Sentinel Lymph Node Pressure in Breast Cancer

Background Leakiness of angiogenic tumor vessels results in elevated pressure in primary breast cancers and increased lymphatic flow to sentinel lymph node(s) (SLNs). We hypothesized that a similar pathophysiology in metastatic axillary SLNs would result in increased intranodal pressure (INP). Metho...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Nathanson, S. David [verfasserIn] Mahan, Meredith [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2011

Schlagwörter:	Sentinel Node Primary Breast Cancer Gamma Probe Contralateral Prophylactic Mastectomy Prophylactic Mastectomy

Übergeordnetes Werk:	Enthalten in: Annals of surgical oncology - Berlin [u.a.] : Springer, 1994, 18(2011), 13 vom: 28. Mai, Seite 3791-3796
Übergeordnetes Werk:	volume:18 ; year:2011 ; number:13 ; day:28 ; month:05 ; pages:3791-3796

Links:	Volltext

DOI / URN:	10.1245/s10434-011-1796-y

Katalog-ID:	SPR009941533

Internformat


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245	1	0	\|a Sentinel Lymph Node Pressure in Breast Cancer
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520			\|a Background Leakiness of angiogenic tumor vessels results in elevated pressure in primary breast cancers and increased lymphatic flow to sentinel lymph node(s) (SLNs). We hypothesized that a similar pathophysiology in metastatic axillary SLNs would result in increased intranodal pressure (INP). Methods SLNs were “hot” and “blue” after intramammary injection of dilute methylene blue and filtered Tc99 sulfur colloid. Intraoperative pressure was measured in SLNs by a noncoring needle and recording device in 114 breast cancer patients. Excised axillary SLNs were examined by standard pathological techniques and metastases measured, recorded, and compared with INP measurements for SLN #1 and sometimes #2. Results INP in 131 SLNs with no tumor (SLN #1, n = 93; SLN #2, n = 38) was 9.1 ± 6.2 (SD; range −2, 35) mmHg and 21.4 ± 15.4 mmHg (range 0–50) in 35 tumor-containing SLNs (SLN #1, n = 29; SLN #2, n = 6) (P = 0.0066). Elevated INPs significantly correlated with SLN tumor metastasis sizes (P = 0.0038; r = 0.4904). In two patients, tumor-laden SLNs with high INP were not blue or “hot” while a blue lymphatic bypassed these nodes and was traced to the next echelon tumor-free blue and “hot” nodes with low INP. Conclusions Breast cancer metastasis in axillary SLNs was associated with significantly higher INP than in tumor-free lymph nodes. When “true” SLNs were replaced by tumor, and the INP levels were very high, lymph flow direction changed; lymphophilic particles (blue dye and radiocolloid) were redirected to the next echelon of nodes, where the pressures were much lower. Mechanical factors may increase the likelihood of metastasis to neighboring lymph nodes with lower INP.
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650		4	\|a Primary Breast Cancer \|7 (dpeaa)DE-He213
650		4	\|a Gamma Probe \|7 (dpeaa)DE-He213
650		4	\|a Contralateral Prophylactic Mastectomy \|7 (dpeaa)DE-He213
650		4	\|a Prophylactic Mastectomy \|7 (dpeaa)DE-He213
700	1		\|a Mahan, Meredith \|e verfasserin \|4 aut
773	0	8	\|i Enthalten in \|t Annals of surgical oncology \|d Berlin [u.a.] : Springer, 1994 \|g 18(2011), 13 vom: 28. Mai, Seite 3791-3796 \|w (DE-627)343969947 \|w (DE-600)2074021-9 \|x 1534-4681 \|7 nnns
773	1	8	\|g volume:18 \|g year:2011 \|g number:13 \|g day:28 \|g month:05 \|g pages:3791-3796
856	4	0	\|u https://dx.doi.org/10.1245/s10434-011-1796-y \|z lizenzpflichtig \|3 Volltext
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912			\|a GBV_ILN_31
912			\|a GBV_ILN_32
912			\|a GBV_ILN_39
912			\|a GBV_ILN_40
912			\|a GBV_ILN_60
912			\|a GBV_ILN_62
912			\|a GBV_ILN_63
912			\|a GBV_ILN_69
912			\|a GBV_ILN_70
912			\|a GBV_ILN_73
912			\|a GBV_ILN_74
912			\|a GBV_ILN_90
912			\|a GBV_ILN_95
912			\|a GBV_ILN_100
912			\|a GBV_ILN_101
912			\|a GBV_ILN_105
912			\|a GBV_ILN_110
912			\|a GBV_ILN_120
912			\|a GBV_ILN_138
912			\|a GBV_ILN_150
912			\|a GBV_ILN_151
912			\|a GBV_ILN_152
912			\|a GBV_ILN_161
912			\|a GBV_ILN_170
912			\|a GBV_ILN_171
912			\|a GBV_ILN_187
912			\|a GBV_ILN_213
912			\|a GBV_ILN_224
912			\|a GBV_ILN_230
912			\|a GBV_ILN_250
912			\|a GBV_ILN_281
912			\|a GBV_ILN_285
912			\|a GBV_ILN_293
912			\|a GBV_ILN_370
912			\|a GBV_ILN_602
912			\|a GBV_ILN_636
912			\|a GBV_ILN_702
912			\|a GBV_ILN_711
912			\|a GBV_ILN_2001
912			\|a GBV_ILN_2003
912			\|a GBV_ILN_2004
912			\|a GBV_ILN_2005
912			\|a GBV_ILN_2006
912			\|a GBV_ILN_2007
912			\|a GBV_ILN_2008
912			\|a GBV_ILN_2009
912			\|a GBV_ILN_2010
912			\|a GBV_ILN_2011
912			\|a GBV_ILN_2014
912			\|a GBV_ILN_2015
912			\|a GBV_ILN_2020
912			\|a GBV_ILN_2021
912			\|a GBV_ILN_2025
912			\|a GBV_ILN_2026
912			\|a GBV_ILN_2027
912			\|a GBV_ILN_2031
912			\|a GBV_ILN_2034
912			\|a GBV_ILN_2037
912			\|a GBV_ILN_2038
912			\|a GBV_ILN_2039
912			\|a GBV_ILN_2044
912			\|a GBV_ILN_2048
912			\|a GBV_ILN_2049
912			\|a GBV_ILN_2050
912			\|a GBV_ILN_2055
912			\|a GBV_ILN_2057
912			\|a GBV_ILN_2059
912			\|a GBV_ILN_2061
912			\|a GBV_ILN_2064
912			\|a GBV_ILN_2065
912			\|a GBV_ILN_2068
912			\|a GBV_ILN_2070
912			\|a GBV_ILN_2086
912			\|a GBV_ILN_2088
912			\|a GBV_ILN_2093
912			\|a GBV_ILN_2106
912			\|a GBV_ILN_2107
912			\|a GBV_ILN_2108
912			\|a GBV_ILN_2110
912			\|a GBV_ILN_2111
912			\|a GBV_ILN_2112
912			\|a GBV_ILN_2113
912			\|a GBV_ILN_2116
912			\|a GBV_ILN_2118
912			\|a GBV_ILN_2119
912			\|a GBV_ILN_2122
912			\|a GBV_ILN_2129
912			\|a GBV_ILN_2143
912			\|a GBV_ILN_2144
912			\|a GBV_ILN_2147
912			\|a GBV_ILN_2148
912			\|a GBV_ILN_2152
912			\|a GBV_ILN_2153
912			\|a GBV_ILN_2188
912			\|a GBV_ILN_2190
912			\|a GBV_ILN_2232
912			\|a GBV_ILN_2336
912			\|a GBV_ILN_2446
912			\|a GBV_ILN_2470
912			\|a GBV_ILN_2472
912			\|a GBV_ILN_2507
912			\|a GBV_ILN_2522
912			\|a GBV_ILN_2548
912			\|a GBV_ILN_4012
912			\|a GBV_ILN_4035
912			\|a GBV_ILN_4037
912			\|a GBV_ILN_4046
912			\|a GBV_ILN_4112
912			\|a GBV_ILN_4125
912			\|a GBV_ILN_4126
912			\|a GBV_ILN_4242
912			\|a GBV_ILN_4246
912			\|a GBV_ILN_4249
912			\|a GBV_ILN_4251
912			\|a GBV_ILN_4305
912			\|a GBV_ILN_4306
912			\|a GBV_ILN_4307
912			\|a GBV_ILN_4313
912			\|a GBV_ILN_4322
912			\|a GBV_ILN_4323
912			\|a GBV_ILN_4324
912			\|a GBV_ILN_4325
912			\|a GBV_ILN_4326
912			\|a GBV_ILN_4328
912			\|a GBV_ILN_4333
912			\|a GBV_ILN_4334
912			\|a GBV_ILN_4335
912			\|a GBV_ILN_4336
912			\|a GBV_ILN_4338
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951			\|a AR
952			\|d 18 \|j 2011 \|e 13 \|b 28 \|c 05 \|h 3791-3796

Indexfelder

author_variant	s d n sd sdn m m mm
matchkey_str	article:15344681:2011----::etnlypndpesri
hierarchy_sort_str	2011
bklnumber	44.81 44.65
publishDate	2011
allfields	10.1245/s10434-011-1796-y doi (DE-627)SPR009941533 (SPR)s10434-011-1796-y-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Nathanson, S. David verfasserin aut Sentinel Lymph Node Pressure in Breast Cancer 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Leakiness of angiogenic tumor vessels results in elevated pressure in primary breast cancers and increased lymphatic flow to sentinel lymph node(s) (SLNs). We hypothesized that a similar pathophysiology in metastatic axillary SLNs would result in increased intranodal pressure (INP). Methods SLNs were “hot” and “blue” after intramammary injection of dilute methylene blue and filtered Tc99 sulfur colloid. Intraoperative pressure was measured in SLNs by a noncoring needle and recording device in 114 breast cancer patients. Excised axillary SLNs were examined by standard pathological techniques and metastases measured, recorded, and compared with INP measurements for SLN #1 and sometimes #2. Results INP in 131 SLNs with no tumor (SLN #1, n = 93; SLN #2, n = 38) was 9.1 ± 6.2 (SD; range −2, 35) mmHg and 21.4 ± 15.4 mmHg (range 0–50) in 35 tumor-containing SLNs (SLN #1, n = 29; SLN #2, n = 6) (P = 0.0066). Elevated INPs significantly correlated with SLN tumor metastasis sizes (P = 0.0038; r = 0.4904). In two patients, tumor-laden SLNs with high INP were not blue or “hot” while a blue lymphatic bypassed these nodes and was traced to the next echelon tumor-free blue and “hot” nodes with low INP. Conclusions Breast cancer metastasis in axillary SLNs was associated with significantly higher INP than in tumor-free lymph nodes. When “true” SLNs were replaced by tumor, and the INP levels were very high, lymph flow direction changed; lymphophilic particles (blue dye and radiocolloid) were redirected to the next echelon of nodes, where the pressures were much lower. Mechanical factors may increase the likelihood of metastasis to neighboring lymph nodes with lower INP. Sentinel Node (dpeaa)DE-He213 Primary Breast Cancer (dpeaa)DE-He213 Gamma Probe (dpeaa)DE-He213 Contralateral Prophylactic Mastectomy (dpeaa)DE-He213 Prophylactic Mastectomy (dpeaa)DE-He213 Mahan, Meredith verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 18(2011), 13 vom: 28. Mai, Seite 3791-3796 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:18 year:2011 number:13 day:28 month:05 pages:3791-3796 https://dx.doi.org/10.1245/s10434-011-1796-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 18 2011 13 28 05 3791-3796
spelling	10.1245/s10434-011-1796-y doi (DE-627)SPR009941533 (SPR)s10434-011-1796-y-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Nathanson, S. David verfasserin aut Sentinel Lymph Node Pressure in Breast Cancer 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Leakiness of angiogenic tumor vessels results in elevated pressure in primary breast cancers and increased lymphatic flow to sentinel lymph node(s) (SLNs). We hypothesized that a similar pathophysiology in metastatic axillary SLNs would result in increased intranodal pressure (INP). Methods SLNs were “hot” and “blue” after intramammary injection of dilute methylene blue and filtered Tc99 sulfur colloid. Intraoperative pressure was measured in SLNs by a noncoring needle and recording device in 114 breast cancer patients. Excised axillary SLNs were examined by standard pathological techniques and metastases measured, recorded, and compared with INP measurements for SLN #1 and sometimes #2. Results INP in 131 SLNs with no tumor (SLN #1, n = 93; SLN #2, n = 38) was 9.1 ± 6.2 (SD; range −2, 35) mmHg and 21.4 ± 15.4 mmHg (range 0–50) in 35 tumor-containing SLNs (SLN #1, n = 29; SLN #2, n = 6) (P = 0.0066). Elevated INPs significantly correlated with SLN tumor metastasis sizes (P = 0.0038; r = 0.4904). In two patients, tumor-laden SLNs with high INP were not blue or “hot” while a blue lymphatic bypassed these nodes and was traced to the next echelon tumor-free blue and “hot” nodes with low INP. Conclusions Breast cancer metastasis in axillary SLNs was associated with significantly higher INP than in tumor-free lymph nodes. When “true” SLNs were replaced by tumor, and the INP levels were very high, lymph flow direction changed; lymphophilic particles (blue dye and radiocolloid) were redirected to the next echelon of nodes, where the pressures were much lower. Mechanical factors may increase the likelihood of metastasis to neighboring lymph nodes with lower INP. Sentinel Node (dpeaa)DE-He213 Primary Breast Cancer (dpeaa)DE-He213 Gamma Probe (dpeaa)DE-He213 Contralateral Prophylactic Mastectomy (dpeaa)DE-He213 Prophylactic Mastectomy (dpeaa)DE-He213 Mahan, Meredith verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 18(2011), 13 vom: 28. Mai, Seite 3791-3796 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:18 year:2011 number:13 day:28 month:05 pages:3791-3796 https://dx.doi.org/10.1245/s10434-011-1796-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 18 2011 13 28 05 3791-3796
allfields_unstemmed	10.1245/s10434-011-1796-y doi (DE-627)SPR009941533 (SPR)s10434-011-1796-y-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Nathanson, S. David verfasserin aut Sentinel Lymph Node Pressure in Breast Cancer 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Leakiness of angiogenic tumor vessels results in elevated pressure in primary breast cancers and increased lymphatic flow to sentinel lymph node(s) (SLNs). We hypothesized that a similar pathophysiology in metastatic axillary SLNs would result in increased intranodal pressure (INP). Methods SLNs were “hot” and “blue” after intramammary injection of dilute methylene blue and filtered Tc99 sulfur colloid. Intraoperative pressure was measured in SLNs by a noncoring needle and recording device in 114 breast cancer patients. Excised axillary SLNs were examined by standard pathological techniques and metastases measured, recorded, and compared with INP measurements for SLN #1 and sometimes #2. Results INP in 131 SLNs with no tumor (SLN #1, n = 93; SLN #2, n = 38) was 9.1 ± 6.2 (SD; range −2, 35) mmHg and 21.4 ± 15.4 mmHg (range 0–50) in 35 tumor-containing SLNs (SLN #1, n = 29; SLN #2, n = 6) (P = 0.0066). Elevated INPs significantly correlated with SLN tumor metastasis sizes (P = 0.0038; r = 0.4904). In two patients, tumor-laden SLNs with high INP were not blue or “hot” while a blue lymphatic bypassed these nodes and was traced to the next echelon tumor-free blue and “hot” nodes with low INP. Conclusions Breast cancer metastasis in axillary SLNs was associated with significantly higher INP than in tumor-free lymph nodes. When “true” SLNs were replaced by tumor, and the INP levels were very high, lymph flow direction changed; lymphophilic particles (blue dye and radiocolloid) were redirected to the next echelon of nodes, where the pressures were much lower. Mechanical factors may increase the likelihood of metastasis to neighboring lymph nodes with lower INP. Sentinel Node (dpeaa)DE-He213 Primary Breast Cancer (dpeaa)DE-He213 Gamma Probe (dpeaa)DE-He213 Contralateral Prophylactic Mastectomy (dpeaa)DE-He213 Prophylactic Mastectomy (dpeaa)DE-He213 Mahan, Meredith verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 18(2011), 13 vom: 28. Mai, Seite 3791-3796 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:18 year:2011 number:13 day:28 month:05 pages:3791-3796 https://dx.doi.org/10.1245/s10434-011-1796-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 18 2011 13 28 05 3791-3796
allfieldsGer	10.1245/s10434-011-1796-y doi (DE-627)SPR009941533 (SPR)s10434-011-1796-y-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Nathanson, S. David verfasserin aut Sentinel Lymph Node Pressure in Breast Cancer 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Leakiness of angiogenic tumor vessels results in elevated pressure in primary breast cancers and increased lymphatic flow to sentinel lymph node(s) (SLNs). We hypothesized that a similar pathophysiology in metastatic axillary SLNs would result in increased intranodal pressure (INP). Methods SLNs were “hot” and “blue” after intramammary injection of dilute methylene blue and filtered Tc99 sulfur colloid. Intraoperative pressure was measured in SLNs by a noncoring needle and recording device in 114 breast cancer patients. Excised axillary SLNs were examined by standard pathological techniques and metastases measured, recorded, and compared with INP measurements for SLN #1 and sometimes #2. Results INP in 131 SLNs with no tumor (SLN #1, n = 93; SLN #2, n = 38) was 9.1 ± 6.2 (SD; range −2, 35) mmHg and 21.4 ± 15.4 mmHg (range 0–50) in 35 tumor-containing SLNs (SLN #1, n = 29; SLN #2, n = 6) (P = 0.0066). Elevated INPs significantly correlated with SLN tumor metastasis sizes (P = 0.0038; r = 0.4904). In two patients, tumor-laden SLNs with high INP were not blue or “hot” while a blue lymphatic bypassed these nodes and was traced to the next echelon tumor-free blue and “hot” nodes with low INP. Conclusions Breast cancer metastasis in axillary SLNs was associated with significantly higher INP than in tumor-free lymph nodes. When “true” SLNs were replaced by tumor, and the INP levels were very high, lymph flow direction changed; lymphophilic particles (blue dye and radiocolloid) were redirected to the next echelon of nodes, where the pressures were much lower. Mechanical factors may increase the likelihood of metastasis to neighboring lymph nodes with lower INP. Sentinel Node (dpeaa)DE-He213 Primary Breast Cancer (dpeaa)DE-He213 Gamma Probe (dpeaa)DE-He213 Contralateral Prophylactic Mastectomy (dpeaa)DE-He213 Prophylactic Mastectomy (dpeaa)DE-He213 Mahan, Meredith verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 18(2011), 13 vom: 28. Mai, Seite 3791-3796 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:18 year:2011 number:13 day:28 month:05 pages:3791-3796 https://dx.doi.org/10.1245/s10434-011-1796-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 18 2011 13 28 05 3791-3796
allfieldsSound	10.1245/s10434-011-1796-y doi (DE-627)SPR009941533 (SPR)s10434-011-1796-y-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Nathanson, S. David verfasserin aut Sentinel Lymph Node Pressure in Breast Cancer 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Leakiness of angiogenic tumor vessels results in elevated pressure in primary breast cancers and increased lymphatic flow to sentinel lymph node(s) (SLNs). We hypothesized that a similar pathophysiology in metastatic axillary SLNs would result in increased intranodal pressure (INP). Methods SLNs were “hot” and “blue” after intramammary injection of dilute methylene blue and filtered Tc99 sulfur colloid. Intraoperative pressure was measured in SLNs by a noncoring needle and recording device in 114 breast cancer patients. Excised axillary SLNs were examined by standard pathological techniques and metastases measured, recorded, and compared with INP measurements for SLN #1 and sometimes #2. Results INP in 131 SLNs with no tumor (SLN #1, n = 93; SLN #2, n = 38) was 9.1 ± 6.2 (SD; range −2, 35) mmHg and 21.4 ± 15.4 mmHg (range 0–50) in 35 tumor-containing SLNs (SLN #1, n = 29; SLN #2, n = 6) (P = 0.0066). Elevated INPs significantly correlated with SLN tumor metastasis sizes (P = 0.0038; r = 0.4904). In two patients, tumor-laden SLNs with high INP were not blue or “hot” while a blue lymphatic bypassed these nodes and was traced to the next echelon tumor-free blue and “hot” nodes with low INP. Conclusions Breast cancer metastasis in axillary SLNs was associated with significantly higher INP than in tumor-free lymph nodes. When “true” SLNs were replaced by tumor, and the INP levels were very high, lymph flow direction changed; lymphophilic particles (blue dye and radiocolloid) were redirected to the next echelon of nodes, where the pressures were much lower. Mechanical factors may increase the likelihood of metastasis to neighboring lymph nodes with lower INP. Sentinel Node (dpeaa)DE-He213 Primary Breast Cancer (dpeaa)DE-He213 Gamma Probe (dpeaa)DE-He213 Contralateral Prophylactic Mastectomy (dpeaa)DE-He213 Prophylactic Mastectomy (dpeaa)DE-He213 Mahan, Meredith verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 18(2011), 13 vom: 28. Mai, Seite 3791-3796 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:18 year:2011 number:13 day:28 month:05 pages:3791-3796 https://dx.doi.org/10.1245/s10434-011-1796-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 18 2011 13 28 05 3791-3796
language	English
source	Enthalten in Annals of surgical oncology 18(2011), 13 vom: 28. Mai, Seite 3791-3796 volume:18 year:2011 number:13 day:28 month:05 pages:3791-3796
sourceStr	Enthalten in Annals of surgical oncology 18(2011), 13 vom: 28. Mai, Seite 3791-3796 volume:18 year:2011 number:13 day:28 month:05 pages:3791-3796
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Sentinel Node Primary Breast Cancer Gamma Probe Contralateral Prophylactic Mastectomy Prophylactic Mastectomy
dewey-raw	610
isfreeaccess_bool	false
container_title	Annals of surgical oncology
authorswithroles_txt_mv	Nathanson, S. David @@aut@@ Mahan, Meredith @@aut@@
publishDateDaySort_date	2011-05-28T00:00:00Z
hierarchy_top_id	343969947
dewey-sort	3610
id	SPR009941533
language_de	englisch
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In two patients, tumor-laden SLNs with high INP were not blue or “hot” while a blue lymphatic bypassed these nodes and was traced to the next echelon tumor-free blue and “hot” nodes with low INP. Conclusions Breast cancer metastasis in axillary SLNs was associated with significantly higher INP than in tumor-free lymph nodes. When “true” SLNs were replaced by tumor, and the INP levels were very high, lymph flow direction changed; lymphophilic particles (blue dye and radiocolloid) were redirected to the next echelon of nodes, where the pressures were much lower. 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author	Nathanson, S. David
spellingShingle	Nathanson, S. David ddc 610 bkl 44.81 bkl 44.65 misc Sentinel Node misc Primary Breast Cancer misc Gamma Probe misc Contralateral Prophylactic Mastectomy misc Prophylactic Mastectomy Sentinel Lymph Node Pressure in Breast Cancer
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topic_title	610 ASE 44.81 bkl 44.65 bkl Sentinel Lymph Node Pressure in Breast Cancer Sentinel Node (dpeaa)DE-He213 Primary Breast Cancer (dpeaa)DE-He213 Gamma Probe (dpeaa)DE-He213 Contralateral Prophylactic Mastectomy (dpeaa)DE-He213 Prophylactic Mastectomy (dpeaa)DE-He213
topic	ddc 610 bkl 44.81 bkl 44.65 misc Sentinel Node misc Primary Breast Cancer misc Gamma Probe misc Contralateral Prophylactic Mastectomy misc Prophylactic Mastectomy
topic_unstemmed	ddc 610 bkl 44.81 bkl 44.65 misc Sentinel Node misc Primary Breast Cancer misc Gamma Probe misc Contralateral Prophylactic Mastectomy misc Prophylactic Mastectomy
topic_browse	ddc 610 bkl 44.81 bkl 44.65 misc Sentinel Node misc Primary Breast Cancer misc Gamma Probe misc Contralateral Prophylactic Mastectomy misc Prophylactic Mastectomy
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title	Sentinel Lymph Node Pressure in Breast Cancer
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title_full	Sentinel Lymph Node Pressure in Breast Cancer
author_sort	Nathanson, S. David
journal	Annals of surgical oncology
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author_browse	Nathanson, S. David Mahan, Meredith
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title_sort	sentinel lymph node pressure in breast cancer
title_auth	Sentinel Lymph Node Pressure in Breast Cancer
abstract	Background Leakiness of angiogenic tumor vessels results in elevated pressure in primary breast cancers and increased lymphatic flow to sentinel lymph node(s) (SLNs). We hypothesized that a similar pathophysiology in metastatic axillary SLNs would result in increased intranodal pressure (INP). Methods SLNs were “hot” and “blue” after intramammary injection of dilute methylene blue and filtered Tc99 sulfur colloid. Intraoperative pressure was measured in SLNs by a noncoring needle and recording device in 114 breast cancer patients. Excised axillary SLNs were examined by standard pathological techniques and metastases measured, recorded, and compared with INP measurements for SLN #1 and sometimes #2. Results INP in 131 SLNs with no tumor (SLN #1, n = 93; SLN #2, n = 38) was 9.1 ± 6.2 (SD; range −2, 35) mmHg and 21.4 ± 15.4 mmHg (range 0–50) in 35 tumor-containing SLNs (SLN #1, n = 29; SLN #2, n = 6) (P = 0.0066). Elevated INPs significantly correlated with SLN tumor metastasis sizes (P = 0.0038; r = 0.4904). In two patients, tumor-laden SLNs with high INP were not blue or “hot” while a blue lymphatic bypassed these nodes and was traced to the next echelon tumor-free blue and “hot” nodes with low INP. Conclusions Breast cancer metastasis in axillary SLNs was associated with significantly higher INP than in tumor-free lymph nodes. When “true” SLNs were replaced by tumor, and the INP levels were very high, lymph flow direction changed; lymphophilic particles (blue dye and radiocolloid) were redirected to the next echelon of nodes, where the pressures were much lower. Mechanical factors may increase the likelihood of metastasis to neighboring lymph nodes with lower INP.
abstractGer	Background Leakiness of angiogenic tumor vessels results in elevated pressure in primary breast cancers and increased lymphatic flow to sentinel lymph node(s) (SLNs). We hypothesized that a similar pathophysiology in metastatic axillary SLNs would result in increased intranodal pressure (INP). Methods SLNs were “hot” and “blue” after intramammary injection of dilute methylene blue and filtered Tc99 sulfur colloid. Intraoperative pressure was measured in SLNs by a noncoring needle and recording device in 114 breast cancer patients. Excised axillary SLNs were examined by standard pathological techniques and metastases measured, recorded, and compared with INP measurements for SLN #1 and sometimes #2. Results INP in 131 SLNs with no tumor (SLN #1, n = 93; SLN #2, n = 38) was 9.1 ± 6.2 (SD; range −2, 35) mmHg and 21.4 ± 15.4 mmHg (range 0–50) in 35 tumor-containing SLNs (SLN #1, n = 29; SLN #2, n = 6) (P = 0.0066). Elevated INPs significantly correlated with SLN tumor metastasis sizes (P = 0.0038; r = 0.4904). In two patients, tumor-laden SLNs with high INP were not blue or “hot” while a blue lymphatic bypassed these nodes and was traced to the next echelon tumor-free blue and “hot” nodes with low INP. Conclusions Breast cancer metastasis in axillary SLNs was associated with significantly higher INP than in tumor-free lymph nodes. When “true” SLNs were replaced by tumor, and the INP levels were very high, lymph flow direction changed; lymphophilic particles (blue dye and radiocolloid) were redirected to the next echelon of nodes, where the pressures were much lower. Mechanical factors may increase the likelihood of metastasis to neighboring lymph nodes with lower INP.
abstract_unstemmed	Background Leakiness of angiogenic tumor vessels results in elevated pressure in primary breast cancers and increased lymphatic flow to sentinel lymph node(s) (SLNs). We hypothesized that a similar pathophysiology in metastatic axillary SLNs would result in increased intranodal pressure (INP). Methods SLNs were “hot” and “blue” after intramammary injection of dilute methylene blue and filtered Tc99 sulfur colloid. Intraoperative pressure was measured in SLNs by a noncoring needle and recording device in 114 breast cancer patients. Excised axillary SLNs were examined by standard pathological techniques and metastases measured, recorded, and compared with INP measurements for SLN #1 and sometimes #2. Results INP in 131 SLNs with no tumor (SLN #1, n = 93; SLN #2, n = 38) was 9.1 ± 6.2 (SD; range −2, 35) mmHg and 21.4 ± 15.4 mmHg (range 0–50) in 35 tumor-containing SLNs (SLN #1, n = 29; SLN #2, n = 6) (P = 0.0066). Elevated INPs significantly correlated with SLN tumor metastasis sizes (P = 0.0038; r = 0.4904). In two patients, tumor-laden SLNs with high INP were not blue or “hot” while a blue lymphatic bypassed these nodes and was traced to the next echelon tumor-free blue and “hot” nodes with low INP. Conclusions Breast cancer metastasis in axillary SLNs was associated with significantly higher INP than in tumor-free lymph nodes. When “true” SLNs were replaced by tumor, and the INP levels were very high, lymph flow direction changed; lymphophilic particles (blue dye and radiocolloid) were redirected to the next echelon of nodes, where the pressures were much lower. Mechanical factors may increase the likelihood of metastasis to neighboring lymph nodes with lower INP.
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container_issue	13
title_short	Sentinel Lymph Node Pressure in Breast Cancer
url	https://dx.doi.org/10.1245/s10434-011-1796-y
remote_bool	true
author2	Mahan, Meredith
author2Str	Mahan, Meredith
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doi_str	10.1245/s10434-011-1796-y
up_date	2024-07-04T03:36:24.048Z
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David</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Sentinel Lymph Node Pressure in Breast Cancer</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2011</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background Leakiness of angiogenic tumor vessels results in elevated pressure in primary breast cancers and increased lymphatic flow to sentinel lymph node(s) (SLNs). We hypothesized that a similar pathophysiology in metastatic axillary SLNs would result in increased intranodal pressure (INP). Methods SLNs were “hot” and “blue” after intramammary injection of dilute methylene blue and filtered Tc99 sulfur colloid. Intraoperative pressure was measured in SLNs by a noncoring needle and recording device in 114 breast cancer patients. Excised axillary SLNs were examined by standard pathological techniques and metastases measured, recorded, and compared with INP measurements for SLN #1 and sometimes #2. Results INP in 131 SLNs with no tumor (SLN #1, n = 93; SLN #2, n = 38) was 9.1 ± 6.2 (SD; range −2, 35) mmHg and 21.4 ± 15.4 mmHg (range 0–50) in 35 tumor-containing SLNs (SLN #1, n = 29; SLN #2, n = 6) (P = 0.0066). Elevated INPs significantly correlated with SLN tumor metastasis sizes (P = 0.0038; r = 0.4904). 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