Thoracoscopic internal mammary sentinel node biopsy

An animal model of a new technique

Eli Avisar, Sayeed Ikramuddin, Howard Edington

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background. The nodal status remains the most important prognostic factor in breast cancer. While evaluation of the axillary lymph nodes remains a standard of practice, evaluation of the internal mammary lymph nodes is no longer routinely performed. In the era of extensive radical mastectomies, it was shown that up to 40% of breast cancer patients had nodal metastases in the internal mammary chain. This resulted in up to 10% of presumed "node-negative" patients actually being node-positive when the internal mammary nodes were examined. In the era of sentinel node biopsies, hot internal mammary nodes on lymphoscintigraphy are sometimes encountered and confusion exists regarding the appropriate approach to these nodes. New advances in endoscopic surgery have enabled a minimally invasive approach to the mediastinum. The aim of this study was to evaluate the feasibility of thoracoscopic internal mammary sentinel node biopsy in an animal model. Materials and methods. Five farm pigs were injected with isosulphan blue under the right upper nipple. After a sentinel node was identified, it was dissected thoracoscopically. Results. In all the animals, an internal mammary blue node was easily identified 1-5 min after the injection and dissected with thoracoscopic instruments without significant damage to other thoracic structures. The procedure length averaged 30 to 60 min. Conclusions. Thoracoscopic internal mammary sentinel node biopsies are feasible, short, easy to perform, minimally invasive, and well focused toward a sentinel node. Well-planned phase I studies should be initiated to further evaluate this new technique.

Original languageEnglish
Pages (from-to)254-257
Number of pages4
JournalJournal of Surgical Research
Volume106
Issue number2
DOIs
StatePublished - Oct 14 2002
Externally publishedYes

Fingerprint

Breast
Animal Models
Biopsy
Lymph Nodes
Breast Neoplasms
Radical Mastectomy
Lymphoscintigraphy
Nipples
Mediastinum
cyhalothrin
Swine
Thorax
Neoplasm Metastasis
Injections

ASJC Scopus subject areas

  • Surgery

Cite this

Thoracoscopic internal mammary sentinel node biopsy : An animal model of a new technique. / Avisar, Eli; Ikramuddin, Sayeed; Edington, Howard.

In: Journal of Surgical Research, Vol. 106, No. 2, 14.10.2002, p. 254-257.

Research output: Contribution to journalArticle

Avisar, Eli ; Ikramuddin, Sayeed ; Edington, Howard. / Thoracoscopic internal mammary sentinel node biopsy : An animal model of a new technique. In: Journal of Surgical Research. 2002 ; Vol. 106, No. 2. pp. 254-257.
@article{099f767fef964a289447aaf11879a969,
title = "Thoracoscopic internal mammary sentinel node biopsy: An animal model of a new technique",
abstract = "Background. The nodal status remains the most important prognostic factor in breast cancer. While evaluation of the axillary lymph nodes remains a standard of practice, evaluation of the internal mammary lymph nodes is no longer routinely performed. In the era of extensive radical mastectomies, it was shown that up to 40{\%} of breast cancer patients had nodal metastases in the internal mammary chain. This resulted in up to 10{\%} of presumed {"}node-negative{"} patients actually being node-positive when the internal mammary nodes were examined. In the era of sentinel node biopsies, hot internal mammary nodes on lymphoscintigraphy are sometimes encountered and confusion exists regarding the appropriate approach to these nodes. New advances in endoscopic surgery have enabled a minimally invasive approach to the mediastinum. The aim of this study was to evaluate the feasibility of thoracoscopic internal mammary sentinel node biopsy in an animal model. Materials and methods. Five farm pigs were injected with isosulphan blue under the right upper nipple. After a sentinel node was identified, it was dissected thoracoscopically. Results. In all the animals, an internal mammary blue node was easily identified 1-5 min after the injection and dissected with thoracoscopic instruments without significant damage to other thoracic structures. The procedure length averaged 30 to 60 min. Conclusions. Thoracoscopic internal mammary sentinel node biopsies are feasible, short, easy to perform, minimally invasive, and well focused toward a sentinel node. Well-planned phase I studies should be initiated to further evaluate this new technique.",
author = "Eli Avisar and Sayeed Ikramuddin and Howard Edington",
year = "2002",
month = "10",
day = "14",
doi = "10.1006/jsre.2002.6445",
language = "English",
volume = "106",
pages = "254--257",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",
number = "2",

}

TY - JOUR

T1 - Thoracoscopic internal mammary sentinel node biopsy

T2 - An animal model of a new technique

AU - Avisar, Eli

AU - Ikramuddin, Sayeed

AU - Edington, Howard

PY - 2002/10/14

Y1 - 2002/10/14

N2 - Background. The nodal status remains the most important prognostic factor in breast cancer. While evaluation of the axillary lymph nodes remains a standard of practice, evaluation of the internal mammary lymph nodes is no longer routinely performed. In the era of extensive radical mastectomies, it was shown that up to 40% of breast cancer patients had nodal metastases in the internal mammary chain. This resulted in up to 10% of presumed "node-negative" patients actually being node-positive when the internal mammary nodes were examined. In the era of sentinel node biopsies, hot internal mammary nodes on lymphoscintigraphy are sometimes encountered and confusion exists regarding the appropriate approach to these nodes. New advances in endoscopic surgery have enabled a minimally invasive approach to the mediastinum. The aim of this study was to evaluate the feasibility of thoracoscopic internal mammary sentinel node biopsy in an animal model. Materials and methods. Five farm pigs were injected with isosulphan blue under the right upper nipple. After a sentinel node was identified, it was dissected thoracoscopically. Results. In all the animals, an internal mammary blue node was easily identified 1-5 min after the injection and dissected with thoracoscopic instruments without significant damage to other thoracic structures. The procedure length averaged 30 to 60 min. Conclusions. Thoracoscopic internal mammary sentinel node biopsies are feasible, short, easy to perform, minimally invasive, and well focused toward a sentinel node. Well-planned phase I studies should be initiated to further evaluate this new technique.

AB - Background. The nodal status remains the most important prognostic factor in breast cancer. While evaluation of the axillary lymph nodes remains a standard of practice, evaluation of the internal mammary lymph nodes is no longer routinely performed. In the era of extensive radical mastectomies, it was shown that up to 40% of breast cancer patients had nodal metastases in the internal mammary chain. This resulted in up to 10% of presumed "node-negative" patients actually being node-positive when the internal mammary nodes were examined. In the era of sentinel node biopsies, hot internal mammary nodes on lymphoscintigraphy are sometimes encountered and confusion exists regarding the appropriate approach to these nodes. New advances in endoscopic surgery have enabled a minimally invasive approach to the mediastinum. The aim of this study was to evaluate the feasibility of thoracoscopic internal mammary sentinel node biopsy in an animal model. Materials and methods. Five farm pigs were injected with isosulphan blue under the right upper nipple. After a sentinel node was identified, it was dissected thoracoscopically. Results. In all the animals, an internal mammary blue node was easily identified 1-5 min after the injection and dissected with thoracoscopic instruments without significant damage to other thoracic structures. The procedure length averaged 30 to 60 min. Conclusions. Thoracoscopic internal mammary sentinel node biopsies are feasible, short, easy to perform, minimally invasive, and well focused toward a sentinel node. Well-planned phase I studies should be initiated to further evaluate this new technique.

UR - http://www.scopus.com/inward/record.url?scp=0036389454&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036389454&partnerID=8YFLogxK

U2 - 10.1006/jsre.2002.6445

DO - 10.1006/jsre.2002.6445

M3 - Article

VL - 106

SP - 254

EP - 257

JO - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

IS - 2

ER -