Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Surg Proced. Mar 28, 2015; 5(1): 14-26
Published online Mar 28, 2015. doi: 10.5412/wjsp.v5.i1.14
Techniques that accurately identify the sentinel lymph node in cancer
Kelly J Rosso, S David Nathanson
Kelly J Rosso, S David Nathanson, Department of Surgery, Wayne State Medical School at Henry Ford Health System, Detroit, MI 48202, United States
Author contributions: Both authors contributed to this manuscript.
Conflict-of-interest: The authors have no conflicts of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: S David Nathanson, MD, Department of Surgery, Wayne State Medical School at Henry Ford Health System, 2799 West Grand Blvd, Detroit, MI 48202, United States. dnathan1@hfhs.org
Telephone: +1-800-4367936
Received: September 29, 2014
Peer-review started: September 29, 2014
First decision: December 12, 2014
Revised: January 19, 2015
Accepted: February 4, 2015
Article in press: February 9, 2015
Published online: March 28, 2015
Abstract

Sentinel lymph node (SLN) biopsy has become the gold standard for patients with melanoma and breast cancer but it’s clinical application in other solid tumor types such as cancers of the esophagus, stomach, colon and rectum, head and neck, penis, uterine cervix and endometrium has been somewhat limited. Commonly used mapping techniques utilizing the combination of radiocolloid and blue dye may result in reduced SLN detection and increased false negative rates when applied to cancers with more complex lymphatic drainage patterns. Novel localization techniques including near infrared fluorescence, high resolution imaging and molecular targeted agents have been developed to address the limitations of conventional SLN detection practices in many solid tumor types. This article reviews the indications, techniques and detection rates for SLN biopsy in several different solid tumor types as well as the promising novel techniques created to address the contemporary limitations of this procedure.

Keywords: Sentinel lymph node biopsy, Carcinoma, Radionucleotide, Blue dye, Techniques, Imaging

Core tip: Novel localization techniques including near infrared fluorescence, high resolution imaging and molecular targeted agents have been developed to address the limitations of conventional sentinel lymph node (SLN) detection practices in many solid tumor types. This article reviews the indications, techniques and detection rates for SLN biopsy in several different solid tumor types as well as the promising novel techniques created to address the contemporary limitations of this procedure.