Sentinel node biopsy side effects11/23/2023 ![]() In the UK, current NICE guidelines (NICE 2009) recommend performing SLNB using the dual technique with isotope and blue dye. In specific cases, taking more SLNs can be beneficial for example, there is evidence that larger numbers of SLNs reduce the risk of a false negative biopsy result in patients who have undergone neoadjuvant chemotherapy (Boughey et al. It is important to establish the optimal number of nodes to be biopsied as an over-dissection can lead to an increased risk of lymphoedema, sensory deficit and impaired shoulder mobility (Mansel et al. 2001), current evidence shows that in low risk tumours, the dissection of fewer SLNs still achieves an accurate biopsy result (Low and Littlejohn 2006). 2006).Īlthough early trials highlight an improved accuracy of SLNB with the removal of multiple nodes (Wong et al. Over the last decade sentinel lymph node biopsy (SLNB) has become the accepted method for staging of the axilla in patients with breast cancer and clinically node negative disease (Giuliano et al. However, this study raises the possibility that 1-day may be preferable when higher sentinel lymph node count is beneficial, for example following neoadjuvant chemotherapy. The 1 and 2 day protocols are both effective, therefore choice of protocol should be driven by patient convenience and hospital efficiency. Using 2-day, sentinel lymph node identification failure rate is higher, although within acceptable rates. ![]() ![]() There was a trend for removing more non-sentinel lymph nodes in 2-day protocol. The median (range) number of sentinel lymph nodes removed per patient was 2 (0–7) and 1 (0–11) in the 1- and 2-day protocols respectively (p = 0.08). Number of sentinel lymph nodes, non-sentinel lymph nodes and pathology was compared. Histopathology for all unilateral sentinel lymph node biopsies (March 2012–March 2013) in a single centre were reviewed. This retrospective cohort study compares efficacy between the two protocols. Sentinel lymph nodes are mapped using 99mTechnetium, injected on day of surgery (1-day protocol) or day before (2-day protocol).
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