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https://www.readbyqxmd.com/read/29329752/role-of-frozen-section-in-sentinel-lymph-node-biopsy-for-breast-cancer-in-the-era-of-the-acosog-z0011-and-ibcsg-23-10-trials
#1
Augusto Lombardi, Giuseppe Nigri, Stefano Maggi, Gianluca Stanzani, Valeria Vitale, Andrea Vecchione, Alessandro Nania, Claudio Amanti
BACKGROUND: Intraoperative frozen sections (FS) of sentinel lymph nodes (SLN) were evaluated to avoid the need for deferred axillary lymph node dissection (ALND) in patients with early breast cancer (EBC). However, FS has low sensitivity for detecting micro-metastases (<2 mm), resulting in patients who later undergo deferred ALND. The aim of the study was to determine the best clinical approach for selecting patients who would derive real benefit from ALND, as well as to minimize the functional and psychological damage caused by delayed surgery, and the risk of undertreating EBC patients...
January 9, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29285043/improved-model-for-predicting-axillary-response-to-neoadjuvant-chemotherapy-in-patients-with-clinically-node-positive-breast-cancer
#2
Hyung Suk Kim, Man Sik Shin, Chang Jong Kim, Sun Hyung Yoo, Tae Kyung Yoo, Yong Hwa Eom, Byung Joo Chae, Byung Joo Song
Purpose: Pathological complete response (pCR) of axillary lymph node (LN) is frequently achieved in patients with clinically node-positive breast cancer after neoadjuvant chemotherapy (NAC). Treatment of the axilla after NAC is not well established and the value of sentinel LN biopsy following NAC remains unclear. This study investigated the predictive value of axillary response following NAC and evaluated the predictive value of a model based on axillary response. Methods: Data prospectively collected on 201 patients with clinically node-positive breast cancer who were treated with NAC and underwent axillary LN dissection (ALND) were retrieved...
December 2017: Journal of Breast Cancer
https://www.readbyqxmd.com/read/29279156/the-impact-of-axillary-ultrasound-with-biopsy-in-overtreatment-of-early-breast-cancer
#3
Javier Del Riego, María Jesús Diaz-Ruiz, Milagros Teixidó, Judit Ribé, Mariona Vilagran, Lydia Canales, Melcior Sentís
PURPOSE: (a) To compare the axillary tumor burden detected by fine-needle aspiration cytology (FNAC) versus sentinel lymph node biopsy (SLNB). (b) To evaluate the relationship between axillary tumor burden and the number of suspicious lymph nodes detected by axillary ultrasonography (US). (c) To calculate the false-positive and false-negative rates for FNAC in patients fulfilling ACOSOG Z0011 criteria. METHODS: Retrospective multicenter cross-sectional study of 355 pT1 breast cancers...
January 2018: European Journal of Radiology
https://www.readbyqxmd.com/read/29235045/axillary-staging-for-breast-cancer-during-pregnancy-feasibility-and-safety-of-sentinel-lymph-node-biopsy
#4
S N Han, F Amant, E H Cardonick, S Loibl, F A Peccatori, O Gheysens, C A Sangalli, V Nekljudova, K Dahl Steffensen, M Mhallem Gziri, C P Schröder, C A R Lok, A Verest, P Neven, A Smeets, G Pruneri, M Cremonesi, O Gentilini
BACKGROUND: Safety of sentinel lymph node (SLN) biopsy for breast cancer during pregnancy is insufficiently explored. We investigated efficacy and local recurrence rate in a large series of pregnant patients. PATIENTS AND METHODS: Women diagnosed with breast cancer who underwent SLN biopsy during pregnancy were identified from the International Network on Cancer, Infertility and Pregnancy, the German Breast Group, and the Cancer and Pregnancy Registry. Chart review was performed to record technique and outcome of SLN biopsy, locoregional and distant recurrence, and survival...
December 12, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29234253/evaluation-of-sentinel-lymph-node-biopsy-and-axillary-lymph-node-dissection-for-breast-cancer-treatment-concepts-a-retrospective-study-of-1-214-breast-cancer-patients
#5
Roland G Stein, Roland Fricker, Thomas Rink, Hartmut Fitz, Sebastian Blasius, Joachim Diessner, Sebastian F M Häusler, Tanja N Stüber, Victoria Andreas, Achim Wöckel, Thomas Müller
Background: Most breast cancer patients require lumpectomy with axillary sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). The ACOSOG Z0011-trial failed to detect significant effects of ALND on disease-free and overall survival among patients with limited sentinel lymph node (SLN) metastases. Intense dose-dense chemotherapy and supraclavicular fossa radiation (SFR) are indicated for patients with extensive axillary metastases. In this multicentered study, we investigated the relevance of ALND after positive SLNB to determine adequate adjuvant therapy...
October 2017: Breast Care
https://www.readbyqxmd.com/read/29209873/99mtc-rituximab-as-a-tracer-for-sentinel-lymph-node-biopsy-in-breast-cancer-patients-a-single-center-analysis
#6
Jiwei Wang, Tie Fan, Yingjian He, Xue Chen, Zhaoqing Fan, Yuntao Xie, Tianfeng Wang, Jinfeng Li, Tao Ouyang
PURPOSE: This study aimed to determine the long-term prognosis of breast cancer patients with 99mTc-rituximab for sentinel lymph node biopsy (SLNB). METHODS: A total of 2947 patients with negative sentinel lymph nodes (SLNs) omitting axillary lymph node dissection (ALND), treated between June 2005 and December 2013, were retrospectively analyzed. SLNB was performed prior to adjuvant therapy. RESULTS: After a median follow-up of 62 months, 22 cases of axillary recurrence (AR) were observed...
December 6, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29197044/intraoperative-ultrasound-guided-excision-of-axillary-clip-in-patients-with-node-positive-breast-cancer-treated-with-neoadjuvant-therapy-ilina-trial-a-new-tool-to-guide-the-excision-of-the-clipped-node-after-neoadjuvant-treatment
#7
Christian Siso, Juan de Torres, Antonio Esgueva-Colmenarejo, Martin Espinosa-Bravo, Neus Rus, Octavi Cordoba, Roberto Rodriguez, Vicente Peg, Isabel T Rubio
BACKGROUND: The accuracy of sentinel lymph node biopsy (SLNB) after neoadjuvant therapy (NAT) has been improved with the placement of a clip in the positive node prior to treatment. Several methods have been described for clipped node excision during SLNB after NAT. We assessed the feasibility of intraoperative ultrasound (IOUS)-guided excision of the clipped node during SLNB and investigated whether the accuracy of SLNB is improved. METHODS: After approval by the Institutional Ethics Committee, all breast cancer patients undergoing NAT had an US-visible clip placed in the positive node...
December 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29181071/application-of-artificial-neural-networks-for-predicting-presence-of-non-sentinel-lymph-node-metastases-in-breast-cancer-patients-with-positive-sentinel-lymph-node-biopsies
#8
Tomasz Nowikiewicz, Paweł Wnuk, Bogdan Małkowski, Andrzej Kurylcio, Janusz Kowalewski, Wojciech Zegarski
Introduction: The aim of this study was to present a new predictive tool for non-sentinel lymph node (nSLN) metastases. Material and methods: One thousand five hundred eighty-three patients with early-stage breast cancer were subjected to sentinel lymph node biopsy (SLNB) between 2004 and 2012. Metastatic SLNs were found in 348 patients - the retrospective group. Selective axillary lymph node dissection (ALND) was performed in 94% of cases. Involvement of the nSLNs was identified in 32...
October 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29151972/comparable-survival-between-additional-radiotherapy-and-local-surgery-in-occult-breast-cancer-after-axillary-lymph-node-dissection-a-population-based-analysis
#9
San-Gang Wu, Wen-Wen Zhang, Jia-Yuan Sun, Feng-Yan Li, Huan-Xin Lin, Yong-Xiong Chen, Zhen-Yu He
Purpose: To investigate the clinical value of additional local treatment strategies in occult breast cancer (OBC) after axillary lymph node dissection (ALND). Methods: Patients diagnosed with OBC between 1990 and 2013 were included from the Surveillance, Epidemiology, and End Results registry database. The significant risk factors of cause-specific survival (CSS) and overall survival (OS) were identified using univariate and multivariate Cox regression analyses. Results: We identified 980 patients, including 219 (22...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/29142748/intraoperative-prediction-of-the-two-axillary-lymph-node-macrometastases-threshold-in-patients-with-breast-cancer-using-a-one-step-nucleic-acid-cytokeratin-19-amplification-assay
#10
Victoria Fung, Stan Kohlhardt, Patricia Vergani, Gregory J Zardin, Norman R Williams
The aim of the present study was to assess the sensitivity, specificity and practicality of using a one-step nucleic acid amplification (OSNA) assay during breast cancer staging surgery to predict and discriminate between at least 2 involved nodes and more than 2 involved nodes and facilitate the decision to provide axillary conservation in the presence of a low total axillary node tumour burden. A total of 700 consecutive patients, not treated with neo-adjuvant chemotherapy, received intraoperative sentinel lymph node (SLN) analysis using OSNA for cT1-T3 cN0 invasive breast cancer...
November 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29104611/frozen-section-evaluation-of-sentinel-lymph-nodes-in-breast-carcinoma-a-retrospective-analysis
#11
Leonardo Russo, Luis Betancourt, Gabriel Romero, Alí Godoy, Laura Bergamo, Rafael Delgado, Ángela Ruiz, Marianna Gutiérrez, Eduardo Salas, Maria Puzzi
Objective: To determine the false-negative rate, sensitivity, and diagnostic accuracy of the frozen section analysis of the sentinel lymph node (SLN) biopsy in early-stage breast cancer compared to the definitive section and to identify the factors that could be associated with the appearance of false-negative cases. Secondarily, to evaluate the pathological results of cases submitted to completion axillary lymph node dissection (ALND) for positive SLN. Methods: We performed a five-year review of cases (2011-2015), including patients with early-stage breast cancer undergoing SLN biopsy, with frozen section evaluation and subsequent definitive pathological analysis...
2017: Ecancermedicalscience
https://www.readbyqxmd.com/read/29100726/expanding-implementation-of-acosog-z0011-in-surgeon-practice
#12
Anna Weiss, Elizabeth A Mittendorf, Sarah M DeSnyder, Rosa F Hwang, Vivian Bea, Isabelle Bedrosian, Karen Hoffman, Beatriz Adrade, Aysegul A Sahin, Henry M Kuerer, Kelly K Hunt, Abigail S Caudle
BACKGROUND: After publication of American College of Surgeons Oncology Group (ACOSOG) Z0011, surgeons at our institution limited axillary surgery to sentinel lymph node dissection (SLND) in 76% of patients meeting trial eligibility criteria. Our study objective was to assess incorporation of the trial data into practice 5 years later. PATIENTS AND METHODS: Patients with clinical T1-2, N0 invasive breast cancer undergoing breast conserving surgery were included. Comparisons were made between patients who underwent axillary lymph node dissection (ALND) and those that had no further surgery...
October 13, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/29082376/factors-influencing-non-sentinel-node-metastasis-in-patients-with-macrometastatic-sentinel-lymph-node-involvement-and-validation-of-three-commonly-used-nomograms
#13
Hikmet Erhan Güven, Lütfi Doğan, Mahmut Onur Kültüroğlu, Mehmet Ali Gülçelik, Cihangir Özaslan
OBJECTIVE: Omitting axillary lymph node dissection (ALND) in a subgroup of patients with sentinel lymph node (SLN) metastasis is becoming a widely accepted practice. Avoiding the well-known complications of ALND is the sole aim without compromising the curative intention of surgery. MATERIALS AND METHODS: The data were probed for breast cancer patients that were operated on between February 2014 and June 2016. SLN biopsies were performed in 507 patients and out of 157 patients who underwent ALND for a metastatic SLN, 151 were found eligible for the analyses as having macrometastatic (>2mm) SLN...
October 2017: European Journal of Breast Health
https://www.readbyqxmd.com/read/29051403/axillary-treatment-of-patients-with-breast-cancer-and-micrometastatic-disease-in-the-sentinel-lymph-node-our-experience
#14
Andrea Morlino, Giuseppe La Torre, Giuseppe Patitucci, Aldo Cammarota
AIM: Since the introduction of the sentinel lymph node biopsy (SLNB) in patients with breast cancer, micrometastases are detected frequently in the sln. PATIENTS AND METHODS: Between July 2005 and June 2016, 1244 patients were submitted to surgery for breast cancer. 431 patients cT1-2 N0 underwent to sentinel lymph node (SLN) and micrometastases were found in 68 of 431 screen-detected patients. Nearly all patients with both micro and macrometastases had axillary lymph node dissection (ALND)...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29033071/secondary-node-analysis-as-an-indicator-for-axillary-lymphadenectomy-in-breast-cancer-patients
#15
Manel Cremades, Mireia Torres, Montse Solà, Jordi Navinés, Icíar Pascual, Antonio Mariscal, Albert Caballero, Eva Castellà, Miguel Ángel Luna, Joan Francesc Julián
INTRODUCTION: Currently, there is no agreement regarding if it would be necessary to perform an axillary lymph node dissection (ALND) in patients who have macrometastases in the sentinel lymph node (SLN). We studied the utility of the secondary node analysis (SN), defined as the following node after the SLN in an anatomical and lymphatic pathway, as a sign of malignant axillary involvement. METHODS: An observational, retrospective and multicentre study was designed to assess the utility of the SN as a sign of axillary involvement...
October 12, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29033068/axillary-treatment-in-breast-cancer-surgery-systematic-review-of-its-impact-on-survival
#16
Alejandra García Novoa, Benigno Acea Nebril
Sentinel lymph node biopsy and ACOSOG-Z0011 criteria have modified axillary treatment in breast cancer surgery. We performed a systematic review of studies assessing the impact of axillary treatment on survival. The search showed 6891 potentially eligible items. Of them, 23 clinical trials and 12 meta-analyses published between 1980 and 2017 met the study criteria. The review revealed that axillary lymph node dissection (ALND) can be omitted in patients pN0 and pN1mic, without compromising survival. In patients pN1 it is proposed not to treat the axilla or replace ALND for axillary radiotherapy...
October 12, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29031423/the-state-of-surgical-axillary-management-and-adjuvant-radiotherapy-for-early-stage-invasive-breast-cancer-in-the-modern-era
#17
Justin M Mann, Xian Wu, Paul Christos, Himanshu Nagar
BACKGROUND: For clinical T1-2N0 breast cancer, sentinel lymph node biopsy (SLNB) has been shown in American College of Surgeons Oncology Group (ACOSOG) Z0011 to be sufficient for women with 1 to 2 positive sentinel lymph nodes with no added benefit for completion axillary lymph node dissection (ALND). Z0011 specified whole breast radiotherapy (RT) using standard tangential fields; however, later analysis showed variation in field design. We assessed nationwide practice patterns and examined factors associated with patients undergoing completion ALND and subsequent radiation field design...
September 19, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/29027318/imaging-and-pathology-features-to-predict-axillary-tumor-load-in-breast-cancer
#18
Pau Nicolau, Rocio Gamero, Ana Rodríguez-Arana, Francisco Plancarte, Rodrigo Alcántara, Ramon Carreras, Dolors Sabadell, Mar Vernet-Tomas
AIM: We investigated if imaging and pathology features could help to identify a high axillary tumor burden (ATB) in breast cancer patients, in order to individualize decisions on axillary lymph node (ALN) dissection (ALND). METHODS: We retrospectively analyzed patients primarily treated with surgery in our unit between 2011 and 2014. We divided the patients in two groups: low ATB (LATB) if ≤ 2 ALN were infiltrated and high ATB (HATB) if > 2 ALN were infiltrated...
October 13, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28991362/axillary-tumour-burden-in-women-with-a-fine-needle-aspiration-core-biopsy-proven-positive-node-on-ultrasonography-compared-to-women-with-a-positive-sentinel-node
#19
COMPARATIVE STUDY
P Lloyd, E Theophilidou, R G Newcombe, L Pugh, A Goyal
BACKGROUND: The sensitivity of axillary ultrasonography (AUS) has increased in recent years, enabling detection of even low-volume axillary nodal metastases. The aim here was to evaluate the axillary tumour burden in women with a fine-needle aspiration/core biopsy-proven positive node on AUS and in those with a positive sentinel node biopsy (SNB). METHODS: This retrospective cohort study included all patients with early breast cancer who had AUS and axillary lymph node dissection (ALND) between 2011 and 2014...
December 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28975889/the-evolution-of-the-sentinel-node-procedure-in-the-treatment-of-breast-cancer
#20
Tove Filtenborg Tvedskov
This thesis is based on 10 original articles, of which 3 were previously included in the PhD thesis "Staging of women with breast cancer after introduction of sentinel node guided axillary dissection". In the PhD thesis is was shown that the introduction of sentinel lymph node dissection (SLND) in the treatment of breast cancer in Denmark has resulted in an increased identification of patients with micrometastases or isolated tumor cells (ITC) in the lymph nodes. Not all these small metastases are likely to disseminate to non-sentinel nodes...
October 2017: Danish Medical Journal
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