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Table of Contents
Intro
Foreword
Preface
Contents
About the Editor
1: Evolution of Sentinel Lymph Node Biopsy
1.1 Introduction
1.2 Understanding the Evolving History of the Sentinel Lymph Node
1.3 Sentinel Node Biopsy in Breast Cancer
References
2: Surgical Anatomy of the Axilla
2.1 Introduction
2.2 Surgical Anatomy of the Axilla
2.3 Surgical Anatomy of Lymph Nodes of Axilla
2.4 Radiological Anatomy of a Malignant Lymph Node
2.5 Anatomy of the Axillary Vein
2.6 Surgical Concept of Axillary Dissection with a Critical Insight of the Relevant Neuroanatomy Related to Axillary Dissection
2.7 Anatomical Anomalies of the Axilla
2.8 Complications of Anatomical Abberations in the Axilla
References
3: Defining an N0 Axilla: Pre-SNB Assessment of the Axilla
3.1 Defining an N0 Axilla
3.2 Physical Examination
3.3 Ultrasound Scan Examination
3.4 Fine-Needle Aspiration and Core Needle Biopsy
3.4.1 Fine-Needle Aspiration
3.4.2 Core Needle Biopsy
3.5 Other Imaging Test to Pre-operatively Assess the Axillary Status
3.5.1 MRI
3.5.2 Chest CT, PET or PET-CT Scan
3.6 Axillary Work-Up According to Guidelines
3.7 Defining an N0 Axilla in Clinical Trials
3.8 Predictive Nomograms in the Pre-operative Assessment of Axillary Status
3.9 Future Perspectives in Defining an N0 Axilla
References
4: Validation Trials of Sentinel Node Biopsy in Breast Cancer
4.1 Introduction
4.2 Sentinel Lymph Node (SLN) Biopsy: Initially Reported Studies on Breast Cancer
4.3 Validation of SLNB in Breast Cancer (Tables 4.1 and 4.2)
4.3.1 Understanding the Validation of SLN
4.3.2 Landmark Trials
4.3.2.1 The Milan Trial
Technical Results
4.3.2.2 National Surgical Adjuvant Breast and Bowel Project (NSABP) B-32
Training and Reducing FNR
4.3.2.3 SENTINELLA/GIVOM [18]
Technical Findings
4.3.2.4 The Axillary Lymph Mapping Against Nodal Axillary Clearance (ALMANAC) Trial
Technical Findings
4.3.2.5 RACS Sentinel Node Biopsy Versus Axillary Clearance (SNAC) 1 Trial [20]
Technical Results
References
5: Sentinel Lymph Node Biopsy in Breast Cancer-Techniques
5.1 Blue Dye
5.1.1 Isosulfan Blue
5.1.2 Patent Blue V
5.1.3 Methylene Blue
5.2 Radioactive Colloid
5.3 Sentinel Lymph Node Biopsy: The Technique
5.3.1 Sites of Injection
5.3.1.1 Intradermal, Intraparenchymal and Sub-areolar
5.4 Dosage
5.4.1 Blue Dye
5.4.2 Radioactive Colloid
5.4.3 1-Day Protocol (Interval of 1-6 h)
5.4.4 2-Day Protocol (Interval of 16-20 h)
5.5 Pre-operative Lymphoscintigraphy
5.6 Steps of SLNB
References
6: Complications of SLNB in Breast Cancer
6.1 Introduction
6.2 Surgical Management of the Axilla
6.3 Complications
6.3.1 Lymphoedema
6.3.2 Seroma Formation
Foreword
Preface
Contents
About the Editor
1: Evolution of Sentinel Lymph Node Biopsy
1.1 Introduction
1.2 Understanding the Evolving History of the Sentinel Lymph Node
1.3 Sentinel Node Biopsy in Breast Cancer
References
2: Surgical Anatomy of the Axilla
2.1 Introduction
2.2 Surgical Anatomy of the Axilla
2.3 Surgical Anatomy of Lymph Nodes of Axilla
2.4 Radiological Anatomy of a Malignant Lymph Node
2.5 Anatomy of the Axillary Vein
2.6 Surgical Concept of Axillary Dissection with a Critical Insight of the Relevant Neuroanatomy Related to Axillary Dissection
2.7 Anatomical Anomalies of the Axilla
2.8 Complications of Anatomical Abberations in the Axilla
References
3: Defining an N0 Axilla: Pre-SNB Assessment of the Axilla
3.1 Defining an N0 Axilla
3.2 Physical Examination
3.3 Ultrasound Scan Examination
3.4 Fine-Needle Aspiration and Core Needle Biopsy
3.4.1 Fine-Needle Aspiration
3.4.2 Core Needle Biopsy
3.5 Other Imaging Test to Pre-operatively Assess the Axillary Status
3.5.1 MRI
3.5.2 Chest CT, PET or PET-CT Scan
3.6 Axillary Work-Up According to Guidelines
3.7 Defining an N0 Axilla in Clinical Trials
3.8 Predictive Nomograms in the Pre-operative Assessment of Axillary Status
3.9 Future Perspectives in Defining an N0 Axilla
References
4: Validation Trials of Sentinel Node Biopsy in Breast Cancer
4.1 Introduction
4.2 Sentinel Lymph Node (SLN) Biopsy: Initially Reported Studies on Breast Cancer
4.3 Validation of SLNB in Breast Cancer (Tables 4.1 and 4.2)
4.3.1 Understanding the Validation of SLN
4.3.2 Landmark Trials
4.3.2.1 The Milan Trial
Technical Results
4.3.2.2 National Surgical Adjuvant Breast and Bowel Project (NSABP) B-32
Training and Reducing FNR
4.3.2.3 SENTINELLA/GIVOM [18]
Technical Findings
4.3.2.4 The Axillary Lymph Mapping Against Nodal Axillary Clearance (ALMANAC) Trial
Technical Findings
4.3.2.5 RACS Sentinel Node Biopsy Versus Axillary Clearance (SNAC) 1 Trial [20]
Technical Results
References
5: Sentinel Lymph Node Biopsy in Breast Cancer-Techniques
5.1 Blue Dye
5.1.1 Isosulfan Blue
5.1.2 Patent Blue V
5.1.3 Methylene Blue
5.2 Radioactive Colloid
5.3 Sentinel Lymph Node Biopsy: The Technique
5.3.1 Sites of Injection
5.3.1.1 Intradermal, Intraparenchymal and Sub-areolar
5.4 Dosage
5.4.1 Blue Dye
5.4.2 Radioactive Colloid
5.4.3 1-Day Protocol (Interval of 1-6 h)
5.4.4 2-Day Protocol (Interval of 16-20 h)
5.5 Pre-operative Lymphoscintigraphy
5.6 Steps of SLNB
References
6: Complications of SLNB in Breast Cancer
6.1 Introduction
6.2 Surgical Management of the Axilla
6.3 Complications
6.3.1 Lymphoedema
6.3.2 Seroma Formation