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By Melody A. Cobleigh M.D. (auth.), William J. Gradishar M.D., William C. Wood M.D. (eds.)

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13. 14. Cuzick J, Stewart H, Rutqvist L, et al: Cause-specific mortality in longterm survivors of breast cancer who participated in trials of radiotherapy. J Clin Oncol 12:447-453, 1994. ) of postmastectomy radiotherapy (Editorial). J Clin Oncol 13:2861-2864, 1995. Harris JR, Morrow M: Local management of invasive breast cancer, in Harris JR, Lippman ME, Morrow M, et al (eds): Diseases of the Breast. B. Lippincott, 1996, pp 485-545. Early Breast Cancer Trialists' Collaborative Group: Effects of radiotherapy and surgery in early breast cancer: an overview of the randomized trials.

Wide variations in technique exist when SLND is performed using radiopharmaceuticals. The specific radiopharmaceutical used, colloid particle size, timing of injection, method and volume of injection, and detection techniques all differ among series. The radioisotope most commonly used is technetium-99m, a high-energy radioisotope that decays by pure gamma emission. With a short half-life of 6 hours, technetium-99m is ideal for detection of a sentinel node with a gamma camera or probe. Colloidal radiopharmaceuticals labeled with technetium-99m are most commonly used for SLND.

3 When the broader definition of LRF is used, including patients with simultaneous distant failure, the rate of LRF will be about one-third higher than when using the more restrictive definition. 27 In the British Columbia trial a substantial proportion of the observed local-regional failures occurred more than 10 years after treatment. 9 Hence the length of follow-up will substantially affect the observed results. Patient populations also differ between the reported series in ways which may impact the observed rates of LRF.

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