Sentinel Node Procedure for Breast Cancer: training, safety, reliability and follow-up aspects
(De schildwachtklier procedure voor borstkanker: training, veiligheid, betrouwbaarheid en follow-up.)
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In the recent years the surgical treatment of breast cancer has changed towards a less invasive and less mutilating procedure. Breast conserving therapy and the introduction of the sentinel node (SN) procedure are the two most important changes. The introduction of a new technique is a time consuming procedure. First it should be developed and evaluated in a local situation. If the new technique is believed to be better than the standard treatment, the technique should be come available if possible after a randomised controlled trial for all patients concerned. In CHAPTER 2 the introduction of the SN procedure in three participating hospitals (a large teaching hospital, a cancer centre and a university hospital) is described. Special attention was made on the role of a co-ordinator to assure standardisation and quality control in this multicenter study. The role of the co-ordinator was two folded; firstly the supervision of the implementation in the several involved departments and secondly to refine the procedure upon the collected data. During our study we adjusted several aspects of the procedure: the concentration of the colloid in the radioactive solution, the injection of the blue dye intracutaneously after disappointing results of the peritumoral injection and, in cases of a preceding lumpectomy, a cranial injection to the scar because of failure of the caudal injections. With these corrections the results became excellent. In the end the results of the procedure (sensitivity and false negativity) were the same for the three participating hospitals.
Eggermont, Prof. Dr. A.M.M.
Wiggers, Prof. Dr. T.
- breast cancer
- breast cancer patients
- sentinel node
- sentinel node biopsy