Techniques for sentinel node biopsy in breast cancer

Gianluca Franceschini, Riccardo Masetti, Giorgia Garganese, Simona Maria Fragomeni, Pierluigi Rinaldi, Ida Paris, Luca Tagliaferri, Fabio Marazzi, Giuseppe Visconti, Sonia Bove, Alessia Romito, Danilo DI Giorgio, Domenico Pagliara, Debora Verri, Ilaria Romito

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Introduction: Sentinel node biopsy (SNB) is the standard of care in women with breast cancer (BC) and clinically non suspicious axillary lymph nodes (LNs), due to its high negative predictive value (NPV) in the assessment of nodal status. SNB has significantly reduced complications related to the axillary lymph node dissection, such as lymphedema and upper limb dysfunction. Evidence acquisition: The gold standard technique for SNB is the blue dye (BD) and technetium labelled nanocolloid (Tc-99m) double technique. However, nuclear medicine is not available in all Institutions and several new tracers and devices have been proposed, such as indocyanine green (ICG) and superparamagnetic iron oxides (SPIO). All these techniques show an accuracy and detection rate not inferior to that of the standard technique, with different specific pros and cons. The choice of how to perform a SNB primarily depends on the surgeon's confidence with the procedure, the availability of nuclear medicine and the economic resources of the Institutions. In this setting, new tracers, hybrid tracers and imaging techniques are being evaluated in order to improve the detection rate of sentinel lymph nodes (SNs) and minimize the number of unnecessary axillary surgeries through an accurate preoperative assessment of nodal status and to guide new minimally invasive diagnostic procedures of SNs. In particular, the contrast-enhanced ultrasound (CEUS) is an active field of research but cannot be recommended for clinical use at this time. Evidence synthesis: The ICG fluorescence technique was superior in terms of DR, as well as having the lowest FNR. The DR descending order was SPIO, Tc, dual modality (Tc/BD), CEUS and BD. Conclusions: This paper is a narrative review of the most common SNB techniques in BC with a focus on recent innovations.
Lingua originaleEnglish
pagine (da-a)1-10
Numero di pagine10
RivistaMinerva Surgery
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • sentinel lymphnode
  • Breast cancer

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