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Breast ,axillary dissection

Arumugom Archana, Sathasivam Sureshkumar, Chellappa Vijayakumar, Chinnakali Palanivel
Introduction Only a few studies compare the efficacy of the harmonic scalpel and electrocautery in performing mastectomies, and these have mainly compared their intraoperative parameters. But the main concern with electrocautery is the incidence of flap necrosis and seroma formation. Therefore, this study was done to determine if the harmonic scalpel has any advantages over electrocautery in reducing postoperative flap necrosis and seroma formation in patients undergoing a modified radical mastectomy (MRM)...
April 13, 2018: Curēus
Anna Marlene Rüland, Friederike Hagemann, Mattea Reinisch, Johannes Holtschmidt, Aylin Kümmel, Christine Dittmer-Grabowski, Frank Stöblen, Horst Rotthaus, Volker Dreesmann, Jens-Uwe Blohmer, Sherko Kümmel
Background: This study presents first feasibility experiences with a new 3-dimensional (3D) marker clip system in clinical practice. The rate of clinical complete responses in the treatment of breast cancer patients is increasing; additionally, a change to targeted axillary dissection is being considered after neoadjuvant chemotherapy (NACT). Consequently, marker clips are needed which are reliable and easy to handle even in the axillary lymph node system. Methods: A total of 50 patients from the Breast Care Unit of the Kliniken Essen Mitte were included...
April 2018: Breast Care
Gunter von Minckwitz, Marco Colleoni, Hans-Christian Kolberg, Serafin Morales, Patricia Santi, Zorica Tomasevic, Nan Zhang, Vladimir Hanes
BACKGROUND: ABP 980 (Amgen Inc, Thousand Oaks, CA, USA) is a biosimilar of trastuzumab, with analytical, functional, and pharmacokinetic similarities. We compared the clinical safety and efficacy of ABP 980 with that of trastuzumab in women with HER2-positive early breast cancer. METHODS: We did a randomised, multicentre, double-blind, active-controlled equivalence trial at 97 study centres in 20 countries, mainly in Europe and South America. Eligible women were aged 18 years or older, had histologically confirmed HER2-positive invasive early breast cancer, an Eastern Cooperative Oncology Group performance status score of 0 or 1, and were planning to have surgical resection of the breast tumour with sentinel or axillary lymph node dissection and neoadjuvant chemotherapy...
June 4, 2018: Lancet Oncology
Susanne Stanzel, Birgit Pernthaler, Thomas Schwarz, Vesna Bjelic-Radisic, Stefan Kerschbaumer, Reingard M Aigner
THE AIM: of the study was to demonstrate the diagnostic and prognostic value of SPECT/CT in sentinel lymph node mapping (SLNM) in patients with invasive breast cancer. METHODS: 114 patients with invasive breast cancer with clinically negative lymph nodes were included in this retrospective study as they were referred for SLNM with 99m Tc-nanocolloid. Planar image acquisition was accomplished in a one-day or two-day protocol depending on the schedule of the surgical procedure...
June 2018: Nuklearmedizin. Nuclear Medicine
Omar Picado, Kristina Khazeni, Casey Allen, Danny Yakoub, Eli Avisar, Susan B Kesmodel
PURPOSE: Management of the axilla in patients with early-stage breast cancer (ESBC) has evolved. Recent trials support less extensive axillary surgery in patients undergoing mastectomy. We examine factors affecting regional lymph node (RLN) surgery and outcomes in patients with ESBC undergoing mastectomy. METHODS: Women with clinical T1/2 N0 M0 invasive BC who underwent mastectomy with 1-2 positive nodes were selected from the National Cancer Database (2004-2015)...
June 5, 2018: Breast Cancer Research and Treatment
Samantha Grossmith, Anvy Nguyen, Jiani Hu, Jennifer K Plichta, Faina Nakhlis, Linda Cutone, Laura Dominici, Mehra Golshan, Margaret Duggan, Katharine Carter, Esther Rhei, Thanh Barbie, Katherina Calvillo, Suniti Nimbkar, Jennifer Bellon, Julia Wong, Rinaa Punglia, William Barry, Tari A King
BACKGROUND: The after mapping of the axilla: radiotherapy or surgery (AMAROS) trial concluded that for patients with cT1-2 N0 breast cancer and one or two positive sentinel lymph nodes (SLNs), axillary radiotherapy (AxRT) provides equivalent locoregional control and a lower incidence of lymphedema compared with axillary lymph node dissection (ALND). The study prospectively assessed how often ALND could be replaced by AxRT in a consecutive cohort of patients undergoing mastectomy for cT1-2 N0 breast cancer...
June 4, 2018: Annals of Surgical Oncology
Jennifer Wellington, Thomas Sanders, Charles Mylander, Ashley Alden, Christine Harris, Robert Buras, Lorraine Tafra, Wen Liang, Lacey Stelle, Martin Rosman, Rubie Sue Jackson
BACKGROUND: Since publication of the American College of Surgeons Oncology Group Z0011 trial results, demonstrating that many patients with nonpalpable axillary lymph nodes and one or two positive sentinel nodes do not require axillary lymph node dissection (ALND), preoperative axillary ultrasound (AUS) has become controversial. Clinicians are concerned that AUS may lead to unnecessary ALND. The authors developed an algorithm (Algorithm 1) in which the number of AUS-suspicious nodes and tumor biology direct management...
June 4, 2018: Annals of Surgical Oncology
G Y Sun, S L Wang, Y Tang, J Jin, Y W Song, Y P Liu, W H Wang, H Fang, S Y Chen, H Ren, X F Liu, Z H Yu, Y X Li
Objective: To analyze the clinical features and prognosis of the ipsilateral breast tumor recurrence (IBTR) after breast conserving surgery. Methods: From 1999 to 2013, 63 women with IBTR after breast conserving surgery were retrospectively reviewed. All patients had adequate information on tumor location both at first presentation and at recurrence, with or without regional recurrence or distant metastasis. The histologic changes between true local recurrence and elsewhere recurrence groups were compared. The local recurrence, the overall survival after IBTR (IBTR-OS), the disease-free survival after IBTR (IBTR-DFS) were also compared...
May 23, 2018: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
Irene de la Rosa-Díaz, María Torres-Lacomba, Paz Acosta-Ramírez, Itxaso García-de Orive, Robert J Nee, Pedro de la Villa-Polo, Eva M Andrés-Esteban, Beatriz Sánchez-Sánchez
Myoelectric activity and range of motion during ULNT1 were recorded in 62 breast cancer (BC) survivors who had axillary lymph node dissection (n = 30) or sentinel lymph node biopsy (n = 32) within the previous 18 months, and 63 age-matched healthy women. BC survivors' symptoms were reproduced by ULNT1 and exhibited greater myoelectric activity in the biceps brachii than healthy women (MD (95% CI): 21,26 (10,83-31,70)). No differences between the axillary lymph node dissection and sentinel lymph node biopsy groups (MD (95% CI): 8,47 (-7,84-24,79)) were found...
May 22, 2018: Musculoskeletal Science & Practice
Wolfram Malter, Martin Hellmich, Mayhar Badian, Verena Kirn, Peter Mallmann, Stefan Krämer
BACKGROUND/AIM: Sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) for axillary staging in patients with early-stage breast cancer. The need for therapeutic ALND is the subject of ongoing debate especially after the publication of the ACOSOG Z0011 trial. In a retrospective trial with univariate and multivariate analyses, factors predictive of sentinel lymph node involvement should be analyzed in order to define tumor characteristics of breast cancer patients, where SLNB should not be spared to receive important indicators for adjuvant treatment decisions (e...
June 2018: Anticancer Research
Achim Wöckel, Ute-Susann Albert, Wolfgang Janni, Anton Scharl, Rolf Kreienberg, Tanja Stüber
BACKGROUND: Breast cancer is the most common cancer in women. The German S3 guideline of 2012 has now been updated to take account of advances in the early detection, diagnostic evaluation, treatment, and follow-up care of this disease. METHODS: The updating process was based on the adaptation of identified source guidelines and on reviews of the scientific evidence. A systematic search in multiple literature databases was carried out, and the full texts of the selected articles were evaluated...
May 4, 2018: Deutsches Ärzteblatt International
Xin Hu, Xiao Zhou, Huawei Yang, Wei Wei, Yi Jiang, Jianlun Liu
The efficacy of axillary lymph node dissection (ALND) following sentinel lymph node biopsy (SLNB) has been questioned. The present study was performed to determine the sensitivity, specificity and accuracy of axillary ultrasound (US) and fine needle aspiration biopsy (FNAB) in the diagnosis of axillary metastases in patients with early breast cancer. A total of 214 patients with stage I and II breast cancer between June 2015 and January 2017 were included. All of the patients received axillary US as a primary investigation for lymph node status...
June 2018: Oncology Letters
Subbiah Shanmugam, Gopu Govindasamy, Syed Afroze Hussain, Prasanna Srinivasa H Rao
BACKGROUND: The major morbidities of modified radical mastectomy both short- and long-term are sequelae of axillary dissection. Flap complications, prolonged seroma, need for axillary drainage, wound infection, lymphedema, shoulder stiffness, and paresthesia are major causes for morbidity after axillary dissection. Different techniques have been implemented to tackle these problems. Few of these include reducing the axillary dead space, using various forms of energy devices. AIMS: We have prospectively compared two energy sources, namely, ultrasonic dissector (UD) against the electrocautery dissection in axillary dissection for breast cancer with respect to outcomes...
July 2017: Indian Journal of Cancer
Parth Kanaiyalal Patel, Ashok Kumar Sinha, Shashikant Saini
BACKGROUND: Breast cancer is the most common cancer in women and second most common type of cancer overall. The prime objectives of axillary surgery in the management of breast cancer are 1) accurate staging, 2) treatment to cure and 3) quantitative information of metastatic lymph nodes for prognostic purposes and allocation to adjuvant protocols. During axillary dissection, all 3 level lymphnodes are removed, while the important axillary structures (axillary vein, long thoracic and thoracodorsal nerves) are preserved...
July 2017: Indian Journal of Cancer
S David Nathanson, David Krag, Henry M Kuerer, Lisa A Newman, Markus Brown, Dontscho Kerjaschki, Ethel R Pereira, Timothy P Padera
Breast cancer metastasizes through the lymphovascular system to the regional lymph nodes in the axilla and to both visceral and non-visceral sites. Renewed interest in the route by which tumor cells gain access to blood and lymphatic capillaries are the subject of research at mechanical, anatomic, pathologic, genetic, epidemiologic and molecular levels. Two papers presented at the 7th International Symposium on Cancer Metastasis in San Francisco showed tumor cells entering the systemic circulation through the sentinel lymph node...
May 23, 2018: Clinical & Experimental Metastasis
Liu Ying-Ying, Yu Tian-Jian, Liu Guang-Yu
Aim: To investigate the benefits of axillary dissection in patients with micrometastases. Methods: A review of data from the Surveillance, Epidemiology, and End Results database was performed from 2004 to 2013. Kaplan-Meier curves, Cox regression models, and propensity score matching were utilized to comprehensively evaluate the cohort. Results: Multivariate analysis after propensity score matching showed that patients with one to two micrometastases did not substantially benefit from axillary lymph node dissection in breast cancer-specific survival (p = 0...
June 2018: Future Science OA
Mohammed Faisal, Hamada Fathy, Hamdy Shaban, Sameh T Abuelela, Ahmed Marie, Islam Khaled
Background: Seroma is the most frequent postoperative complication following breast cancer surgery. Our aim was to evaluate the effect of the harmonic focus scalpel versus electrocautery in reducing seroma formation post-mastectomy and axillary clearance. Methods: A prospective randomized controlled trial study was conducted at the Department of Surgery of Suez Canal University Hospital from April 26th 2014 to 30th June 2016. Seventy-two women, in whom a mastectomy and axillary clearance for breast cancer were performed, were randomly allocated to either harmonic dissection ( n  = 36) or electrocautery ( n  = 36)...
2018: Patient Safety in Surgery
Tolga Ozmen, Mesa Lazaro, Yan Zhou, Alicia Vinyard, Eli Avisar
OBJECTIVE: To assess the efficiency of Simplified Lymphatic Microsurgical Preventing Healing Approach (S-LYMPHA) in preventing lymphedema (LE) in a prospective cohort of patients. BACKGROUND: LE is a serious complication of axillary lymph node dissection (ALND) with an incidence rate of 25%. LYMPHA has been proposed as an effective adjunct to ALND for the prevention of LE. This procedure, however, requires microsurgical techniques and significant coordination between services...
May 23, 2018: Annals of Surgery
Nobuyoshi Kittaka, Ryu Tokui, Chika Ota, Yoko Hashimoto, Kazuyoshi Motomura, Makoto Ishitobi, Takahiro Nakayama, Yasuhiro Tamaki
BACKGROUND: In patients undergoing breast-conserving surgery and having positive sentinel lymph nodes (SLNs), the ACOSOG Z0011 trial showed equivalent loco-regional outcomes for patients receiving SLN dissection (SLND) alone and those receiving axillary lymph node dissection (ALND). We conducted a prospective single-arm study to confirm the applicability of the Z0011 criteria to Japanese patients with breast cancer. METHODS: Patients meeting the Z0011 inclusion criteria and providing consent to receive no additional ALND were prospectively enrolled at the Osaka International Cancer Institute from April 2012 to December 2016...
May 22, 2018: International Journal of Clinical Oncology
T Nowikiewicz, W Zegarski, K Pagacz, M Nowacki, A Morawiec-Sztandera, I Glowacka-Mrotek, M Sowa, M Biedka, A Kolacinska
The main objective of the ACOSOG Z0011 trial was to determine the impact of abandoning complete axillary lymph node dissection (ALND) on survival of breast cancer patients with sentinel node lymph (SLN) metastasis in whom breast conserving therapy (BCT) had been performed. The aim of our study was to assess the clinical value of intra-operative histopathological examination of SLN. Our study comprised 1284 invasive breast cancer patients in whom sentinel lymph node biopsy (SLNB) was carried out. SLN intra-operative histopathological assessment was routinely performed in patients treated within the first period (07...
March 14, 2018: Neoplasma
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