Multicenter Trial of Sentinel Node Biopsy for Breast Cancer Using Both Technetium Sulfur Colloid and Isosulfan Blue Dye
Author
Tafra, Lorraine; Lannin, Donald R.; Swanson, Melvin S.; Van Eyk, Jason J.; Verbanac, Kathryn M.; Chua, Arlene N.; Ng, Peter C.; Edwards, Maxine S.; Halliday, Bradford E.; Henry, C. Alan; Sommers, Linda M.; Carman, Claire M.; Molin, Melinda R.; Yurko, John E.; Perry, Roger R.; Williams, Robert
Abstract
Objective
To determine the factors associated with false-negative results
on sentinel node biopsy and sentinel node localization
(identification rate) in patients with breast cancer enrolled in a
multicenter trial using a combination technique of isosulfan
blue with technetium sulfur colloid (Tc99).
Summary Background Data
Sentinel node biopsy is a diagnostic test used to detect
breast cancer metastases. To test the reliability of this
method, a complete lymph node dissection must be performed
to determine the false-negative rate. Single-institution
series have reported excellent results, although one multicenter
trial reported a false-negative rate as high as 29% using
radioisotope alone. A multicenter trial was initiated to test
combined use of Tc99 and isosulfan blue.
Methods
Investigators (both private-practice and academic surgeons)
were recruited after attending a course on the technique of
sentinel node biopsy. No investigator participated in a learning
trial before entering patients. Tc99 and isosulfan blue were
injected into the peritumoral region.
Results
Five hundred twenty-nine patients underwent 535 sentinel
node biopsy procedures for an overall identification rate in
finding a sentinel node of 87% and a false-negative rate of
13%. The identification rate increased and the false-negative
rate decreased to 90% and 4.3%, respectively, after investigators
had performed more than 30 cases. Univariate analysis
of tumor showed the poorest success rate with older patients
and inexperienced surgeons. Multivariate analysis identified
both age and experience as independent predictors of failure.
However, with older patients, inexperienced surgeons, and
patients with five or more metastatic axillary nodes, the falsenegative
rate was consistently greater.
Conclusions
This multicenter trial, from both private practice and academic
institutions, is an excellent indicator of the general
utility of sentinel node biopsy. It establishes the factors that
play an important role (patient age, surgical experience,
tumor location) and those that are irrelevant (prior surgery,
tumor size, Tc99 timing). This widens the applicability of
the technique and identifies factors that require further
investigation. originally published Annals of Surgery, Vol. 233, No. 1, Jan 2001
Subject
Date
2001-01
Citation:
APA:
Tafra, Lorraine, & Lannin, Donald R., & Swanson, Melvin S., & Van Eyk, Jason J., & Verbanac, Kathryn M., & Chua, Arlene N., & Ng, Peter C., & Edwards, Maxine S., & Halliday, Bradford E., & Henry, C. Alan, & Sommers, Linda M., & Carman, Claire M., & Molin, Melinda R., & Yurko, John E., & Perry, Roger R., & Williams, Robert. (January 2001).
Multicenter Trial of Sentinel Node Biopsy for Breast Cancer Using Both Technetium Sulfur Colloid and Isosulfan Blue Dye.
Annals of Surgery,
233(1),
51-
59. Retrieved from
http://hdl.handle.net/10342/3423
MLA:
Tafra, Lorraine, and Lannin, Donald R., and Swanson, Melvin S., and Van Eyk, Jason J., and Verbanac, Kathryn M., and Chua, Arlene N., and Ng, Peter C., and Edwards, Maxine S., and Halliday, Bradford E., and Henry, C. Alan, and Sommers, Linda M., and Carman, Claire M., and Molin, Melinda R., and Yurko, John E., and Perry, Roger R., and Williams, Robert.
"Multicenter Trial of Sentinel Node Biopsy for Breast Cancer Using Both Technetium Sulfur Colloid and Isosulfan Blue Dye". Annals of Surgery.
233:1. (51-59),
January 2001.
April 25, 2024.
http://hdl.handle.net/10342/3423.
Chicago:
Tafra, Lorraine and Lannin, Donald R. and Swanson, Melvin S. and Van Eyk, Jason J. and Verbanac, Kathryn M. and Chua, Arlene N. and Ng, Peter C. and Edwards, Maxine S. and Halliday, Bradford E. and Henry, C. Alan and Sommers, Linda M. and Carman, Claire M. and Molin, Melinda R. and Yurko, John E. and Perry, Roger R. and Williams, Robert,
"Multicenter Trial of Sentinel Node Biopsy for Breast Cancer Using Both Technetium Sulfur Colloid and Isosulfan Blue Dye," Annals of Surgery 233, no.
1 (January 2001),
http://hdl.handle.net/10342/3423 (accessed
April 25, 2024).
AMA:
Tafra, Lorraine, Lannin, Donald R., Swanson, Melvin S., Van Eyk, Jason J., Verbanac, Kathryn M., Chua, Arlene N., Ng, Peter C., Edwards, Maxine S., Halliday, Bradford E., Henry, C. Alan, Sommers, Linda M., Carman, Claire M., Molin, Melinda R., Yurko, John E., Perry, Roger R., Williams, Robert.
Multicenter Trial of Sentinel Node Biopsy for Breast Cancer Using Both Technetium Sulfur Colloid and Isosulfan Blue Dye. Annals of Surgery.
January 2001;
233(1):
51-59.
http://hdl.handle.net/10342/3423. Accessed
April 25, 2024.
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Publisher
East Carolina University