?
Medical and nursing staff should become fami-
liar with the safe use of ionising radiation.
?
Training and a multidisciplinary team approach
are the keys to the success of the technique.
References
1.
Nopajaroonsri C, Luk SC, Simon GT. Ultrastructure of the
normal lymph node.
Am J Pathol
1971; 65:124
2.
Tortora GJ, Grabowski SR.
Principles of anatomy and phy-
siology
.New York: Harper-Collins; 1996: 676678
3.
Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lym-
phatic mapping and sentinel lymphadenectomy for
breast
cancer.
Ann Surg
1994; 220 : 391 398
4.
Krag DN, Weaver DL, Alex JC, Fairbank JT. Surgical re-
section and radiolocalization of the sentinel lymph
node
in
breast cancer using a gamma probe.
Surg Oncol
1993;
2:335340
5.
Alex JC, Krag DN. Gamma-probe guided localization of
lymph nodes.
Surg Oncol
1993; 2 : 137143
6.
Alex JC, Weaver DL, Fairbank JT, Krag DN. Gamma-probe
guided lymph node localization in malignant
melanoma.
Surg Oncol
1993; 2 : 303 308
7.
Albertini JJ, Lyman GH, Cox C, Yeatman T, Balducci L, Ku
N,
Shivers S, Berman C, Wells K, Rapaport D, Shons A, Hor-
ton J, Greenberg H, Nicosia S, Clark R, Cantor A,
Reintgen
DS. Lymphatic mapping and sentinel node biopsy in
the
patient with breast cancer.
JAMA
1996; 276 : 1818 1822
8.
Veronesi U, Paganelli G, Galimberti V, Viale G, Zurrida ST,
Bodeni N, Costa A, Chicco C, Geraghty JG, Luine A,
Sacchini V, Veronesi P. Sentinel-node biopsy to avoid
axil-
lary dissection in breast cancer with clinically
negative
lymph-nodes.
Lancet
1997; 349 : 1864 1867
9.
Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lym-
phatic mapping and sentinel lymphadenectomy for
breast
cancer.
Ann Surg
1994; 220 : 391 398
10. Giuliano AE, Jones RC, Brennan M, Statman R.
Sentinel
lymphadenectomy in breast cancer.
J
Clin Oncol
1997; 15 :
2345 2350
11. Pijpers R, Meijer S, Hoekstra OS, Collet GJ, Comans
FI,
Boom RP, van Diest PJ, Teule GJ. Impact of
lymphoscinti-
graphy on sentinel node identification with
technetium-
99m-colloidal albumin in breast cancer.
J
Nucl Med
1997;
38: 366368
12. Krag D, Weaver D, Ashikaga T, Moffat F, Klimberg
VS,
Shriver C, Feldman S, Kusminsky R, Gadd M, Kuhn J,
Harlow S, Be itsch P. The sentinel node in breast
cancer,
a
multicenter validation study.
N
Engl J Med
1998; 339 :
13. Gulec SA, Moffat FL, Carroll RG, Serafini AN,
Sfakianakis
GN, Allen L, Boggs J, Escobedo D, Pruett CS, Gupta
A,
Livingstone AS, Krag DN. Sentinel lymph node
local-
ization in early breast cancer.
J
Nucl Med
1998; 39 :
1388 1393
14.Krag D, Harlow S, Weaver D, Ashikaga T. Technique
of
sentinel node resection in melanoma and breast
cancer:
probe guided surgery and lymphatic mapping.
Eur J Surg
Oncol
1998; 24 : 89 93
15. Rodier JF, Janser JC. Surgical technical details
improving
sentinel node identification in breast cancer.
Oncol Rep
1997; 4 : 281 283
16. Borgstein PJ, Pijpers R, Comans EF, van Diest PJ, Boom
RP,
Me ije r S. Sentinel lymph node biopsy in breast
cancer:
guidelines and pitfalls of lymphoscintigraphy and
gamma
probe detection.
J
Am Coll Surg
1998; 186 : 275 283
17. Krag DN, Ashikaga T, Harlow SP, Weaver DL.
Development
of sentinel node targeting technique in breast cancer
patients.
Breast
1998; 4 : 67 74
18. Morton DL, Wen D, Wong JH et al. Technical details
of
intraoperative ly mphatic mapping for early stage
mela-
noma.
Arch Surg
1992; 127 : 392 399
19. Noguchi M, Kawahara F, Tsugawa K et al. Sentinel
lymph-
adenectomy in breast cancer: an alternative to
routine
axillary dissection.
Breast Cancer
1998; 5 : 16
20. OHea BJ, Hill AD, El-Shirbiny AM, Yeh SD, Rosen PP,
Coit
DG, Borgen PI,Cody HS. Sentinel lymph node biopsy
in breast cancer: initial experience at Memorial
Sloan-
Kettering Cancer Center.
J
Am Coll Surg
1998; 186 : 423 427
21.Uren RF, Howman-Giles RB, Thompson JF. The value
of
pre-operative lymphoscintigraphy in breast cancer
treat-
ment.
Eur J Cancer
1998; 34 : 203 204
22. Kapteijn BAE, Nieweg OE, Liem I et al. Localizing
the
sentinel node in cutaneous melanoma: gamma probe
detection versus blue dye.
Ann Surg Oncol
1997; 4 : 156 160
23. Cabanas RM. An approach for the treatment of
penile
carcinoma.
Cancer
1977; 39 : 456 466
24. Pijpers R, Borgstein PJ, Meijer S et al. Sentinel node
biopsy in melanoma patients: dynamic lymphoscinti-
graphy followed by intraoperative gamma probe and
vital
dye guidance.
Wor ld J Surg
1997; 21: 788 793
25. Saha S, Espinosa M, Gauthier J, Morrison A, Rohatgi
C,
Dorman S, Ganatra BK, Desai D, Arora M. Diagnostic
and
therapeutic implications of sentinel node mapping
in
colorectal cancer. 51
st
Society of Surgical Oncology, 1
st
Wo r l d F e de r at i o n of Surgical Oncology Societies
Cancer
Symposium, San Diego, Calif, March 2629, 1998: p
31
26. Perkins A. Peroperative nuclear medicine.
Eur J Nucl Med
1993; 20: 573 575
27. McMasters KM, Giuliano AE, Ross MI et al.
Sentinel-
lymph-node biopsy for breast cancer not yet the
stan-
dard of care.
N
Engl J Med
1998; 339 : 990 995
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