By Jan H. Wong MD (auth.), Stanley P. L. Leong (eds.)
Atlas of Selective Lymphadenectomy for cancer, Breast melanoma and Colon Cancer emphasizes a multidisciplinary process combining the reviews of a nuclear medication healthcare professional, health practitioner, and pathologist. this can be a big reference additionally for researchers and clinicians who are looking to get to grips with sentinel lymph node mapping. The underlying thesis in good tumor biology is that metastasis typically begins in an orderly development with lymphatic unfold first to the sentinel lymph node (SLN) within the nearest lymph node basin. hence, the logical strategy is to reap that categorical SLN for thorough analysis.
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Additional info for Atlas of Selective Sentinel Lymphadenectomy for Melanoma, Breast Cancer and Colon Cancer
On occasion, delayed films may be required. About three hours should be allotted prior to the scheduled surgery. When the injection is close to the axillary basin, the breast can be displaced to better visualize the sentinel node. Pinhole images can be quite helpful when the injection site is very close to the axillary basin. Marking can be difficult however because the area to be imaged is small. A general area can be marked as to the location of SLN and the surgeon advised. Intradermal injection A dynamic set is obtained as described.
Always proceed the dissection as close to the SLN as possible to avoid injury to nerves and vessels. In general, the SLN may be identified using a gamma probe, blue dye, or both. Identification of SLNs After the removal of the SLN, the hand-held gamma probe is used to search the resection bed to make sure that no residual elevated radioactivity remained. Further exploration is carried out, if the resection bed count remained high. Figures 2 and 3 (pg. 48) show two patterns of resection bed radioactivity, as determined by a gamma probe, depending on the number of SLNs.
A recent study has demonstrated no significant discordancy between immediate and overnight patterns of lymphoscintigraphy [White 1999]. We have performed over 20 cases on patients with extremity melanoma. Lymphoscintigraphy on the day before and the next day prior to surgery showed a concordancy rate of almost 100% (unpublished data). Therefore, patients, certainly those with melanoma of the extremity, may have preoperative lymphoscintigraphy the night before surgery and can be scheduled for the first case the next day without delay in the nuclear medicine suite.
Atlas of Selective Sentinel Lymphadenectomy for Melanoma, Breast Cancer and Colon Cancer by Jan H. Wong MD (auth.), Stanley P. L. Leong (eds.)