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Injection Techniques

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The Sentinel Node in Surgical Oncology

Abstract

There is as yet no single accepted method for sentinel node localisation, and there are significant variations in the injection technique used for the administration of radionuclide colloids. The techniques range from single subdermal injection [1] to multiple peritumoral [2–6] and even intratumoral injection [7]. Other variables (described elsewhere in the book) include the type of colloidal particles used, with special emphasis on particle size [8] and the volume [9,10] of the injectate. In brief, with a small particle size the risk of sampling non-sentinel nodes is increased due to spill-over of the colloid to other nodes, leading to sampling of an increased number of lymph nodes [3,11]; on the other hand, with a larger particle size the transport may be inadequate, resulting in a higher sentinel node detection failure rate. Despite variation in the techniques used for sentinel node localisation, the overall results are encouraging. In a recent combined analysis by McMasters and co-workers [12], in 1385 patients with breast carcinoma the overall sensitivity was 94% and the specificity 100% when the sentinel node histology was compared with the axillary node dissection specimen.

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Authors and Affiliations

  1. Institute of Nuclear Medicine, Royal Free and University College Medical School University College London, Mortimer Street, W1N 8AA, London, UK

    Mohammad R. S. Keshtgar BSc, MB, BS, FRCSI, FRGS(Gen) (Clinical Lecturer/Surgical Oncologist), Wendy A. Waddington BSc, MSc, MIPEM (Principal Nuclear Medicine Physicist) & Peter J. Ell MD, PD, MSc, FRCR, FRCP (Professor and Head)

  2. Department of Histopathology, Royal Free and University College Medical School University College London, Rockefeller Building, University Street, WC1E 6JJ, London, UK

    Sunil R. Lakhani BSc, MB, BS, MD, MRCPATH (Senior Lecturer and Consultant)

Authors
  1. Mohammad R. S. Keshtgar BSc, MB, BS, FRCSI, FRGS(Gen)
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  2. Wendy A. Waddington BSc, MSc, MIPEM
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  3. Sunil R. Lakhani BSc, MB, BS, MD, MRCPATH
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  4. Peter J. Ell MD, PD, MSc, FRCR, FRCP
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© 1999 Springer-Verlag Berlin Heidelberg

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Keshtgar, M.R.S., Waddington, W.A., Lakhani, S.R., Ell, P.J. (1999). Injection Techniques. In: The Sentinel Node in Surgical Oncology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60038-8_5

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  • DOI: https://doi.org/10.1007/978-3-642-60038-8_5

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-64230-2

  • Online ISBN: 978-3-642-60038-8

  • eBook Packages: Springer Book Archive

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