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The role of ultrasound and lymphoscintigraphy in the assessment of axillary lymph nodes in patients with breast cancer.

Nieciecki M, Dobruch-Sobczak K, Wareluk P, Gumińska A, Białek E, Cacko M, Królicki L - J Ultrason (2016)

Bottom Line: The importance of ultrasound in patient qualification for sentinel lymph-node biopsy has been discussed in a number of works.Furthermore, different lymphoscintigraphy protocols have been compared in the literature.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Imaging, Mazovian Bródno Hospital, Warsaw, Poland.

ABSTRACT
Breast cancer is the most common malignancy and the leading cause of death due to cancer in European women. Mammography screening programs aimed to increase the detection of early cancer stages were implemented in numerous European countries. Recent data show a decrease in mortality due to breast cancer in many countries, particularly among young women. At the same time, the number of sentinel node biopsy procedures and breast-conserving surgeries has increased. Intraoperative sentinel lymph node biopsy preceded by lymphoscintigraphy is used in breast cancer patients with no clinical signs of lymph node metastasis. Due to the limited sensitivity and specificity of physical examination in detecting metastatic lesions, developing an appropriate diagnostic algorithm for the preoperative assessment of axillary lymph nodes seems to be a challenge. The importance of ultrasound in patient qualification for sentinel lymph-node biopsy has been discussed in a number of works. Furthermore, different lymphoscintigraphy protocols have been compared in the literature. The usefulness of novel radiopharmaceuticals as well as the methods of image acquisition in sentinel lymph node diagnostics have also been assessed. The aim of this article is to present, basing on current guidelines, literature data as well as our own experience, the diagnostic possibilities of axillary lymph node ultrasound in patient qualification for an appropriate treatment as well as the role of lymphoscintigraphy in sentinel lymph node biopsy.

No MeSH data available.


Related in: MedlinePlus

Microscopic image of axillary lymph node cells with the presence of cancer cells – breast cancer metastases. The material for histopathological evaluation was collected during sentinel lymph node biopsy
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Figure 0004: Microscopic image of axillary lymph node cells with the presence of cancer cells – breast cancer metastases. The material for histopathological evaluation was collected during sentinel lymph node biopsy

Mentions: Sentinel lymph node is the first regional lymph node that receives lymph fluid from the primary tumor and, potentially, the first site to which cancer cells are likely to spread via the lymphatic vessels. Elective breast cancer surgery is preceded by lymphoscintigraphy, which allows both, to specify the flow direction of lymph from the tumor, and to perform an intraoperative identification of sentinel lymph node. In the scintigraphic image, sentinel lymph node is visualized as a focus of increased tracer accumulation in the route of lymph flow. There is usually one sentinel lymph node. However, an increased tracer uptake in several lymph nodes is not rare. Tracer accumulation in the parasternal lymph nodes may also occur and its detection is important for planning the extent of adjuvant radiotherapy. It should be remembered that lymphoscintigraphy findings do not provide information on the presence of metastases in the lymph nodes, but it only locates sentinel lymph node(s). During a surgery, the surgeon uses a scintillation detector to locate the lymph node with higher radioactivity compared to background radiation. This allows to sample material for histopathological testing and assessment for the presence of cancer cells (Fig. 4).


The role of ultrasound and lymphoscintigraphy in the assessment of axillary lymph nodes in patients with breast cancer.

Nieciecki M, Dobruch-Sobczak K, Wareluk P, Gumińska A, Białek E, Cacko M, Królicki L - J Ultrason (2016)

Microscopic image of axillary lymph node cells with the presence of cancer cells – breast cancer metastases. The material for histopathological evaluation was collected during sentinel lymph node biopsy
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834366&req=5

Figure 0004: Microscopic image of axillary lymph node cells with the presence of cancer cells – breast cancer metastases. The material for histopathological evaluation was collected during sentinel lymph node biopsy
Mentions: Sentinel lymph node is the first regional lymph node that receives lymph fluid from the primary tumor and, potentially, the first site to which cancer cells are likely to spread via the lymphatic vessels. Elective breast cancer surgery is preceded by lymphoscintigraphy, which allows both, to specify the flow direction of lymph from the tumor, and to perform an intraoperative identification of sentinel lymph node. In the scintigraphic image, sentinel lymph node is visualized as a focus of increased tracer accumulation in the route of lymph flow. There is usually one sentinel lymph node. However, an increased tracer uptake in several lymph nodes is not rare. Tracer accumulation in the parasternal lymph nodes may also occur and its detection is important for planning the extent of adjuvant radiotherapy. It should be remembered that lymphoscintigraphy findings do not provide information on the presence of metastases in the lymph nodes, but it only locates sentinel lymph node(s). During a surgery, the surgeon uses a scintillation detector to locate the lymph node with higher radioactivity compared to background radiation. This allows to sample material for histopathological testing and assessment for the presence of cancer cells (Fig. 4).

Bottom Line: The importance of ultrasound in patient qualification for sentinel lymph-node biopsy has been discussed in a number of works.Furthermore, different lymphoscintigraphy protocols have been compared in the literature.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Imaging, Mazovian Bródno Hospital, Warsaw, Poland.

ABSTRACT
Breast cancer is the most common malignancy and the leading cause of death due to cancer in European women. Mammography screening programs aimed to increase the detection of early cancer stages were implemented in numerous European countries. Recent data show a decrease in mortality due to breast cancer in many countries, particularly among young women. At the same time, the number of sentinel node biopsy procedures and breast-conserving surgeries has increased. Intraoperative sentinel lymph node biopsy preceded by lymphoscintigraphy is used in breast cancer patients with no clinical signs of lymph node metastasis. Due to the limited sensitivity and specificity of physical examination in detecting metastatic lesions, developing an appropriate diagnostic algorithm for the preoperative assessment of axillary lymph nodes seems to be a challenge. The importance of ultrasound in patient qualification for sentinel lymph-node biopsy has been discussed in a number of works. Furthermore, different lymphoscintigraphy protocols have been compared in the literature. The usefulness of novel radiopharmaceuticals as well as the methods of image acquisition in sentinel lymph node diagnostics have also been assessed. The aim of this article is to present, basing on current guidelines, literature data as well as our own experience, the diagnostic possibilities of axillary lymph node ultrasound in patient qualification for an appropriate treatment as well as the role of lymphoscintigraphy in sentinel lymph node biopsy.

No MeSH data available.


Related in: MedlinePlus