Lymphatic Mapping and Sentinel Lymph Node Biopsy

Abstract

January 2005

Section 3 Breast, Skin, and Soft Tissue

6 Lymphatic Mapping and Sentinel Lymph Node Biopsy

Seth P. Harlow, M.D.
University of Vermont College of Medicine

David N. Krag, M.D., F.A.C.S.
University of Vermont College of Medicine

Douglas S. Reintgen, M.D., F.A.C.S.
University of South Florida

Frederick L. Moffat, Jr., M.D., F.A.C.S.
University of Miami School of Medicine

Thomas G. Frazier, M.D., F.A.C.S.
Jefferson Medical College of Thomas Jefferson University

The development of intraoperative lymphatic mapping and selective lymphadenectomy has made it possible to map lymphatic flow from a primary tumor to the initial draining node (i.e., the sentinel lymph node [SLN]) in the regional nodal basin. The pathologic status of the SLN is known to be concordant with the pathologic status of the nodal basin as a whole. Integration of these techniques, along with increasingly detailed and sophisticated pathologic examination of the SLN, into the surgical treatment of melanoma and breast cancer offers the potential for more conservative operations, lower morbidity, and more accurate disease staging. This chapter describes the rationale for the procedure, patient selection, technique, complications, and outcome. Training and credentialing and radiation exposure guidelines are also covered. This chapter contains 101 references.

WebMD Professional Publishing, P.O. Box 1819, Danbury CT 06813 (800-545-0554 or 203-790-2087)