Our Summary

This research paper is about a study conducted on patients who underwent a certain type of biopsy called sentinel lymph node biopsy (SLNB). This procedure is commonly used for detecting the spread of breast cancer. Most of the time, a combination of isotope (a type of radioactive substance) and blue dye is used to locate the lymph nodes to be removed. However, the blue dye can cause adverse reactions in some patients.

In the study, which was carried out from July 2010 to April 2012, only the isotope was used for locating the lymph nodes if the signal was clear enough, without the need for the blue dye. The researchers studied the records of 426 patients who underwent this isotope-only procedure. They found that the isotope alone was able to accurately locate the lymph nodes in 97.4% of cases.

The researchers also tracked the patients’ health over a median period of about 63.5 months. They found that the rate of cancer recurrence in the armpit area was only 1.4%. The rates of cancer returning in the same breast, spreading to distant parts of the body, or appearing in the opposite breast were 2.8%, 7%, and 1.9% respectively. Fifteen patients (3.5%) died of metastatic breast cancer, which is cancer that has spread beyond the original site.

The researchers concluded that using only the isotope for SLNB is a viable and safe alternative to using both the isotope and blue dye. This approach can avoid the risk of adverse reactions to the blue dye. The low rate of cancer recurrence in the armpit area over more than five years also supports the effectiveness and safety of this method.

FAQs

  1. What is the localization rate for isotope-only sentinel lymph node biopsy?
  2. What are the potential risks associated with using blue dye in sentinel lymph node biopsy?
  3. How does the axillary recurrence rate compare between isotope-only sentinel lymph node biopsy and the dual blue dye/isotope localization technique?

Doctor’s Tip

One helpful tip a doctor might tell a patient about sentinel lymph node biopsy is that isotope-only localization has been shown to have a high success rate and can be a safe alternative to dual isotope/blue dye localization. This can help reduce the risk of adverse reactions associated with blue dye. It is important to discuss all options with your doctor and make an informed decision based on your individual situation.

Suitable For

Patients who are typically recommended sentinel lymph node biopsy include those with clinically node negative breast cancer. The study mentioned in the abstract specifically looked at patients with breast cancer who underwent isotope-only sentinel lymph node localization. This technique had a high localization rate and was found to be a feasible and safe alternative to dual isotope/blue dye localization. Patients who may benefit from sentinel lymph node biopsy include those with early-stage breast cancer, as well as those with larger tumors or tumors with higher risk of metastasis.

Timeline

Before Sentinel Lymph Node Biopsy:

  • Patient is diagnosed with breast cancer and undergoes imaging and biopsy to determine the stage of the disease.
  • Patient discusses treatment options with their healthcare team, including the possibility of a sentinel lymph node biopsy to determine if the cancer has spread to the lymph nodes.
  • Patient undergoes pre-operative testing and preparation for the biopsy procedure.

After Sentinel Lymph Node Biopsy:

  • Patient undergoes the sentinel lymph node biopsy procedure, where a radioactive tracer is injected near the tumor to locate the sentinel lymph node.
  • The surgeon uses a gamma probe to locate the radioactive sentinel lymph node and remove it for examination.
  • The sentinel lymph node is examined for the presence of cancer cells to determine if the cancer has spread to the lymph nodes.
  • If the sentinel lymph node is negative for cancer cells, the patient may be spared further lymph node dissection and may proceed with other treatments such as surgery, radiation, or chemotherapy.
  • If the sentinel lymph node is positive for cancer cells, the patient may require further treatment such as additional lymph node dissection or more aggressive therapy to target the cancer.
  • The patient undergoes follow-up care and monitoring to track their response to treatment and monitor for any signs of recurrence or metastasis.

What to Ask Your Doctor

  1. What are the risks and benefits of using blue dye for sentinel lymph node biopsy compared to using isotope-only localization?
  2. Are there any specific factors that would make me a better candidate for isotope-only localization?
  3. What is the success rate of isotope-only localization in accurately identifying the sentinel lymph node?
  4. How long will the results of the biopsy take to come back, and how will they be communicated to me?
  5. What is the typical recovery process after a sentinel lymph node biopsy, and are there any specific instructions I should follow?
  6. What are the potential complications or side effects of the biopsy procedure?
  7. How will the results of the sentinel lymph node biopsy impact my treatment plan moving forward?
  8. What are the chances of recurrence in the axillary region after a successful sentinel lymph node biopsy?
  9. Are there any long-term effects or considerations I should be aware of following the biopsy procedure?
  10. Are there any alternative methods or technologies that could be considered for sentinel lymph node biopsy in my case?

Reference

Authors: Micha A, Parvaiz MA, O’Riordan L, MacNeill F, Rusby JE. Journal: Clin Breast Cancer. 2022 Jul;22(5):e636-e640. doi: 10.1016/j.clbc.2022.02.012. Epub 2022 Mar 1. PMID: 35396153