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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
#1
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
#2
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
#3
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
#4
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: Eur J 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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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...
October 9, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28975889/the-evolution-of-the-sentinel-node-procedure-in-the-treatment-of-breast-cancer
#11
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
https://www.readbyqxmd.com/read/28961070/vascular-alterations-in-axillary-and-brachial-vessels-in-patients-with-axillary-web-syndrome-after-breast-cancer-surgery
#12
Cintia Furlan, Carolina Nascimben Matheus, Rodrigo Menezes Jales, Sophie Derchain, Luís Otávio Sarian
BACKGROUND: Surgical manipulations of the axilla may cause a condition known as Axillary Web Syndrome (AWS). The systems compromised and the sequence of events leading to this syndrome remains unknown. This study evaluated clinical, surgical, and vascular factors associated with onset and duration of AWS after breast cancer surgery. METHODS AND RESULTS: In this prospective study, 155 women were included. They were submitted to a physical examination that consisted of ultrasound Doppler of axillary and brachial vessels and the evaluation of AWS in 1, 3, and 6 months after breast cancer surgery...
September 29, 2017: Lymphatic Research and Biology
https://www.readbyqxmd.com/read/28956696/alteration-of-blood-circulation-in-the-upper-limb-before-and-after-surgery-for-breast-cancer-associated-with-axillary-lymph-node-dissection-or-sentinel-lymph-node-biopsy
#13
Maíta M O L L Vaz, Rinaldo Roberto de Jesus Guirro, Hélio Humberto Angotti Carrara, Thais Montezuma, Carla Silva Perez, Elaine Caldeira de Oliveira Guirro
BACKGROUND: This aim of this study was to assess and compare arterial and venous circulation in women with axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB) before and after breast cancer surgery. METHODS AND RESULTS: Fifty-two women took part in the study, divided into three groups: those undergoing ALND at levels I, II, and III (ALNDG), with mean age of 56.29 ± 10.85 years old; those undergoing sentinel lymph node biopsy (SLNBG), with mean age of 57...
September 28, 2017: Lymphatic Research and Biology
https://www.readbyqxmd.com/read/28945489/management-of-the-axilla-in-t1-2-breast-cancer-patients-with-macrometastatic-sentinel-node-involvement-who-underwent-breast-conserving-therapy
#14
Bekir Kuru, Savas Yuruker, Yurdanur Sullu, Bilge Gursel, Necati Ozen
PURPOSE: The aims of our study were to determine the incidence of axillary recurrence and arm morbidity in T1-2 invasive breast cancer patients with macrometastases on the sentinel lymph node (SLN) who underwent breast-conserving therapy (BCT), with or without axillary lymph node dissection (ALND). METHODS: One hundred and nine T1-2 invasive breast cancer patients with macrometastases on the SLN who underwent BCT in our institution were included in the study. Patients with 1-2 positive SLN and without extra nodal extension (ENE) on the SLN did not undergo ALND (SLN-only group) and patients with ENE or patients who had >2 metastatic nodes underwent level I, II ALND (ALND group)...
September 25, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28943062/the-success-of-sentinel-lymph-node-biopsy-after-neoadjuvant-therapy-a-single-institution-review
#15
James M Chang, Heidi E Kosiorek, Nabil Wasif, Richard J Gray, Chee-Chee H Stucky, Donald W Northfelt, Karen S Anderson, Ann E McCullough, Idris Tolgay Ocal, Barbara A Pockaj
BACKGROUND: The appropriate management of the axilla among women undergoing neoadjuvant therapy is in evolution. METHOD: A retrospective review of a prospective database of women with breast cancer who underwent neoadjuvant systemic therapy using endocrine/chemotherapy (NE/CT) from 2002 to 2015 was performed. RESULTS: We reviewed 253 women: triple negative breast cancer (30%), ER+HER2- (44%) breast cancer and HER2+ (25%) disease. The mean age was 55 years (SD = 12)...
September 18, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28942366/t-regulatory-cells-mediate-local-immunosuppression-in-lymphedema
#16
Gabriela D García Nores, Catherine L Ly, Ira L Savetsky, Raghu P Kataru, Swapna Ghanta, Geoffrey E Hespe, Stanley G Rockson, Babak J Mehrara
Patients who suffer from lymphedema have impaired immunity and, as a result, are at an increased risk for infections. Furthermore, previous studies have shown that lymphadenectomy impairs acquisition of adaptive immune responses and antibody production in response to foreign antigens. Although it is clear that antigen presentation in lymph nodes plays a key role in adaptive immunity, the cellular mechanisms that regulate impaired immune responses in patients with lymphedema or following lymphatic injury remain unknown...
September 20, 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/28919032/the-role-of-preoperative-axillary-ultrasound-and-fine-needle-aspiration-cytology-in-identifying-patients-with-extensive-axillary-lymph-node-involvement
#17
Robert Maráz, Tamás Zombori, Éva Ambrózay, Gábor Cserni
INTRODUCTION: In the recent past, both clinically node-positive and node-negative but sentinel node-positive patients underwent axillary lymph node dissection (ALND), although the two groups seem to have substantially different degree of nodal involvement. METHODS: Data on consecutive primary breast cancer patients with documented axillary ultrasound (AXUS) results who underwent ALND between January 2003 and December 2015 either because of AXUS-guided fine needle aspiration (A-FNAC) results or because of a positive sentinel lymph node were retrospectively analysed...
August 30, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28898379/effect-of-axillary-dissection-vs-no-axillary-dissection-on-10-year-overall-survival-among-women-with-invasive-breast-cancer-and-sentinel-node-metastasis-the-acosog-z0011-alliance-randomized-clinical-trial
#18
RANDOMIZED CONTROLLED TRIAL
Armando E Giuliano, Karla V Ballman, Linda McCall, Peter D Beitsch, Meghan B Brennan, Pond R Kelemen, David W Ollila, Nora M Hansen, Pat W Whitworth, Peter W Blumencranz, A Marilyn Leitch, Sukamal Saha, Kelly K Hunt, Monica Morrow
Importance: The results of the American College of Surgeons Oncology Group Z0011 (ACOSOG Z0011) trial were first reported in 2005 with a median follow-up of 6.3 years. Longer follow-up was necessary because the majority of the patients had estrogen receptor-positive tumors that may recur later in the disease course (the ACOSOG is now part of the Alliance for Clinical Trials in Oncology). Objective: To determine whether the 10-year overall survival of patients with sentinel lymph node metastases treated with breast-conserving therapy and sentinel lymph node dissection (SLND) alone without axillary lymph node dissection (ALND) is noninferior to that of women treated with axillary dissection...
September 12, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28879416/patient-age-and-tumor-subtype-predict-the-extent-of-axillary-surgery-among-breast-cancer-patients-eligible-for-the-american-college-of-surgeons-oncology-group-trial-z0011
#19
Cecilia T Ong, Samantha M Thomas, Rachel C Blitzblau, Oluwadamilola M Fayanju, Tristen S Park, Jennifer K Plichta, Laura H Rosenberger, Terry Hyslop, E Shelley Hwang, Rachel A Greenup
BACKGROUND: The American College of Surgeons Oncology Group (ACOSOG) Z0011 trial established the safety of omitting axillary lymph node dissection (ALND) for early-stage breast cancer patients with limited nodal disease undergoing lumpectomy. We examined the extent of axillary surgery among women eligible for Z0011 based on patient age and tumor subtype. METHODS: Patients with cT1-2, cN0 breast cancers and one or two positive nodes diagnosed from 2009 to 2014 and treated with lumpectomy were identified in the National Cancer Data Base...
November 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28876628/axillary-lymph-node-dissection-in-invasive-breast-cancer-patients-at-charlotte-maxeke-johannesburg-academic-hospital-and-chris-hani-baragwanath-academic-hospital
#20
C Groenewald, S Neitz, H Cubasch, A Mannell
BACKGROUND: Axillary lymph node dissection (ALND) carries a high morbidity and sentinel node biopsy has become the standard of care in node-negative disease. Patients in our setting are assessed as node-positive on the basis of physical examination and axillary ultrasound and will undergo ALND without prior biopsy. The administration of neoadjuvant chemotherapy (NACT) may downstage the axilla and offer opportunities for axilla-sparing surgery. METHOD: This retrospective cohort study included all female patients older than 18 years of age who underwent axillary surgery in the breast units at Charlotte Maxeke Johannesburg Academic Hospital and Chris Hani Baragwanath Academic Hospital from March 2013 to March 2015...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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