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Sillem M, Bromberger U, Heitzelmann B, et al. Manual Lymphatic Drainage after Subepidermal Tracer Injection Optimizes Results of Sentinel Lymph Node Labeling in Primary Breast Cancer. Breast Care (Basel). 2015;11(1):40-4doi: 10.1159/000442727.
Sillem, M., Bromberger, U., Heitzelmann, B., Brauer, W. J., Werner, M., & Timme, S. (2016). Manual Lymphatic Drainage after Subepidermal Tracer Injection Optimizes Results of Sentinel Lymph Node Labeling in Primary Breast Cancer. Breast care (Basel, Switzerland), 11(1), 40-4. https://doi.org/10.1159/000442727
Sillem, Martin, et al. "Manual Lymphatic Drainage after Subepidermal Tracer Injection Optimizes Results of Sentinel Lymph Node Labeling in Primary Breast Cancer." Breast care (Basel, Switzerland) vol. 11,1 (2016): 40-4. doi: https://doi.org/10.1159/000442727
Sillem M, Bromberger U, Heitzelmann B, Brauer WJ, Werner M, Timme S. Manual Lymphatic Drainage after Subepidermal Tracer Injection Optimizes Results of Sentinel Lymph Node Labeling in Primary Breast Cancer. Breast Care (Basel). 2016 Feb;11(1):40-4. doi: 10.1159/000442727. Epub 2015 Dec 21. PMID: 27051395; PMCID: PMC4813651.
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Breast Care (Basel). 2016 Feb;11(1):40-4. doi: 10.1159/000442727. Epub 2015 Dec 21.

Manual Lymphatic Drainage after Subepidermal Tracer Injection Optimizes Results of Sentinel Lymph Node Labeling in Primary Breast Cancer.

Breast care (Basel, Switzerland)

Martin Sillem, Urban Bromberger, Barbara Heitzelmann, Wolfgang J Brauer, Martin Werner, Sylvia Timme

Affiliations

  1. Praxisklinik am Rosengarten, Mannheim, Germany.
  2. Department of Radiology and Nuclear Medicine, Kreiskrankenhaus Emmendingen, Emmendingen, Germany.
  3. Department of Obstetrics and Gynecology, Kreiskrankenhaus Emmendingen, Emmendingen, Germany.
  4. Institute of Clinical Pathology, University Hospital Freiburg, Freiburg i.Br., Germany.

PMID: 27051395 PMCID: PMC4813651 DOI: 10.1159/000442727

Abstract

INTRODUCTION: Our aim was to assess the practicability and reliability of a novel labeling regime for axillary sentinel lymph nodes (SLNs) in early breast cancer.

METHODS: 362 patients with early breast cancer (bilateral in 9 cases, giving a total of 371 cases) underwent intradermal radio tracer injection with simultaneous manual lymphatic drainage. SLN biopsy was performed within 24 h. For retrospective analysis, data were extracted from patient's records.

RESULTS: At least 1 SLN was detected intraoperatively in 369 cases (99.5%, range 1-9 nodes). This node was metastatic in 88 and unaffected in 281 cases. Coincidentally removed but unlabeled lymph nodes were affected in 3 cases in which the SLN was unaffected (3/153 = 2%). In all cases, on histological evaluation, tissue removed as SLN contained lymph nodes. After a period of 69.5 months (median 1.7-115.8 months), no axillary recurrences were observed in 213 patients.

CONCLUSION: Manual lymphatic drainage is a simple technique that leads to an extremely high pick-up rate of axillary SLNs after subepidermal radio tracer injection. If unaffected, this node correctly predicts nodal-negative disease in 98% of cases studied.

Keywords: Breast cancer; Manual lymphatic drainage; Sentinel node

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