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Periareolar or Peritumoral Injection of Isosulfan Blue and the Effect on the Number of Sentinel Lymph Nodes Examined.

Abstract The conduct of sentinel node biopsy (SLNBx) for breast cancer (BC) has evolved substantially since its original description. No national standards for the performance of SLNBx exist, therefore, we sought to determine the effect of isosulfan blue (ISB) injection technique on nodal harvesting and staging accuracy during SLNBx. Our main outcome measures included the number of SLNs examined and the number of positive axillae in patients undergoing SLNBx after injection of filtered sulfur colloid intradermally and either small volume ISB injected in the periareolar dermis (PA,∼0.75 cc) or large volume peritumoral (PT, 5 cc). Between January 1, 2009, and September 30, 2013, 1357 patients at an academic/community practice setting underwent SLNBx of which 966 (71.2%) were node negative. These patients ranged in age from 27 to 97 years (mean 60.1 years). The majority of patients (76%) underwent PT injection of ISB. There was no significant difference in the mean age of these two groups (61.2 PT vs 59.7 PA years). All were female. The majority of patients (72.7%) had T1 primaries. Nearly 73 per cent of patients were Luminal A/B, 10.8 per cent HER, and 16.4 per cent were triple negative. There was no significant difference in the distribution of T stage (P = 0.56) or breast cancer subtypes between the techniques (P = 0.59). The mean number of nodes examined was 3.1 (range, 1-18). PT patients had a mean of 3.5 (range, 1-18) nodes, whereas PA patients had a mean of 2.4 nodes (range, 1-10) (P < 0.001). The technical aspects of injecting ISB affect the number of nodes harvested during SLNBx but not staging accuracy.
PMID
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Authors

Mayor MeshTerms

Nipples

Keywords
Journal Title the american surgeon
Publication Year Start




PMID- 28234133
OWN - NLM
STAT- MEDLINE
DA  - 20170224
DCOM- 20170310
LR  - 20170310
IS  - 1555-9823 (Electronic)
IS  - 0003-1348 (Linking)
VI  - 83
IP  - 1
DP  - 2017 Jan 01
TI  - Periareolar or Peritumoral Injection of Isosulfan Blue and the Effect on the
      Number of Sentinel Lymph Nodes Examined.
PG  - 98-102
AB  - The conduct of sentinel node biopsy (SLNBx) for breast cancer (BC) has evolved
      substantially since its original description. No national standards for the
      performance of SLNBx exist, therefore, we sought to determine the effect of
      isosulfan blue (ISB) injection technique on nodal harvesting and staging accuracy
      during SLNBx. Our main outcome measures included the number of SLNs examined and 
      the number of positive axillae in patients undergoing SLNBx after injection of
      filtered sulfur colloid intradermally and either small volume ISB injected in the
      periareolar dermis (PA, approximately 0.75 cc) or large volume peritumoral (PT, 5
      cc). Between January 1, 2009, and September 30, 2013, 1357 patients at an
      academic/community practice setting underwent SLNBx of which 966 (71.2%) were
      node negative. These patients ranged in age from 27 to 97 years (mean 60.1
      years). The majority of patients (76%) underwent PT injection of ISB. There was
      no significant difference in the mean age of these two groups (61.2 PT vs 59.7 PA
      years). All were female. The majority of patients (72.7%) had T1 primaries.
      Nearly 73 per cent of patients were Luminal A/B, 10.8 per cent HER, and 16.4 per 
      cent were triple negative. There was no significant difference in the
      distribution of T stage (P = 0.56) or breast cancer subtypes between the
      techniques (P = 0.59). The mean number of nodes examined was 3.1 (range, 1-18).
      PT patients had a mean of 3.5 (range, 1-18) nodes, whereas PA patients had a mean
      of 2.4 nodes (range, 1-10) (P &lt; 0.001). The technical aspects of injecting ISB
      affect the number of nodes harvested during SLNBx but not staging accuracy.
FAU - Weber, Joseph J
AU  - Weber JJ
AD  - Division of Surgical Oncology, Department of Surgery, Brody School of Medicine,
      East Carolina University North Carolina, Greenville, North Carolina, USA.
FAU - Wong, Jan H
AU  - Wong JH
LA  - eng
PT  - Evaluation Studies
PT  - Journal Article
PL  - United States
TA  - Am Surg
JT  - The American surgeon
JID - 0370522
RN  - 0 (Coloring Agents)
RN  - 0 (Rosaniline Dyes)
RN  - 39N9K8S2A4 (iso-sulfan blue)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Breast Neoplasms/*pathology
MH  - Coloring Agents/*administration &amp; dosage
MH  - Female
MH  - Humans
MH  - Lymph Node Excision
MH  - Middle Aged
MH  - *Nipples
MH  - Rosaniline Dyes/*administration &amp; dosage
MH  - Sentinel Lymph Node/*pathology
MH  - Sentinel Lymph Node Biopsy/*statistics &amp; numerical data
EDAT- 2017/02/25 06:00
MHDA- 2017/03/11 06:00
CRDT- 2017/02/25 06:00
PST - ppublish
SO  - Am Surg. 2017 Jan 1;83(1):98-102.

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