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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
#1
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
#2
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
#3
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...
September 6, 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
#4
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
https://www.readbyqxmd.com/read/28861665/non-visualized-sentinel-nodes-in-breast-cancer-patients-prevalence-risk-factors-and-prognosis
#5
N C Verheuvel, A C Voogd, V C G Tjan-Heijnen, S Siesling, R M H Roumen
BACKGROUND: Evidence and consensus is lacking in international guidelines regarding axillary treatment recommendations for patients in whom a sentinel lymph node (SLN) cannot be visualized (non-vSLN) during the sentinel node procedure. In this study we aimed to determine the prevalence of non-vSLNs in a Dutch population of breast cancer patients and to examine predictors and survival rate for non-vSLN. METHODS: A nationwide, retrospective, population-based study was performed including 116,920 patients with invasive breast cancer who underwent a SLN procedure in the Netherlands between January 2005 and December 2013...
August 31, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28843225/managing-the-axilla-in-early-breast-cancer-impact-of-acosog-z0011-trial-in-changing-practices-in-a-low-middle-income-country
#6
Awais Amjad Malik, Namra Urooj, Romaisa Shamim, Mariam Salim, Razia Bano, Zulqurnain Chaudhry, Huma Majeed Khan, Amina Iqbal Khan
Objective: To determine the impact of the trial on surgeon practice patterns at our institution. Methodology: A comparison of patients undergoing surgery for early breast cancer before and after the implementation of the new guidelines was done. We adopted the new guidelines in April 2015. Patients meeting Z0011 inclusion criteria were identified. For group A (Pre Z0011) patients operated between Jan to Dec 2013 were studied. And for Group B (Post Z0011) patients operated between July 2014 to Jun 2015 were included...
August 27, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28831632/utilization-of-bioimpedance-spectroscopy-in-the-prevention-of-chronic-breast-cancer-related-lymphedema
#7
David I Kaufman, Chirag Shah, Frank A Vicini, Marisa Rizzi
BACKGROUND: This analysis was performed to assess the impact of early intervention following prospective surveillance using bioimpedance spectroscopy (BIS) to detect and manage breast cancer-related lymphedema (BCRL). METHODS: From 8/2010 to 12/2016, 206 consecutive patients were evaluated with BIS. The protocol included pre-operative assessment with L-Dex as well as post-operative assessments at regular intervals. Patients with L-Dex scores >10 from baseline were considered to have subclinical BCRL and were treated with over-the-counter (OTC) compression sleeve for 4 weeks...
August 22, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28797856/neuropathic-pain-after-breast-cancer-treatment-characterization-and-risk-factors
#8
Susana Pereira, Filipa Fontes, Teresa Sonin, Teresa Dias, Maria Fragoso, José Castro-Lopes, Nuno Lunet
CONTEXT: Neuropathic pain (NP) may be an important contributor to the morbidity burden of breast cancer. OBJECTIVES: We aimed to quantify the incidence of NP in the first year after diagnosis of breast cancer, and to identify its main determinants. METHODS: We performed a prospective cohort study including 506 patients with incident breast cancer, recruited at the Portuguese Institute of Oncology of Porto, and followed for one year; patients with incident NP were additionally evaluated when this condition was diagnosed and after six months, to identify chronic NP...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28766228/breast-cancer-related-lymphedema-risk-is-related-to-multidisciplinary-treatment-and-not-surgery-alone-results-from-a-large-cohort-study
#9
Toan T Nguyen, Tanya L Hoskin, Elizabeth B Habermann, Andrea L Cheville, Judy C Boughey
BACKGROUND: Breast cancer-related lymphedema (BCRL) is a significant complication for women undergoing treatment. We assessed BCRL incidence and risk factors in a large population-based cohort. METHODS: We utilized the Olmsted County Rochester Epidemiology Project Breast Cancer Cohort from 1990-2010 and ascertained BCRL and risk factors. The cumulative incidence estimator was used to estimate the rate of BCRL; competing risks regression was used for multivariable analysis...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766210/positive-ultrasound-guided-lymph-node-needle-biopsy-in-breast-cancer-may-not-mandate-axillary-lymph-node-dissection
#10
Christine K Harris, Hanh Tam Tran, Katherine Lee, Charles Mylander, Daina Pack, Martin Rosman, Lorraine Tafra, Christopher B Umbricht, Reema Andrade, Wen Liang, Rubie Sue Jackson
BACKGROUND: The ACOSOG Z0011 (Z11) trial demonstrated that in patients with nonpalpable axillary lymph nodes (LN) and one to two positive sentinel LN (SLN), axillary LN dissection (ALND) is unnecessary.JAMA 305:569-575, [2011], Ann Surg 264:413-42, [2016] The Z11 trial did not require preoperative axillary ultrasound (axUS). In many centers, preoperative axUS is part of the standard workup of a newly diagnosed breast cancer patient, but in light of the Z11 results, its role is now questioned...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766198/factors-influencing-management-and-outcome-in-patients-with-occult-breast-cancer-with-axillary-lymph-node-involvement-analysis-of-the-national-cancer-database
#11
Lindsay K Hessler, Jason K Molitoris, Paula Y Rosenblatt, Emily C Bellavance, Elizabeth M Nichols, Katherine H R Tkaczuk, Steven J Feigenberg, Soren M Bentzen, Susan B Kesmodel
BACKGROUND: Occult breast cancer (OBC) is rare and optimal local-regional (LR) management has not been defined. Using a patient registry database, we examine factors associated with treatment and outcomes in OBC. METHODS: Female patients with cT0 N1/2 M0 BC were selected from the National Cancer Database (2004-2013) and categorized into four treatment groups: MAST = mastectomy with axillary lymph node dissection (ALND) ± radiation (RT); RT + ALND = RT with ALND, no breast surgery; ALND = ALND alone; OBS = no breast surgery, RT, or ALND...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28762114/the-optimal-treatment-plan-to-avoid-axillary-lymph-node-dissection-in-early-stage-breast-cancer-patients-differs-by-surgical-strategy-and-tumor-subtype
#12
Melissa Pilewskie, Emily C Zabor, Anita Mamtani, Andrea V Barrio, Michelle Stempel, Monica Morrow
BACKGROUND: Strategies to reduce the likelihood of axillary lymph node dissection (ALND) include application of Z0011 or use of neoadjuvant chemotherapy (NAC). Indications for ALND differ by treatment plan, and nodal pathologic complete response rates after NAC vary by tumor subtype. This study compared ALND rates for cT1-2N0 tumors treated with upfront surgery versus those treated with NAC. METHODS: The ALND rates for cT1-2N0 breast cancer patients were compared by tumor subtype among women undergoing upfront surgery to NAC...
July 31, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28759990/risk-factors-for-a-false-negative-result-of-sentinel-node-biopsy-in-patients-with-clinically-node-negative-breast-cancer
#13
Seung Ah Lee, Hak Min Lee, Hak Woo Lee, Ban Seok Yang, Jong Tae Park, Sung Gwe Ahn, Joon Jeong, Seung Il Kim
Purpose: Although sentinel lymph node biopsy (SLNB) can accurately represent the axillary lymph node (ALN) status, the false-negative rate (FNR) of SLNB is the main concern in the patients who receive SLNB alone instead of ALN dissection (ALND). Materials and Methods: We analyzed 1886 patients who underwent ALND after negative results of SLNB, retrospectively. A logistic regression analysis was used to identify risk factors associated with a false negative (FN) result...
July 31, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28755879/prospective-feasibility-trial-of-sentinel-lymph-node-biopsy-in-the-setting-of-inflammatory-breast%C3%A2-cancer
#14
Sarah M DeSnyder, Elizabeth A Mittendorf, Carissa Le-Petross, Savitri Krishnamurthy, Gary J Whitman, Naoto T Ueno, Wendy A Woodward, Henry M Kuerer, Catherine L Akay, Gildy V Babiera, Wei Yang, Anthony Lucci
BACKGROUND: Most inflammatory breast cancer (IBC) patients have axillary disease at presentation. Current standard is axillary lymph node dissection (ALND) after neoadjuvant chemotherapy (NACT). Advances in NACT have improved pathologic complete response (pCR) rates increasing interest in performing sentinel lymph node (SLN) biopsy (SLNB). Previous studies on SLNB for IBC patients did not assess nodal response with imaging or use dual tracer mapping. We sought to prospectively determine false negative rates of SLNB in IBC patients using dual tracer mapping, and to correlate pathology with preoperative axillary imaging...
July 10, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28752233/upper-limb-lymphedema-in-breast-cancer-patients-in-the-era-of-z0011-sentinel-lymph-node-biopsy-and-breast-conservation
#15
N R Bhatt, M R Boland, R McGovern, A Lal, S Tormey, A J Lowery, B A Merrigan
INTRODUCTION: Surgical techniques in breast cancer (BCa) have seen a dramatic change recently with breast-conserving surgery (BCS) and sentinel lymph node biopsy (SLNB). The ACOSOG-Z0011 trial reported equivalence in outcomes for certain patients with SLN metastases treated with axillary lymph node dissection (ALND) or SLNB alone. Our aim was to investigate changes in lymphedema referral patterns in BCa patients over the last 3 years in a specialist unit and to elucidate effects of SLNB, BCS, and Z0011 trial publication on such patterns...
July 27, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28742702/trends-on-axillary-surgery-in-nondistant-metastatic-breast-cancer-patients-treated-between-2011-and-2015-a-dutch-population-based-study-in-the-acosog-z0011-and-amaros-era
#16
Ingrid G M Poodt, Pauline E R Spronk, Guusje Vugts, Thijs van Dalen, M T F D Vrancken Peeters, Marjolijn L Rots, Anne Kuijer, Grard A P Nieuwenhuijzen, Robert-Jan Schipper
OBJECTIVES: To evaluate patterns of care in axillary surgery for Dutch clinical T1-4N0M0 (cT1-4N0M0) breast cancer patients and to assess the effect of the American College for Surgeons Oncology Group (ACOSOG)-Z0011 and After Mapping of the Axilla: Radiotherapy Or Surgery (AMAROS) trial on axillary surgery patterns in Dutch cT1-2N0M0 sentinel node positive breast cancer patients. BACKGROUND: Since publication of the ACOSOG-Z0011 and AMAROS trial, omitting a completion axillary lymph node dissection (cALND) in sentinel node positive breast cancer patients is proposed in selected patients...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28735457/impact-of-sentinel-lymph-node-biopsy-by-ultrasound-guided-core-needle-biopsy-for-patients-with-suspicious-node-positive-breast-cancer
#17
Rikiya Nakamura, Naohito Yamamoto, Toshiko Miyaki, Makiko Itami, Nobumitsu Shina, Masayuki Ohtsuka
PURPOSE: The purpose of this study was to investigate the accuracy of preoperative diagnostic tools for axillary lymph nodes (LNs) staging of breast cancer. MATERIALS AND METHODS: A total of 2464 consecutive patients with operable breast cancer were prospectively identified at our institution between April 2012 and March 2017. Patients with suspicious axillary LN of breast cancer were assessed using preoperative ultrasound(US) or computed tomography (CT), underwent fine-needle aspiration cytology (FNA) or core needle biopsy (CNB)...
July 22, 2017: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://www.readbyqxmd.com/read/28718896/nomograms-for-preoperative-prediction-of-axillary-nodal-status-in-breast-cancer
#18
L Dihge, P-O Bendahl, L Rydén
BACKGROUND: Axillary staging in patients with breast cancer and clinically node-negative disease is performed by sentinel node biopsy (SLNB). The aim of this study was to integrate feasible preoperative variables into nomograms to guide clinicians in stratifying treatment options into no axillary staging for patients with non-metastatic disease (N0), SLNB for those with one or two metastases, and axillary lymph node dissection (ALND) for patients with three or more metastases. METHODS: Patients presenting to Skåne University Hospital, Lund, with breast cancer were included in a prospectively maintained registry between January 2009 and December 2012...
October 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28702770/oncologic-outcomes-after-treatment-for-mri-occult-breast-cancer-pt0n
#19
Damian P McCartan, Emily C Zabor, Monica Morrow, Kimberly J Van Zee, Mahmoud B El-Tamer
BACKGROUND: Studies assessing outcomes in occult breast cancer have often included women treated before the routine use of magnetic resonance imaging (MRI). This study examined outcomes for patients presenting with axillary adenopathy and no primary breast tumor detectable by MRI or other imaging methods. METHODS: All patients with axillary nodal metastases consistent with breast carcinoma and no breast primary tumor detectable by physical exam, mammography, or MRI treated between 1 January 1996 and 30 June 2011 were identified from an institutional database...
July 12, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28688661/use-of-axillary-lymph-node-dissection-alnd-in-patients-with-micrometastatic-breast-cancer
#20
Madison Collins, Cristina O'Donoghue, Weihong Sun, Jun-Min Zhou, Zhenjun Ma, Christine Laronga, Marie Catherine Lee
BACKGROUND: Sentinel lymph node (SLN) biopsy is the current prognostic tool for clinically node-negative breast cancer patients. If the SLN reveals macrometastasis, axillary lymph node dissection (ALND) is recommended. However, the use of ALND in patients with micrometastasis is debated. The objective of this study was to assess the utilization of ALND in the treatment of micrometastatic breast cancer. METHODS: An IRB approved, retrospective study of a pooled dataset of breast cancer patients with micrometastatic disease on SLN biopsy was performed...
July 2017: Journal of Surgical Research
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