Sentinella Mini‐Symposium Moderators: Alessandro Testori and Sergi Vidal‐Sicart (non‐CME...
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Transcript of Sentinella Mini‐Symposium Moderators: Alessandro Testori and Sergi Vidal‐Sicart (non‐CME...
Dra. Cristina Noblía.Instituto de Oncología “Angel.H.Roffo”.Universidad de Buenos Aires
Joint International Oncology Congress
May 27-May 29,2013
Armando Giuliano Stanley Leong
Sentinella Symposium Moderators : A.Testori, MD and S. Vidal-Sicart, MD
Breast Surgery Departament Instituto Instituto de de Oncología Oncología “Angel H. “Angel H. Roffo Roffo ” UBA ” UBA
PERIODS
• First Period : Blue Dye • Second Period : Radioisotope + Blue Dye • Third Period : PET/CT + SNB • Fourth Period :SENTINELLA
The blue lymphatic channel was followed proximally and distally until the first node was identified
All the blue nodes were excised
PERIODS
• First Period : Blue Dye • Second Period : Radioisotope +
Blue Dye • Third Period : PET/CT + TGS • Fourth Period :SENTINELLA
SECOND PERIOD (2000) • Radioisotope + lymphoscintigraphy
•Gamma Probe •Patent blue
Tc 99 labelled human albumin colloide particles in 0.2 ml saline
ADVANTAGES OF USING RADIOISOTOPE
• 1.Technically easier and requires less tissue dissection.
• 2.Lymphoscintigraphy can
determinate if there is extra axillary drainage.
COMBINED TECHNIQUES
• Sentinel Node Identification is facilitated when the two techniques are used together, since the additional visual guidance of the blue dye simplifies the operative procedure.
• The simultaneous use of both techniques may
accelerate the learning curve for each method used alone.
PERIODS
• First Period : Blue Dye • Second Period : Radioisotope + Blue Dye • Third Period : PET/CT + TGS • Fourth Period :SENTINELLA
Utility of 18FDG – PET/CT and Sentinel Node Biopsy for axillary staging in primary breast
cancer: Roffo PET/CT 1 Trial
N = 54
T1T2NO
RESULTS PET / CT IN AXILA
• PET / CT (-): 45 (83%). • 6 presented metastases
in the sentinel node. • 3 had microMETS
• FALSE NEGATIVE : 40%. • SENSITIVITY: 60%. • VPN : 87%.
CONCLUSION • PET/CT has low sensitivity for detecting axillary
nodes in breast cancer at initial stages because of its low spacial resolution (greater than 6 mm).
• A negative PET/CT does not replace the sentinel
node biopsy • A positive PET/CT would indicate the need to
make an axillary dissection even in clinically negative axilla .
PERIODS
• First Period : Blue Dye • Second Period : Radioisotope + Blue Dye • Third Period : PET/CT + TGS • Fourth Period :SENTINELLA
Fourth Period SENTINELLA
• N:42 PATIENTS • T1T2NO. • In 2 cases
additional nodes were discovered with Sentinella that the gamma probe didn’t detect.
Axillary bed
Second SN
Secondly: SENTINELLA is useful for detecting nodes that are difficult for the probe because of the closeness to the tumor
(Shine Through)
Radio- Guided Surgery for Ethiological Diagnosis of Solitary Rib Lesions
Dr Osvaldo Salariato Oncology Institute Angel H. Roffo
N: 18
14 neoplasic disease
7 benign lesions
Radio-Guided Surgery for Ethiological Diagnosis of
Solitary Rib Lesions
No residual mass in the surgical site
Departamento de Mastología: Dr.Cresta Morgado Dra.Cristina Noblía
Dr. González Dr. Armanasco
Dra. Azar Dra. Montoya
Dr. Ipiña
Departamento de Medicina Nuclear:
Dra. Parma Dra. Zarlenga Dra.Armesto
Dra San Martin Gabriela.
Dra Lidia Katz Departamento de Anatomía
Patológica: Dra. Gorostidi
Departamento de Oncología:
Dra. Mickiewicz Dra. Alvarez