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Lymphatic Mapping and Sentinel Node Biopsy in Breast Cancer

Armando E. Giuliano, MD
JAMA. 1997;277(10):791. doi:10.1001/jama.1997.03540340025024.
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To the Editor.  —The study by Dr Albertini and colleagues1 confirms our sentinel node hypothesis in breast cancer. Since our group began investigating the sentinel node technique for breast cancer 5 years ago, we have performed nearly 400 mapping procedures using isosulfan blue dye to identify the first axillary lymph node draining a primary breast cancer,2,3 and have abandoned routine axillary lymph node dissection. As reported in a summary of our last 100 cases, dye-based mapping in our hands has reached an accuracy of 100%, with a 93% rate of sentinel node detection.4 Thus, the authors' comment, "Previous studies have used either the vital blue dye or the radiocolloid alone, with lower success rates reported," is not correct. In addition, the use of preoperative lymphoscintigraphy for inner-quadrant lesions has increased our detection rate even further.Although we have started to evaluate the combined use of blue dye


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