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Should the Hunt for Internal Mammary Chain Sentinel Nodes Begin? An Evaluation of 150 Breast Cancer Patients

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Abstract

Background: The aim of this study was to determine the visualization rate, identification rate, and clinical implications of biopsy of sentinel nodes in the internal mammary chain (IMC) in patients with breast cancer.

Methods: From January 1999 to December 2002, 691 sentinel node procedures were performed. Preoperative lymphoscintigraphy was performed after injection of 99mTc-labeled nanocolloid into the tumor (.2 mL; 115 MBq; 3.1 mCi). The sentinel node was surgically identified with the aid of patent blue dye and a gamma ray detection probe.

Results: The sentinel node in the IMC could be harvested in 130 (87%) of the 150 patients in whom it was visualized on the images and contained metastases in 22 (17%) of these 130 cases. In nine patients (7%), the IMC sentinel node was tumor positive, whereas the axilla was tumor-free. Stage migration was seen in all patients with a tumor-positive IMC sentinel node (17%). There was a change of management in 38 (29%) of the 130 patients: institution or omission of radiotherapy to the IMC, adjuvant systemic therapy, or omission of an axillary lymph node dissection.

Conclusions: Pursuit of IMC sentinel nodes improves the staging of patients with breast cancer and enables treatment to be better adjusted to the needs of the individual patient.

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Authors and Affiliations

  1. Department of Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    Susanne H. Estourgie MD, Omgo E. Nieweg MD, PhD, Emiel J. Th. Rutgers MD, PhD, FRCS & Bin B. R. Kroon MD, PhD, FRCS

  2. Department of Nuclear Medicine, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    Renato A. Valdés Olmos MD, PhD

  3. Department of Surgery, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands

    Pieter J. Tanis MD, PhD

  4. Department of Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    Susanne H. Estourgie MD

Authors
  1. Susanne H. Estourgie MD
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  2. Pieter J. Tanis MD, PhD
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  3. Omgo E. Nieweg MD, PhD
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  4. Renato A. Valdés Olmos MD, PhD
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  5. Emiel J. Th. Rutgers MD, PhD, FRCS
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  6. Bin B. R. Kroon MD, PhD, FRCS
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Correspondence to Susanne H. Estourgie MD.

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Estourgie, S.H., Tanis, P.J., Nieweg, O.E. et al. Should the Hunt for Internal Mammary Chain Sentinel Nodes Begin? An Evaluation of 150 Breast Cancer Patients. Ann Surg Oncol 10, 935–941 (2003). https://doi.org/10.1245/ASO.2003.02.015

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  • DOI: https://doi.org/10.1245/ASO.2003.02.015

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