nodes swell ...
MSOT may provide a non-radioactive, non-invasive alternative for examination of the metastatic status of the sentinel lymph node. Initial studies have shown that MSOT can detect sentinel lymph nodes based on indocyanine green (ICG) accumulation after injection in the tumor, as well as melanoma metastasis inside the lymph nodes. [22]
To locate the draining lymph nodes or sentinel lymph nodes from a breast cancer tumour, a Technetium-99m based radiopharmaceutical is common. This may be a nanocolloid or sestamibi . [ 7 ] Although imaging with a gamma camera may also take place, the idea of a small gamma probe is that it can be used to identify lymph nodes (or other sites ...