PubMed · 9425333
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J F Thompson. 1997. Sentinel node biopsy.. https://doi.org/10.1002/(sici)1096-9098(199712)66%3A4%3C270%3A%3Aaid-jso10%3E3.0.co%3B2-4
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Mammography is used to screen the population for breast cancer but often is inconclusive. There are several developing techniques to further assess the breast before biopsy that may decrease the number of benign biopsies. These include ultrasound, nuclear medicine, and MR imaging. When a biopsy is deemed necessary, there are several methods used to obtain tissue that are less invasive and less costly than open biopsy. This evolving area of breast evaluation is now filled with great expectation and uncertain future.
Tumors of the small bowel are uncommon and seldom suspected on a clinical basis. Together with the relative inaccessibility of the small bowel to endoscopic investigation, the rarity of these tumors undoubtedly delays the diagnosis. Small bowel tumors may be an interesting field of application for enteroscopy, which now can be readily performed with dedicated enteroscopic evaluation in patients with suspected small bowel neoplasia could improve prognosis and treatment. Enteroscopy may also play an important role in the surveillance of inherited polyposis syndromes, as in other precancerous condition of the small bowel. In Peutz-Jeghers syndrome it may reduce polyp-induced complications and improve planning for surgery; in familial adenomatous polyposis it may contribute to preventing upper gastrointestinal tract cancer.
Enteroscopy does not yet carry the conviction that physicians are used to with gastroscopy and colonoscopy. The examination is never complete. The distance of small bowel examined in any individual examination is unknown. Although some therapeutic maneuvers are possible, the further the endoscope is into the small bowel the more difficult it becomes to pass and control the instruments. There is more room for improvement in enteroscopy than in almost any other area of gastrointestinal endoscopy. Nonetheless, there have been real gains for patients with difficult gastrointestinal bleeding and small bowel pathology with advances in diagnostic and therapeutic ability with enteroscopes achieved by a combination of relatively minor technologic changes and some clinical enthusiasm.