Skip to main content
SpringerLink
Log in

Sentinel Node Identification using Radionuclides in Melanoma and Breast Cancer

  • Chapter
Cancer Metastasis And The Lymphovascular System: Basis For Rational Therapy

Part of the book series: Cancer Treatment and Research ((CTAR,volume 135))

The metastatic spread of breast cancer to regional lymph nodes has been recognized for centuries (1), and the propensity of melanoma for lymphatic spread was documented in the nineteenth century (2).The basis for the sentinel node hypothesis is that tumors with a propensity for lymphatic invasion initially spread preferentially to nodes located on their draining lymphatic pathways. Hence these lymph nodes are the ones most likely to contain metastatic cells (3, 4), and they can be regarded as sentinel for the lymphatic spread of the cancer. Knowledge of the tumor status of these sentinel lymph nodes is now recognized as essential for staging and treating malignancies with a propensity for lymphatic invasion. Before discussing the mechanics and details of sentinel node localization, it is worthwhile to review relevant lymphatic physiology.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Kardinal CG, Yabro JW: A conceptual history of cancer. Semin. Oncol. 1979; 6:396–408.

    PubMed  CAS  Google Scholar 

  2. Snow H: Melanotic cancerous disease. Lancet 1892; 2:872.

    Google Scholar 

  3. Cabanas RM: An approach for the treatment of penile carcinoma. Cancer 1977; 39:456–466.

    Article  PubMed  CAS  Google Scholar 

  4. Morton DL, Wen DR, Wong J, et al: Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 1992; 127:392–399.

    PubMed  CAS  Google Scholar 

  5. Leung MY, Liu C, Koon JC, Fung KP: Polysaccharide biologic response modifiers. Immunol Lett 2006; 105(2):101–14.

    Article  PubMed  CAS  Google Scholar 

  6. Frangioni JV: In vivo near-infrared fluorescence imaging. Curr Opin Chem Biol 2003; 7(5):626–34.

    Article  PubMed  CAS  Google Scholar 

  7. Vera DR, Wallace AM, Hoh C, Mattrey RF: A synthetic macromolecule for sentinel node detection: (99m) Tc-DTPA-Mannosyl-Dextran. J Nucl Med 2001; 42:951–959.

    PubMed  CAS  Google Scholar 

  8. Torabi M, Aquino SL, Harasinghani MG: Current concepts in lymph node imaging. J Nucl Med 2004; 45(9):1509–18.

    PubMed  Google Scholar 

  9. Sherman AI, Ter-Pogossian M: Lymph-node concentration of radioactive colloidal gold following interstitial injection. Cancer 1953; 6:1238–40.

    Article  PubMed  CAS  Google Scholar 

  10. Sage HH, Kizilay D, Miyazaki M, Shapiro G, Sinha B: Lymph node scintigrams. Am J Roentgenol, Rad Therapy, and Nuclear Medicine 1960; 84:666–72.

    Google Scholar 

  11. Ege GN: Internal mammary lymphoscintigraphy. Radiology 1976; 118:101–7.

    PubMed  CAS  Google Scholar 

  12. Ariel IM, Resnick MI, Oropeza R: The intralymphatic administration of radioactive isotopes for treating malignant melanoma. Surgery, Gynecol, & Obstet 1967; 124:1–15.

    Google Scholar 

  13. Seitzman DM, Wright R, Halaby FA, Freeman JH: Radioactive lymphangiography as a therapeutic adjunct. Am J Roentgen Rad Ther & Nucl Med. 1963; LXXXIX; 140–9.

    Google Scholar 

  14. Bennett LR, Lago G. Cutaneous lymphoscintigraphy in malignant melanoma. Semin Nucl Med 1983; 13:61–69.

    Article  PubMed  CAS  Google Scholar 

  15. Uren RF, Howman-Giles RB, Shaw HM, Thompson JF, McCarthy WH. Lymphoscintigraphy in high risk melanoma of the trunk: predicting drainage node groups, defining lymphatic channels, and locating the sentinel node. J Nucl Med 1993; 34:1435–1440.

    PubMed  CAS  Google Scholar 

  16. Glass EC, Essner R, Morton DL: Comparison of three lymphoscintigraphic agents in patients with cutaneous melanoma. J Nucl Med 1998; 39:1185–1190.

    PubMed  CAS  Google Scholar 

  17. Ikomi F, Hanna GK, Schmid-Schonbein GW: Mechanism of colloidal particle uptake into the lymphatic system: Basic study with percutaneous lymphography. Radiology 1995; 196:107–115.

    PubMed  CAS  Google Scholar 

  18. Tafra L, Chua AN, Ng PC, Aycock D, Swanson M, Lannin D: Filtered versus unfiltered sulfur colloid in lymphatic mapping: A significant variable in a pig model. Ann Surg Oncol 1999; 6(1):83–87.

    Article  PubMed  CAS  Google Scholar 

  19. Bergqvist L, Strand S-E, Persson BRR: Particle sizing and biokinetics of interstitial lymphoscintigraphic agents. Semin Nucl Med 1983; XII:9–19.

    Article  Google Scholar 

  20. Krynyckyi BR, Zhang ZY, Kim CK, Lipszyc H, Mosci K, Machac J: Effect of high specific-activity sulfur colloid preparations on sentinel node count rates. Clin Nucl Med. 2002 Feb; 27(2):92–5.

    Article  PubMed  Google Scholar 

  21. Babiera GV, Delpassand ES, Breslin TM, et al: Lymphatic drainage patterns on early versus delayed breast lymphoscintigraphy performed after injection of filtered Tc99m sulfur colloid in breast cancer patients undergoing sentinel lymph node biopsy. Clin Nucl Med 2005; 30:11–15.

    Article  PubMed  Google Scholar 

  22. Gray RJ, Pockaj BA, Roarke MC: Injection of Tc99m-labeled sulfur colloid the day before operation for breast cancer sentinel node mapping is as successful as injection the day of operation. Am J Surg 2004; 188:685–689.

    Article  PubMed  Google Scholar 

  23. Haigh PI, Hansen NM, Giuliano AE, Edwards GK, Ye W, Glass EC: Factors affecting sentinel node localization during preoperative breast lymphoscintigraphy. J Nucl Med 2000; 41:1682–1688.

    PubMed  CAS  Google Scholar 

  24. Kersey TW, Van Eyk J, Lannin DR, Chua AN, Tafra L: Comparison of intradermal and subcutaneous injections in lymphatic mapping. J Surg Res 2001 Apr; 96(2):255–259.

    Article  PubMed  CAS  Google Scholar 

  25. El-Tamer M, Saouaf R, Wang T, Fawwaz R: A new agent, blue and radioactive, for sentinel node detection. Ann Surg Oncol 2003; 10(3):323–329.

    Article  PubMed  Google Scholar 

  26. Sutton R, Tsopelas C, Kollias J, Coventry B, Chatterton BE: Sentinel node biopsy and lymphoscintigraphy with a technetium 99m labeled blue dye in a rabbit model. Surgery 2002; 131(1):44–9.

    Article  PubMed  Google Scholar 

  27. Tsopelas C, Bevington K, Kollias J, Shibli S, Farshid J, Coventry B, Chatterton BE: 99mTc-Evans blue dye for mapping contiguous lymph node sequences and discriminating the sentinel lymph node in an ovine model. Ann Surg Oncol. 2006; 13(5):692–700.36.

    Article  PubMed  Google Scholar 

  28. Nieweg OE, Tanis PJ, Rutgers EJ: Summary of the Second International Sentinel Node Conference. Eur J Nucl Med 2001 May; 28(5):646–649.

    Article  PubMed  CAS  Google Scholar 

  29. Bostick P, Essner R, Glass EC, et al: Comparison of blue dye and probe-assisted intraoperative lymphatic mapping in melanoma to identify sentinel nodes in 100 lymphatic basins. Arch Surg 1999; 134:43–49.

    Article  PubMed  CAS  Google Scholar 

  30. Rettenbacher L, Koller J, Kassman H, Holzmannhofer J, Rettenbacher T, Galvan G: Reproducibility of lymphoscintigraphy in cutaneous melanoma: Can we accurately detect the sentinel lymph node by expanding the tracer injection distance from the tumor site? J Nucl Med 2001; 42:424–429.

    PubMed  CAS  Google Scholar 

  31. Kapteijn BAE, Nieweg OE, Valdes Olmos RA, et al: Reproducibility of lymphoscintigraphy for lymphatic mapping in cutaneous melanoma. J Nucl Med 1996; 37:972–976.

    PubMed  CAS  Google Scholar 

  32. Mudun A, Murray DR, Herda SC, et al: Early stage melanoma: lymphoscintigraphy, reproducibility of sentinel node detection, and effectiveness of the intraoperative gamma probe. Radiology 1996; 199: 171–175.

    PubMed  CAS  Google Scholar 

  33. Nieweg OE, Rijk MC, Valdes Olmos RA, Hoefnagel CA: Sentinel node biopsy and selective lymph node clearance–impact on regional control and survival in breast cancer and melanoma. Eur J Nucl Med Mol Imaging 2005; 32:631–634.

    Article  PubMed  Google Scholar 

  34. Morton DL, Thompson JF, Cochran AJ, Mozillo N, Elashoff R, Essner R, Nieweg O, Roses DF, Hoekstra HJ, Karakousis CP, Rientgen DS, Coventry BJ, Glass EC, Wang HJ: Sentinel node biopsy or observation in melanoma. New Engl J Med 2006; 355(13) 1307 Glass EC, Essner R, Giuliano AE: Sentinel node localization in breast cancer. Semin Nucl. Med 1999; XXIX:57–68.

    Google Scholar 

  35. Duncan M, Cech A, Wechter D, Moonka R: Criteria for establishing the adequacy of a sentinel lymphadenectomy. Am J Surg 2004; 187:639–642.

    Article  PubMed  Google Scholar 

  36. Woznick A, Franco M, Bendick P, Benitez PR: Sentinel lymph node dissection for breast cancer: how many nodes are enough and which technique is optimal? Am J Surg 2006; 191:330–333.

    Article  PubMed  Google Scholar 

  37. Feggi L, Basaglia E, Corcione S, Querzoli P, Soliani G, Ascanelli S, Prandini N, Bergossi L, Carcoforo P: An original approach in the diagnosis of breast cancer: Use of the same radiopharmaceutical for both non-palpable lesions and sentinel node localization. Eur J Nucl Med 2001; 28(11):1589–96.

    Article  PubMed  CAS  Google Scholar 

  38. Canavese G, Gioponi M, Catturic A, et al: Pattern of lymphatic drainage to the sentinel lymph node in breast cancer patients. J Surg Oncol. 2000; 74(1):69–74.

    Article  PubMed  CAS  Google Scholar 

  39. Kapteijn BA, Nieweg OE, Petersen JL, Rutgers EJ, Hart AA van Dongen JA, Kroon BB: Identification and biopsy of the sentinel lymph node in breast cancer. Eur J Surg Oncol. 1998; 24(5):427–30.

    Article  PubMed  CAS  Google Scholar 

  40. Byrd DR, Dunnwald LK, Mankoff DA, Anderson BO, Moe RE, Yeung RS, Schubert EK, Eary JF: Internal mammary lymph node drainage patterns in patients with breast cancer documented by lymphoscintigraphy. Ann Surg Oncol 2001; 8:234–240.

    Article  PubMed  CAS  Google Scholar 

  41. Roumen RMH, Geuskens LM, Valkenburg JGH: In search of the true sentinel node by different injection techniques in breast cancer patients. Eur J Surg Oncol 1999; 25:347–351.

    Article  PubMed  CAS  Google Scholar 

  42. Shen P, Glass EC, Hansen N, Giuliano AE: Dermal versus intraparenchymal lymphoscintigraphy of the breast. Ann Surg Oncol. 2001 Apr; 8(3):241–8.

    Article  PubMed  CAS  Google Scholar 

  43. Estourgie SH, Nieweg OE, Valdes Olmos RA, Rutgers EJT, Kroon BR: Intratumoral versus intraparenchymal injection for lymphoscintigraphy in breast cancer. Clin Nucl Med 2003; 28(5):371–4.

    Article  PubMed  Google Scholar 

  44. Tanis PJ, van Sandick JW, Nieweg OE, Valdes Olmos RA, Rutgers EJ, Hoefnagel CA, Kroon BB.: The hidden sentinel node in breast cancer. Eur J Nucl Med Mol Imaging. 2002 Mar; 29(3):305–11.

    Google Scholar 

  45. Tafra L, Lannin DR, Swanson MS, Van Eyk JJ, Verbanac KM, Chua AN, Ng PC, Edwards MS, Halliday BE, Henry CA, Sommers LM, Carman CM, Molin MR, Yurko JE, Perry RR, Williams R: Multicenter trial of sentinel node biopsy for breast cancer using both technetium sulfur colloid and isosulfan blue dye. Ann Surg. 2001 Jan; 233(1):51–9.

    Article  PubMed  CAS  Google Scholar 

  46. Lamonica D, Edge SB, Hurd T, Proulx G, Stomper PC: Mammographic and clinical predictors of drainage patterns in breast lymphoscintigrams obtained during sentinel node procedures. Clin Nucl Med 2003; 28(7):558–564.

    Article  PubMed  Google Scholar 

  47. Kinoshita T, Takasugi M, Iwamoto E, Akashi-Tanaka S, Fukutomi T, Terui S: Sentinel lymph node biopsy for breast cancer patients with clinically negative axillary lymph nodes after neoadjuvant chemotherapy. Am J Surg 2006; 191:225–229.

    Article  PubMed  Google Scholar 

  48. Avery M, Nathanson SD, Hetzel FW. Lymph flow from murine foot pad tumors before and after sublethal hyperthermia. Radiation Research 1992; 132:50–53.

    Article  PubMed  CAS  Google Scholar 

  49. Valdes Olmos RA, Tanis PJ, Hoefnagel CA, Nieweg OE, Muller SH, Rutgers EJ, Kooi ML, Kroon BB: Improved sentinel node visualization in breast by optimizing the colloid particle concentration and tracer dosage. Nucl Med Commun 2001; 22(5):579–86.

    Article  PubMed  CAS  Google Scholar 

  50. Waddington WA, Keshtar MR, Taylor I, Lakhani SR, Short MD, Ell PJ: Radiation Safety of the sentinel node technique in breast cancer. Eur J Nucl Med 2000; 27(4):377–391.

    Article  PubMed  CAS  Google Scholar 

  51. Eshima D, Fauconnier T, Eshima L, Thornback JR: Radiopharmaceuticals for lymphoscintigraphy: Including dosimetry and radiation considerations. Semin Nucl Med 2000; XXX(1):56–64.

    Google Scholar 

  52. Glass EC, Basinski JE, Krasne DL, Giuliano AE: Radiation safety considerations for sentinel node techniques. Ann Surg Oncol 1999; 6:10–1.

    Article  PubMed  CAS  Google Scholar 

  53. Bronskill MJ: Radiation dose estimates for interstitial radiocolloid lymphoscintigraphy. Semin Nucl Med 1983; XIII: 20–25.

    Article  Google Scholar 

  54. Kohn HI, Fry RJM: Radiation carcinogenesis. N Engl J Med 1984; 310:504–511.

    Article  PubMed  CAS  Google Scholar 

  55. Wanebo CK, Johnson KG, Sato K, Thorslund TW: Breast cancer after the exposure to the atomic bombings of Hiroshima and Nagasaki. N Engl J Med 1968;279: 667–671.

    PubMed  CAS  Google Scholar 

  56. Huston TL, Simmons RM: Locally recurrent breast cancer after breast conservation. Am J Surgery 2005; 189:229–35.

    Article  Google Scholar 

  57. Stratman SL, McCarty TM, Kuhn JA: Radiation safety with breast sentinel node biopsy. Am J Surg 1999; 178:454–7.

    Article  Google Scholar 

  58. Miner TJ, Shriver CD, Flicek PR, Miner FC, Jaques DP, Maniscalco-Theberge ME, Krag DN: Guidelines for the safe use of radioactive materials during the localization and resection of the sentinel lymph node. Ann Surg Oncol. Ann Surg Oncol 1999 Jan-Feb; 6(1):75–82.

    CAS  Google Scholar 

  59. Fitzgibbons PL, LiVolsi VA: Recommendations for handling Radioactive specimens obtained by sentinel lymphadenectomy. Am J Surg Pathol 2000; 24(11):1549–51.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. John Wayne Cancer Institute, Santa Monica, CA, USA

    Edwin Glass MD

Authors
  1. Edwin Glass MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. University of California San Francisco and UCSF Comprehensive Cancer Center at Mount Zion, 1600 Divisadero Street, 94143, San Francisco, CA, USA

    Stanley P. L. Leong MD, FACS

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Glass, E. (2007). Sentinel Node Identification using Radionuclides in Melanoma and Breast Cancer. In: Leong, S.P.L. (eds) Cancer Metastasis And The Lymphovascular System: Basis For Rational Therapy. Cancer Treatment and Research, vol 135. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-69219-7_7

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-69219-7_7

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-387-69218-0

  • Online ISBN: 978-0-387-69219-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation