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IAEA RADIOISOTOPES AND RADIOPHARMACEUTICALS SERIES No. 6 RADIOPHARMACEUTICALS FOR SENTINEL LYMPH NODE DETECTION: STATUS AND TRENDS AND STATUS DETECTION: NODE LYMPH SENTINEL FOR RADIOPHARMACEUTICALS This publication summarizes the current status of and future trends in the development of radiopharmaceuticals for sentinel lymph node detection (SLND), a widely recognized, essential diagnostic tool for the effective treatment of superfi cial cancers such as breast tumours and melanoma. The fi rst part of the publication covers all current aspects of this diagnostic methodology, including the production of nanocolloidal particles, their biological mechanism of action and relevant clinical applications. In the second part, recent outstanding developments in the fi eld fuelled by the introduction of molecular imaging agents for SLND and of multimodality optical and radioactive agents are discussed. A portion of the results on the novel generation of SLND radiopharmaceuticals presented here were obtained through an IAEA co-ordinated research project. RADIOPHARMACEUTICALS FOR SENTINEL LYMPH NODE DETECTION: STATUS AND TRENDS INTERNATIONAL ATOMIC ENERGY AGENCY VIENNA ISBN 978–92–0–109714–9 ISSN 2077–6462 14-46601_PUB1674_cover.indd 1-3 2015-03-25 09:38:49 IAEA RADIOISOTOPES AND RADIOPHARMACEUTICALS SERIES PUBLICATIONS One of the main objectives of the IAEA Radioisotope Production and Radiation Technology programme is to enhance the expertise and capability of IAEA Member States in deploying emerging radioisotope products and generators for medical and industrial applications in order to meet national needs as well as to assimilate new developments in radiopharmaceuticals for diagnostic and therapeutic applications. This will ensure local availability of these applications within a framework of quality assurance. Publications in the IAEA Radioisotopes and Radiopharmaceuticals Series provide information in the areas of: reactor and accelerator produced radioisotopes, generators and sealed sources development/production for medical and industrial uses; radiopharmaceutical sciences, including radiochemistry, radiotracer development, production methods and quality assurance/ quality control (QA/QC). The publications have a broad readership and are aimed at meeting the needs of scientists, engineers, researchers, teachers and students, laboratory professionals, and instructors. International experts assist the IAEA Secretariat in drafting and reviewing these publications. Some of the publications in this series may also be endorsed or co-sponsored by international organizations and professional societies active in the relevant fields. There are two categories of publications: the IAEA Radioisotopes and Radiopharmaceuticals Series and IAEA Radioisotopes and Radiopharmaceuticals Reports. IAEA RADIOISOTOPES AND RADIOPHARMACEUTICALS SERIES Publications in this category present guidance information or methodologies and analyses of long term validity, for example protocols, guidelines, codes, standards, quality assurance manuals, best practices and high level technological and educational material. IAEA RADIOISOTOPES AND RADIOPHARMACEUTICALS REPORTS In this category, publications complement information published in the IAEA Radioisotopes and Radiopharmaceuticals Series in areas of the: development and production of radioisotopes and generators for medical and industrial applications; and development, production and QA/QC of diagnostic and therapeutic radiopharmaceuticals. These publications include reports on current issues and activities such as technical meetings, the results of IAEA coordinated research projects, interim reports on IAEA projects, and educational material compiled for IAEA training courses dealing with radioisotope and radiopharmaceutical related subjects. In some cases, these reports may provide supporting material relating to publications issued in the IAEA Radioisotopes and Radiopharmaceuticals Series. All of these publications can be downloaded cost free from the IAEA web site: http://www.iaea.org/Publications/index.html Further information is available from: Marketing and Sales Unit International Atomic Energy Agency Vienna International Centre PO Box 100 1400 Vienna, Austria Readers are invited to provide feedback to the IAEA on these publications. Information may be provided through the IAEA web site, by mail at the address given above, or by email to: [email protected] 14-46601_PUB1674_cover.indd 4-6 2015-03-25 09:38:49 RADIOPHARMACEUTICALS FOR SENTINEL LYMPH NODE DETECTION: STATUS AND TRENDS The following States are Members of the International Atomic Energy Agency: AFGHANISTAN GHANA OMAN ALBANIA GREECE PAKISTAN ALGERIA GUATEMALA PALAU ANGOLA GUYANA PANAMA ARGENTINA HAITI PAPUA NEW GUINEA ARMENIA HOLY SEE PARAGUAY AUSTRALIA HONDURAS PERU AUSTRIA HUNGARY PHILIPPINES AZERBAIJAN ICELAND POLAND BAHAMAS INDIA PORTUGAL BAHRAIN INDONESIA QATAR BANGLADESH IRAN, ISLAMIC REPUBLIC OF REPUBLIC OF MOLDOVA BELARUS IRAQ ROMANIA BELGIUM IRELAND RUSSIAN FEDERATION BELIZE ISRAEL RWANDA BENIN ITALY SAN MARINO BOLIVIA JAMAICA SAUDI ARABIA BOSNIA AND HERZEGOVINA JAPAN SENEGAL BOTSWANA JORDAN SERBIA BRAZIL KAZAKHSTAN SEYCHELLES BRUNEI DARUSSALAM KENYA SIERRA LEONE BULGARIA KOREA, REPUBLIC OF SINGAPORE BURKINA FASO KUWAIT SLOVAKIA BURUNDI KYRGYZSTAN SLOVENIA CAMBODIA LAO PEOPLE’S DEMOCRATIC SOUTH AFRICA CAMEROON REPUBLIC SPAIN CANADA LATVIA SRI LANKA CENTRAL AFRICAN LEBANON SUDAN REPUBLIC LESOTHO SWAZILAND CHAD LIBERIA SWEDEN CHILE LIBYA SWITZERLAND CHINA LIECHTENSTEIN SYRIAN ARAB REPUBLIC COLOMBIA LITHUANIA CONGO LUXEMBOURG TAJIKISTAN COSTA RICA MADAGASCAR THAILAND CÔTE D’IVOIRE MALAWI THE FORMER YUGOSLAV CROATIA MALAYSIA REPUBLIC OF MACEDONIA CUBA MALI TOGO CYPRUS MALTA TRINIDAD AND TOBAGO CZECH REPUBLIC MARSHALL ISLANDS TUNISIA DEMOCRATIC REPUBLIC MAURITANIA, ISLAMIC TURKEY OF THE CONGO REPUBLIC OF UGANDA DENMARK MAURITIUS UKRAINE DJIBOUTI MEXICO UNITED ARAB EMIRATES DOMINICA MONACO UNITED KINGDOM OF DOMINICAN REPUBLIC MONGOLIA GREAT BRITAIN AND ECUADOR MONTENEGRO NORTHERN IRELAND EGYPT MOROCCO UNITED REPUBLIC EL SALVADOR MOZAMBIQUE OF TANZANIA ERITREA MYANMAR UNITED STATES OF AMERICA ESTONIA NAMIBIA URUGUAY ETHIOPIA NEPAL UZBEKISTAN FIJI NETHERLANDS VENEZUELA, BOLIVARIAN FINLAND NEW ZEALAND REPUBLIC OF FRANCE NICARAGUA VIET NAM GABON NIGER YEMEN GEORGIA NIGERIA ZAMBIA GERMANY NORWAY ZIMBABWE The Agency’s Statute was approved on 23 October 1956 by the Conference on the Statute of the IAEA held at United Nations Headquarters, New York; it entered into force on 29 July 1957. The Headquarters of the Agency are situated in Vienna. Its principal objective is “to accelerate and enlarge the contribution of atomic energy to peace, health and prosperity throughout the world’’. IAEA RADIOISOTOPES AND RADIOPHARMACEUTICALS SERIES No. 6 RADIOPHARMACEUTICALS FOR SENTINEL LYMPH NODE DETECTION: STATUS AND TRENDS INTERNATIONAL ATOMIC ENERGY AGENCY VIENNA, 2015 COPYRIGHT NOTICE All IAEA scientific and technical publications are protected by the terms of the Universal Copyright Convention as adopted in 1952 (Berne) and as revised in 1972 (Paris). The copyright has since been extended by the World Intellectual Property Organization (Geneva) to include electronic and virtual intellectual property. Permission to use whole or parts of texts contained in IAEA publications in printed or electronic form must be obtained and is usually subject to royalty agreements. Proposals for non-commercial reproductions and translations are welcomed and considered on a case-by-case basis. Enquiries should be addressed to the IAEA Publishing Section at: Marketing and Sales Unit, Publishing Section International Atomic Energy Agency Vienna International Centre PO Box 100 1400 Vienna, Austria fax: +43 1 2600 29302 tel.: +43 1 2600 22417 email: [email protected] http://www.iaea.org/books © IAEA, 2015 Printed by the IAEA in Austria April 2015 STI/PUB/1674 IAEA Library Cataloguing in Publication Data Radiopharmaceuticals for sentinel lymph node detection : status and trends. — Vienna : International Atomic Energy Agency, 2015. p. ; 24 cm. — (IAEA radioisotopes and radiopharmaceuticals series, ISSN 2077–6462 ; no. 6) STI/PUB/1674 ISBN 978–92–0–109714–9 Includes bibliographical references. 1. Radioactive tracers. 2. Lymph nodes — Biopsy. 3. Cancer — Diagnosis. 4. Radiopharmaceuticals. I. International Atomic Energy Agency. II. Series. IAEAL 15–00951 COPYRIGHT NOTICE FOREWORD All IAEA scientific and technical publications are protected by the terms of In a continuous effort to support and promote scientific research in cancer the Universal Copyright Convention as adopted in 1952 (Berne) and as revised diagnosis and therapy, the IAEA organized a coordinated research project (CRP) in 1972 (Paris). The copyright has since been extended by the World Intellectual on the Development of 99mTc Radiopharmaceuticals for Sentinel Node Detection Property Organization (Geneva) to include electronic and virtual intellectual and Cancer Diagnosis. This project stemmed from results obtained from a property. Permission to use whole or parts of texts contained in IAEA publications previous IAEA CRP on the Labelling of Small Biomolecules with Novel 99mTc in printed or electronic form must be obtained and is usually subject to royalty Cores. The CRP on Development of 99mTc Radiopharmaceuticals for Sentinel agreements. Proposals for non-commercial reproductions and translations are Node Detection and Cancer Diagnosis was followed by a technical meeting on welcomed and considered on a case-by-case
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  • About Mastectomy and Sentinel Lymph Node Biopsy

    About Mastectomy and Sentinel Lymph Node Biopsy

    All About Mastectomy and Sentinel Lymph Node Biopsy One of the most important goals of Moffitt Cancer Center is to provide you with quality patient care through education, research and patient care. The following information has been developed to help you understand the mastectomy and sentinel lymph node biopsy procedures for which you have been scheduled. Members of your health care team will review this information with you and answer any questions that you may have. Definitions: Mastectomy – Removal of the entire breast but not the muscles underneath. Lymph Nodes - Small bean shaped glands found in the armpit. They remove waste and fluids from the arm and breast and help fight infection. They are also call lymph glands. Sentinel Lymph Node - The first place breast cancer may metastasize (or spread) is to lymph nodes in the axilla (underarm area) on the side of the body where the cancer is. The first lymph node(s) are referred to as the sentinel lymph node(s) or the “gate keepers”. These nodes are first biopsied to determine if the cancer has spread. If cancer cells are not found in the sentinel lymph node(s) that were removed, it will not be necessary to remove the remaining lymph nodes in the arm pit. Sentinel Lymph Node Mapping and Biopsy - This procedure is a two step process. Performing the sentinel lymph node biopsy requires a small incision in your axilla. In the first step, the doctor injects a radioactive substance and/ or blue dye in the area around the tumor. Lymphatic channels (like blood vessels) carry these materials to the sentinel lymph node.