[Axillary lymph node recurrence after sentinel lymph node biopsy for breast cancer]. / Récidives ganglionnaires axillaires après lymphadénectomie sentinelle pour cancer du sein.

OBJECTIVE: The aim of this review is to summarize the current knowledge about axillary recurrences after sentinel lymph node (SLN) biopsy for breast cancer. METHODS: A Pubmed search for publications (in English or French) related to breast cancer, SLN and axillary recurrence was carried out from 1995 to 2006. RESULTS: Under controlled conditions (notably after a learning curve concerning the multidisciplinary team), the SLN procedure proved to be a reliable method for evaluation of axillary nodal status in selected patients with early-stage invasive breast cancer. When the SLN is free of cancer cells, the rate of axillary recurrence varies from 0% to 2% with a follow-up ranging from 14 to 57 months. Recurrence after axillary lymph node dissection is similar. When isolated cancer cells or micrometastases invaded the SLN, the rate of axillary recurrence remains low, but a complete axillary lymph node dissection must be performed to reduce this rate significantly. The use of intraoperative miniaturized gamma cameras could contribute to the optimization of the SLN procedure and to reduce axillary recurrences.

[Development of technologies for sentinel lymph node biopsy in case of breast cancer]. / Technologies en développement pour l'identification des ganglions sentinelles en chirurgie mammaire.

Sentinel lymph node (SLN) biopsy is now routinely used in breast cancer multidisciplinary management. The combined use of blue dye and lymphoscintigraphy gives the best SLN identification rate. Two different types of probes are available for the SLN procedure: semi-conductor probes and scintillator ones. Moreover, to increase the performances of the SLN procedure, intra-operative gamma cameras have recently been developed. The objectives of our review are to describe these materials to highlight their advantages and drawbacks from the point of view of the surgeon and the physicist.

Performances of a new prototype handheld scintillating probe for the search of sentinel lymph nodes in breast cancer.

AIM: The aim of this study is to evaluate the performances of a new prototype handheld gamma probe in a series of patients with infiltrative breast cancer justifying sentinel lymph node (SLN) excision. METHODS AND PATIENTS: SLN excision was performed on nine patients being treated for infiltrative breast cancer. After preoperative radio-isotope injection and lymphoscintigraphy, individual removal of all radioactive nodes was performed after their localisation using a novel new prototype handheld gamma intraoperative probe named CarolIReS. The activity of SLN following resection has been measured by a gamma ray counter. The mean geometrical detection efficiency of this gamma ray counter has been obtained by Monte Carlo simulation. RESULTS: With respect to the total number of SLNs identified by the CarolIReS probe, the detection probability was 80% for the lymphoscintigraphy. A mean number of 2.2 (1-5) SLNs per patient was detected after the complete SLN procedure. Among the removed SLNs, 19 were axillary SLN, 17 were located in the level I of Berg, two were located in the Rotter area and one was an intramammary SLN (ISLN) located in the lower inner area of the breast. The detection efficiency of the CarolIReS probe ranged from 2.1 to 100.0cpskBq(-1) referred to the activity of the SLN at the time of the surgery. CONCLUSION: This study shows that the CarolIReS probe is well adapted to the SLN detection and allows an efficient identification of both axillary and intramammary lymph nodes.

First results of the search for neutrinoless double-beta decay with the NEMO 3 detector.

The NEMO 3 detector, which has been operating in the Fréjus underground laboratory since February 2003, is devoted to the search for neutrinoless double-beta decay (beta beta 0v). The half-lives of the two neutrino double-beta decay (beta beta 2v) have been measured for 100Mo and 82Se. After 389 effective days of data collection from February 2003 until September 2004 (phase I), no evidence for neutrinoless double-beta decay was found from approximately 7 kg of 100Mo and approximately 1 kg of 82Se. The corresponding limits are T1/2(beta beta0v) > 4.6 x 10(23) yr for 100Mo and T1/2(beta beta 0v) > 1.0 x 10(23) yr for 82Se (90% C.L.). Depending on the nuclear matrix element calculation, the limits for the effective Majorana neutrino mass are < 0.7-2.8 e/v for 100Mo and < 1.7-4.9 eV for 82Se.