Background: Cervical cancer is the second most common type of cancer among women. Effective screening programs can help cancer detection in early phases and reduce death. Metastasis to lymph nodes is one of the most prognostic factors in patients who underwent surgery. Also, a positive result from pathology report alert oncologist as a cause of death. Sentinel lymph node biopsy has been widely studied and clinically used for many types of cancer. Methods: Two techniques exist for detecting Sentinel node in cervical cancer, which are Blue dye and gamma probe with radioactive isotope (99mTc). Moreover, lymphoscintigraphy has many advantages over the stain method. Detecting the Sentinel node is performed via laparoscopy or laparotomy; former method is better and more accurate. Results: Various researchers have focused on this method and its positive results; its superiority against full lymphadenectomy has been declared in previous studies. Moreover, the role of Sentinel lymph nodes biopsy in cervical cancer is still being extensively studied. Sentinel lymph nodes (SLN) method has a higher accuracy level to detect metastasis. Conclusion: Hence, it can be considered as a more appropriate alternative for pelvic lymph node dissection (PLND), which is a standard technique. Altering the method to a standard clinical method needs in-depth researches and studies.

Background: The tendency to spread to Sentinel lymph node (SLN) may differ depending on the biological, clinical, and histopathological features of tumors. If the factors that affect SLN metastasis (SLNM) are known, there may be no need to perform SLN biopsy (SLNB) in some groups. Objectives: This study aimed to investigate the factors affecting SLNM in patients who underwent surgery and SLNB before (surgery group) or after (neoadjuvant chemotherapy group) systemic therapy in the light of current biological characteristics of tumors and patients. Methods: The study included patients who were operated on for breast cancer and underwent SLNB in our institute between 2017 and 2019. The study included a total of 1, 050 patients, who were divided into the surgery (n=900) and neoadjuvant chemotherapy (NAC) groups (n=150). The patients' tumor localization, tumor size, histological subtype, grade, receptor status, lymphovascular invasion (LVI) status, the number of Sentinel lymph nodes removed, metastatic lymph nodes in SLNB, and axillary dissection status were analyzed in this study. Results: The study included a total of 1, 050 patients, who were assigned to the surgery (n=900) and NAC groups (n=150). Of the patients, 311 (34. 5%) cases had SLNM. In the surgery group, multivariate analyses showed that grade III, LVI, Her2 (+) increased the risk of metastasis. In the NAC group, the analyses showed Pre-NAC clinical findings of LN metastasis and luminal A subtypes as effective factors. The factors affecting SLNM were analyzed, and the univariate analyses showed that grades II and III, a tumor size of>2 cm, LVI, Her2 (+), and triple negative increased the risk of metastasis. The analyses also revealed LVI as the most important risk factor for SLN metastasis. Conclusion: Knowing the factors affecting SLNM can provide clues for the type of intervention, reconstruction, and radiotherapy planning of patients to be operated on directly or after NAC. In our study, it was found that patient age, tumor size, tumor biology, tumor grade, and especially LVI status were very important in predicting SLN positivity. It is believed that these features should be taken into account when determining the treatment strategy.

Background: Sentinel lymph node biopsy is used as an accurate staging procedure to detect early breast cancer. Several studies have documented that Sentinel lymph node biopsy can accurately determine the status of axillary nodes. Sentinel node biopsy offers the advantage of accurately staging the axilla and eliminating the need for a full axillary dissection for patients who have a negative Sentinel node. The aim of this study is to determine the predictors of non-Sentinel lymph node metastasis by Sentinel node biopsy.Methods: In this study, all patients (n=88) who underwent Sentinel node biopsy for invasive breast cancer from June 2005 to June 2010 in Shahid Faghihi Hospital, Shiraz, Iran were enrolled. We reviewed the medical files of patients and their tumor characteristics. Statistical analysis was performed to determine whether any of these characteristics alone could accurately predict the remaining non-Sentinel node status.SPSS statistical package was used.Results: The mean age of the patients was 46.1 years. Tumor size was 2.73 cm. Of the 88 patients who underwent complete axillary node dissection, 34 had metastases in the non-Sentinel nodes, with a mean of 4 positive non-Sentinel nodes in each patient.Statistically, neither the patient's age nor the clinicopathological features of the tumor were significantly associated with non-Sentinel node metastases (all: P>0.05).Conclusion: Our study shows that neither the primary tumor characteristics nor the size of metastasis in the Sentinel lymph node can predict the status of non-Sentinel nodes.However, further investigation is necessary. Complete axillary node dissection should remain the most appropriate management for patients with positive Sentinel lymph nodes.

Background and Aim: Sentinel lymph node (SLN) biopsy is a useful way of assessing axillary nodal status and obviating the need for axillary lymph node dissection (ALND) in patients with breast cancer. The aim of this study was to assess the accuracy of the SLN biopsy in the correct prediction of ALN involvement.Materials and Methods: Thirty three patients with breast cancer that had been operated in Ayatollah Taleghani and Mehr hospitals in Tehran were enrolled in a prospective study. In these patients, at first SLN biopsy and then ALND was performed. SLN was found via radionuclide scintigraphy and blue dye during the surgery. Both SLN and ALN involvement were assessed by a pathologist.Results: Mean age of the cases was 52.03±8.4. Accuracy of SLN in predicting ALN involvement was 90.91% (Confidence Interval (CI)=95%: 77.88%-96.60%), sensitivity was 92% (Confidence Interval=95%: 75.03%-97.78%) and specificity was 87.5% (CI=95%: 52.91%-97.76%).Conclusion: Success rate of SLN finding was high, so SLN biopsy can be used to determine the stage of breast cancer in hospitals and the centers which have this equipment.

We report a young male with an initial excisional biopsy report of melanoma of the lower back, referred to our hospital for complete excision and Sentinel lymph node (SLN) biopsy. Four peritumoral intradermal Tc-99m phytate injection was performed and SLNs were detected in both axillary and right inguinal regions. On the biopsy only the right axillary SLN was metastatic leading to right axillary lymph nodes dissection 6 days later. No other surgical intervention was done for two other lymphatic drainage basins. On follow up the patient noted a right axillary mass with highly suspicious ultrasound findings. Metastatic work up was negative. Second axillary lymph node dissection confirmed conglomerated lymph nodes metastases in this area. Multiple drainage basins in the trunk melanoma are common and many authors have concern about changing in lymphatic drainage pattern after SLN biopsy and surgical manipulation. This case showed correct initial diagnosis of involved lymph nodes in one out of three lymphatic drainage basins, and also correctly predicts regional recurrence in the same location.

Background: Sentinel node biopsy (SLNB) is the standard of care for breast cancer treatment and it is getting wide acceptance in Iran. The radiation safety of the procedure has been investigated under controlled conditions, but the standard dose of radiotracer and techniques are not always observed in the community setting. The aim of this study was to assess the magnitude of the absorbed doses of radiation to the hands of operating surgeons.Materials and Methods: Twenty consecutive SLNB procedures were studied. Radiation dose to the hands of the surgeons was measured by placing lithium fluoride thermoluminescent dosimeters (TLDs) in the surgeons' glove. The radiation dose to the abdomen and thyroid area was measured by placing TLDs at these areas. The injected dose of radiotracer, the time interval to the surgery and the duration of the surgery were recorded.Results: The injected dose of radiotracer ranged from 0.1 to 5 mCi. The highest absorbed dose was recorded by TLD, placed on the non-dominant hand third finger (189.1 mSv). Mean recorded doses were higher for non-dominant hand second finger (53.49 ± 24.60 mSv). The measured absorbed doses for the abdominal and thyroid area were lower than those for the fingers.Conclusion: This study has confirmed the procedure safety, even with high dose of radiotracer. Nevertheless, it is advisable to use the lowest dose of the radiotracer to avoid the waste of resources.