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Axillary lymph node dissection

Bret Taback, Priya Jadeja, Richard Ha
BACKGROUND: Recently there are efforts to use sentinel lymph node biopsy (SLNB) techniques after neoadjuvant chemotherapy (NAC) to minimize axillary surgery. However, studies have shown higher false negative rates in this scenario, which might result in inaccurate assessment of treatment response and patient prognosis as well as leaving residual disease behind. In this study, we describe the use of reflector-guided excision of the percutaneously biopsied node (PBN) as an aid to conventional SLNB and its predictor of the axillary status after NAC...
February 12, 2018: Clinical Breast Cancer
Yayoi Adachi, Masataka Sawaki, Masaya Hattori, Akiyo Yoshimura, Noami Gondo, Haruru Kotani, Madoka Iwase, Ayumi Kataoka, Sakura Onishi, Kayoko Sugino, Mitsuo Terada, Nanae Horisawa, Makiko Mori, Isao Oze, Hiroji Iwata
BACKGROUND: Recent studies suggested that ALND (axillary lymph node dissection) can be avoided in breast cancer patients with limited SLN (sentinel lymph node) metastasis. However, these trials included only several invasive lobular carcinoma (ILC) cases, and the validity of omitting ALND for ILC remains controversial. Here, we examined whether omitting ALND is feasible in ILC treatment. METHODS: A total of 3771 breast cancer patients underwent surgery for breast cancer at the Aichi Cancer Center Hospital between January 2006 and December 2015...
March 13, 2018: Breast Cancer: the Journal of the Japanese Breast Cancer Society
Youssef H Zeidan, Joyce G Habib, Lieveke Ameye, Marianne Paesmans, Evandro de Azambuja, Richard D Gelber, Ian Campbell, Bo Nordenskjöld, Jorge Gutiérez, Michael Anderson, Ana Lluch, Michael Gnant, Aron Goldhirsch, Angelo Di Leo, David J Joseph, John Crown, Martine Piccart-Gebhart, Prudence A Francis
PURPOSE: To analyze the impact of postmastectomy radiation therapy (PMRT) for patients with T1-T2 tumors and 1 to 3 positive lymph nodes enrolled on the Breast International Group (BIG) 02-98 trial. METHODS AND MATERIALS: The BIG 02-98 trial randomized patients to receive adjuvant anthracycline with or without taxane chemotherapy. Delivery of PMRT was nonrandomized and performed according to institutional preferences. The present analysis was performed on participants with T1-T2 breast cancer and 1 to 3 positive lymph nodes who had undergone mastectomy and axillary nodal dissection...
February 6, 2018: International Journal of Radiation Oncology, Biology, Physics
Jun Zhang, Tiemei Zhang, Nan Wu, Xinhua Zhao, Qingsong Wang, Yanyang Jiang, Ming Gao, Lin Gu
BACKGROUND: Intracystic papillary carcinoma (IPC) is a rare breast neoplasm. There are few studies focusing on its clinical features and limited data about its preoperative diagnosis,treatment and outcomes. The purpose of this study is to explore specific characteristics of patients with IPC, investigate its clinicopathological features, prognosis in China and confirm its surgery management. METHODS: We identified 111 patients with IPC from the registry of Tianjin Medical University Cancer Institute and Hospital between 2004 and 2017...
March 8, 2018: Pathology, Research and Practice
P Roy, A Leizorovicz, R Villet, C Mercier, J Y Bobin
PURPOSE: Sentinel-lymph-node (SLN) resection seems to minimize systematic axillary-lymph-node dissection (sALND) side effects in operated breast cancer patients. We explored whether SLN resection achieves similar therapeutic outcomes as sALND but with fewer side effects. METHODS: A randomized, controlled, open-label trial with parallel-group design compared sALND restricted to cases with positive SLN biopsy (test arm, n = 774) versus SLN biopsy followed by sALND (control arm, n = 770)...
March 10, 2018: Breast Cancer Research and Treatment
M E M van der Noordaa, F H van Duijnhoven, M E Straver, E J Groen, M Stokkel, C E Loo, P H M Elkhuizen, N S Russell, M T F D Vrancken Peeters
BACKGROUND: Axillary lymph node dissection (ALND) is frequently performed for node-positive (cN+) breast cancer patients. Combining positron emission tomography/computed tomography (PET/CT) before-NST and the MARI (marking axillary lymph nodes with radioactive iodine seeds) procedure after neoadjuvant systemic therapy (NST) has the potential for avoiding unnecessary ALNDs. This report presents the results from implementation of this strategy. METHODS: All breast cancer patients treated with NST at the Netherlands Cancer Institute who underwent a PET/CT and the MARI procedure from July 2014 to July 2017 were included in the study...
March 6, 2018: Annals of Surgical Oncology
Ingrid G M Poodt, Guusje Vugts, Adriana J G Maaskant-Braat, Robert-Jan Schipper, Adri C Voogd, Grard A P Nieuwenhuijzen
BACKGROUND: Repeat sentinel lymph node biopsy (rSLNB) has increasingly been used in patients with ipsilateral breast tumor recurrence (IBTR). The safety in terms of regional disease control after this procedure remains unclear. This study evaluates occurrence of regional recurrence as first event in patients with IBTR and negative rSLNB, treated without additional lymph node dissection. PATIENTS AND METHODS: Data were obtained from the Sentinel Node and Recurrent Breast Cancer (SNARB) study...
March 1, 2018: Annals of Surgical Oncology
Kyoko Hara, Seiji Yoshitomi, Hisashi Tsuji
A 66-years-old woman was referred to our hospital with the chief complaint of a huge exposed left breast mass, associated massive exudates, bleedingand foul-smelling discharge. Invasive ductal carcinoma was diagnosed by core needle biopsy. The computed tomography showed left axillary lymph node metastases and no distant metastasis. Her performance status(PS) was Grade 3. She had serious comorbidities such as non-alcoholic steatohepatitis and liver cirrhosis, renal dysfunction. DMpC therapy and Mohs paste therapy were started since her overall status was improved...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Miyuki Takahashi, Yuki Suematsu, Shunsuke Yamagishi, Kyohei Kanematsu, Hiroyuki Saitou, Mao Nakayama, Michiko Fukahori, Kazuhiko Wakabayashi, Yutaka Ito
A 78-year-old woman presented with a right axillary mass.With an incisional biopsy a diagnosis of invasive ductal carcinoma was achieved.In the whole body search, any primary focus including the breast was unclear, advanced occult breast cancer with supraclavicular lymph node metastases was diagnosed.Administration of 3 courses of docetaxel achieved disappearance of supraclavicular lymph node and reduction of an axillary mass.Right axillary lymph node dissection could be successfully performed.Pathological report showed a right ectopic cancer with right axillary lymph node metastases...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Tomasz Nowikiewicz, Wojciech Zegarski, Konrad Pagacz, Maciej Nowacki, Alina Morawiec-Sztandera, Iwona Głowacka-Mrotek, Magdalena Sowa, Marta Biedka, Agnieszka Kołacińska
According to the current guidelines on treatment of breast cancer patients, identification of metastases in the sentinel lymph node (SLN (+)) is not an absolute indication for necessary axillary lymph node dissection (ALND). In our study, we present long-term outcomes of treatment among SLN(+) patients referred for conservative treatment, for example, no further ALND. A total of 3145 breast cancer patients subjected to sentinel lymph node biopsy (SLNB) between November 2008 and June 2015. SLN metastases were identified in 719 patients (22...
February 24, 2018: Breast Journal
Charalampos Siotos, Mohamad E Sebai, Eric L Wan, Ricardo J Bello, Mehran Habibi, Damon S Cooney, Michele A Manahan, Carisa M Cooney, Stella M Seal, Gedge D Rosson
BACKGROUND: Lymphedema remains a significant complication following breast cancer surgery when there is axillary lymph node intervention. Previous systematic reviews have identified risk factors for breast cancer-related lymphedema, including increased BMI, number of lymph nodes dissected and radiotherapy. However, they have not examined the effect of breast reconstruction on lymphedema occurrence. In this systematic review and meta-analysis, we sought to evaluate the association between breast reconstruction (BR) and lymphedema...
February 21, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Ingrid G M Poodt, Guusje Vugts, Robert-Jan Schipper, Grard A P Nieuwenhuijzen
BACKGROUND: During recent years, an increasing number of patients with ipsilateral breast tumor recurrence (IBTR) and previous axillary surgery have undergone repeat sentinel lymph node biopsy (rSLNB). The influence of axillary nodal status on prognosis for IBTR patients remains unclear. This study aimed to evaluate the technical success rate, follow-up assessment, and prognostic value of rSLNB for patients with IBTR. METHODS: A systematic search conducted in MEDLINE, Embase, and the Cochrane Library up to July 2017 included all studies on rSLNB in IBTR...
February 21, 2018: Annals of Surgical Oncology
Fan Zhang, Jing Zhang, Qing-Xin Meng, Xin Zhang
This study aimed to explore the clinical usefulness of ultrasound-guided fine needle aspiration cytology (USG-FNAC) for the evaluation of axillary lymph nodes in patients with early stage breast cancer (BC) among the Chinese Han female population.Around 124 patients with early stage BC were included in this retrospective study. All patients underwent USG-FNAC (group A). Patients with proven metastasis also underwent axillary lymph node dissection (ALND) (group B). In addition, sentinel lymph node biopsy (SLNB) was performed 2 to 5 hours prior to the surgery...
February 2018: Medicine (Baltimore)
Li-Feng Dong, Shu-Ying Xu, Jing-Pei Long, Fang Wan, Yi-Ding Chen
Objective The aim of the present study was to determine how many sentinel lymph nodes (SLNs) are appropriate for predicting non-SLN metastasis in breast cancer. Methods The association between clinicopathological features and non-SLN metastasis was retrospectively analyzed in 472 patients who underwent axillary lymph node dissection (ALND) following SLN biopsy. Another 251 patients who underwent only SLN biopsy without ALND were analyzed and followed up for 2 years. Results A large tumor size, positive SLN, and HER-2 positivity were independent predictors of non-SLN metastasis...
February 2018: Journal of International Medical Research
S Lowes, A Leaver, K Cox, K Satchithananda, D Cosgrove, A Lim
The presence and extent of axillary nodal metastases at the time of breast cancer diagnosis is a critical factor in disease prognosis and plays a central role in deciding the best treatment for patients. Accurate assessment of the axilla is therefore an essential component in staging breast cancer. Over the years, axillary staging has evolved from surgical axillary lymph node dissection (ALND), with its numerous associated long-term complications, to the much less-radical surgical sentinel lymph node excision biopsy (SLNB), the current reference standard...
February 10, 2018: Clinical Radiology
Kazuo Matsuura, Toshiyuki Itamoto, Midori Noma, Masahiro Ohara, Etsushi Akimoto, Mihoko Doi, Takashi Nishisaka, Koji Arihiro, Takayuki Kadoya, Morihito Okada
The aim of the present study was to evaluate the significance of lung biopsy for the modification of the treatment strategy in breast cancer patients who develop lung nodules during follow-up after breast surgery. Of 53 consecutive patients who underwent lung biopsies in two institutions (Hiroshima University Hospital and Hiroshima Prefectural Hospital, Hiroshima, Japan) between 1997 and 2014, 45 underwent lung surgery and 8 underwent percutaneous or transbronchial tumor biopsy for lung nodules developing after curative surgery for breast cancer...
February 2018: Molecular and Clinical Oncology
Alessandro A Testori, Stefan Suciu, Alexander C J van Akkooi, Mariano Suppa, Alexander M M Eggermont, Esther de Vries, Arjen Joosse
The aim of this study was to assess the prognostic importance of lymph node ratio (LNR) in stage III melanoma after complete lymph nodal dissections. From European Organization for Research and Treatment of Cancer randomized trials 18871, 18952, and 18991, 2358 patients had full information on positive and examined lymph nodes (LNs) and were included. Cox proportional hazards models stratified by trial were used to assess the prognostic impact of LNR adjusted for confounders on melanoma-specific survival. Optimal cutoff values for LNR were calculated for each LN dissection site (axillary, inguinal, and neck)...
February 9, 2018: Melanoma Research
Yeliz Emine Ersoy, Huseyin Kadioglu
Breast cancer patients who present with nodal metastasis receive neoadjuvant chemotherapy (NAC) with increasing frequency and can have complete pathologic response after treatment. In this clinical scenario, sentinel node mapping and biopsy are gaining acceptance instead of axillary dissection to avoid morbidity. Biopsy proven positive lymph nodes must be reliably excised and examined after NAC to further decrease the false negativity rate of sentinel lymph node (SLN) surgery. The standard method for axillary staging in breast cancer patients even after NAC is SLN biopsy (SLNB) with a radioisotope, blue dye, or both (dual technique)...
January 31, 2018: Clinical Breast Cancer
Ying Zhu, Wei Zhou, Xiao-Hong Jia, Ou Huang, Wei-Wei Zhan
OBJECTIVES: To determine whether imaging and clinicopathologic features could predict false-positive axillary ultrasound (US) results in the selection of patients with breast cancer who had a heavy axillary tumor burden (≥3 tumor-involved nodes). METHODS: Among 788 patients with histologically confirmed invasive breast cancer at Ruijin Hospital from October 2014 to September 2015, 162 patients (cT1-T2, cN0) with 167 axillae had suspicious axillary US findings...
February 9, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Jerica Novak, Nikola Besic, Radan Dzodic, Barbara Gazic, Andrej Vogrin
BACKGROUND: Despite the recent changes in the treatment of the axilla in selected breast cancer patient, positive sentinel lymph node (SLN) in patients undergoing mastectomy still necessitates axillary lymph node dissection (ALND). In invasive lobular carcinoma (ILC), pre-operative detection of the lymph node metastasis may be demanding due to its unique morphology. The aim of this study was to examine the benefit of preoperative axillary ultrasound (AUS), ultrasound-guided fine-needle aspiration biopsy (US-FNAB), and intra-operative imprint cytology (IIC), in order to avoid two-stage axillary surgery in patients with ILC undergoing mastectomy...
February 5, 2018: BMC Cancer
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