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https://www.readbyqxmd.com/read/28818521/current-approach-of-the-axilla-in-patients-with-early-stage-breast-cancer
#1
REVIEW
Eleftherios P Mamounas, Thorsten Kuehn, Emiel J T Rutgers, Gunter von Minckwitz
The surgical approach of the axilla in patients with early-stage breast cancer has witnessed considerable evolution during the past 25 years. The previously undisputed gold standard of axillary-lymph-node dissection for staging has now been replaced by sentinel-lymph-node biopsy for patients with clinically negative axilla. For selected patients with limited sentinel-lymph-node involvement, completion axillary-lymph-node dissection can be omitted or replaced by axillary radiotherapy, reducing morbidity. The clinical interest of axillary staging after neoadjuvant chemotherapy is increasing and this approach might contribute to morbidity reduction, and to the further tailoring of future systemic and locoregional treatment decisions by response assessment...
August 14, 2017: Lancet
https://www.readbyqxmd.com/read/28818349/fifteen-year-decrease-in-general-surgery-resident-breast-operative-experience-are-we-training-proficient-breast-surgeons
#2
Kelsey E Larson, Stephen R Grobmyer, Mika A B Reschke, Stephanie A Valente
OBJECTIVE: The goal of the study was to evaluate trends in general surgery resident breast cases over the past 15 years. STUDY DESIGN: The Accreditation Council for Graduate Medical Education (ACGME) Case Logs Statistics Reports from 2000 to 2015 were reviewed for average breast-specific case numbers and trends over time. ACGME data were available for all cases and breast-specific cases including the following: excisional biopsy/lumpectomy, simple mastectomy, modified radical mastectomy, and sentinel lymph node excision...
August 14, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28814071/feasibility-of-charcoal-tattooing-of-cytology-proven-metastatic-axillary-lymph-node-at-diagnosis-and-sentinel-lymph-node-biopsy-after-neoadjuvant-chemotherapy-in-breast-cancer-patients
#3
Seho Park, Ja Seung Koo, Gun Min Kim, Joohyuk Sohn, Seung Il Kim, Young Up Cho, Byeong-Woo Park, Vivian Youngjean Park, Jung Hyun Yoon, Hee Jung Moon, Min Jung Kim, Eun-Kyung Kim
Purpose: Sentinel lymph node biopsy (SLNB) can be performed when node-positive disease is converted to node-negative status after neoadjuvant chemotherapy (NCT). Tattooing nodes might improve accuracy but supportive data are limited. This study aimed to investigate the feasibility of charcoal tattooing metastatic axillary lymph node (ALN) at presentation followed by SLNB after NCT in breast cancers. Materials and Methods: Twenty patients with cytology-proven node metastases prospectively underwent charcoal tattooing at diagnosis...
August 17, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28808943/a-logistic-regression-model-predicting-high-axillary-tumour-burden-in-early-breast-cancer-patients
#4
I Barco, M García Font, A García-Fernández, N Giménez, M Fraile, J M Lain, E Vallejo, S González, L Canales, J Deu, M C Vidal, M Rodríguez-Carballeira, A Pessarrodona, C Chabrera
PURPOSE: As elective axillary dissection is loosing ground for early breast cancer (BC) patients both in terms of prognostic and therapeutic power, there is a growing interest in predicting patients with (nodal) high tumour burden (HTB), especially after a positive sentinel node biopsy (SNB) because they would really benefit from further axillary intervention either by complete lymph-node dissection or axillary radiation therapy. METHODS/PATIENTS: Based on an analysis of 1254 BC patients in whom complete axillary clearance was performed, we devised a logistic regression (LR) model to predict those with HTB, as defined by the presence of three or more involved nodes with macrometastasis...
August 14, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28808843/feasibility-of-preoperative-axillary-lymph-node-marking-with-a-clip-in-breast-cancer-patients-before-neoadjuvant-chemotherapy-a-preliminary-study
#5
Eun Young Kim, Woo Seok Byon, Kwan Ho Lee, Ji-Sup Yun, Yong Lai Park, Chan Heun Park, In Young Youn, Seon Hyeong Choi, Yoon Jung Choi, Shin Ho Kook, Sung-Im Do
BACKGROUND: The aim of this study was to determine the feasibility of image-guided marker-clip placement in axillary lymph nodes (ALNs) for breast cancer upon initial presentation and to assess the reliability of this method with sentinel lymph node biopsy (SLNB) for axillary restaging after neoadjuvant chemotherapy (NAC). METHODS: Between June 2015 and August 2016, a marker clip was placed at a clinically positive ALN under ultrasonography (US) guidance before initiation of NAC in 20 patients...
August 14, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28797030/one-step-nucleic-acid-amplification-assay-is-an-accurate-technique-for-sentinel-lymph-node-biopsy-of-breast-cancer-patients-a-meta-analysis
#6
Fang Shi, Qian Zhang, Zhenzhen Liang, Mengmeng Zhang, Xin Liu
BACKGROUND: To estimate the accuracy of one-step nucleic acid amplification (OSNA) assay as an intra-operative sentinel lymph node biopsy (SLNB) for sentinel lymph node (SLN) metastasis in breast cancer. METHODS: PubMed, Cochrane Library and Web of Science databases were searched by two independent reviewers to retrieve literature with per-patient analysis. The deadline was up until December 2016. A meta-analysis was performed using STATA, Meta-Disc, and Revman software...
August 10, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28781782/-18-f-fluorodeoxyglucose-uptake-as-predictor-for-invasion-in-preoperatively-diagnosed-breast-ductal-carcinoma-in-situ-significance-in-cases-without-mass-formation
#7
Takaaki Fujii, Reina Yajima, Hironori Tatsuki, Hiroyuki Kuwano
A diagnosis of ductal carcinoma in situ (DCIS) at needle biopsy often changes to that of invasive ductal carcinoma as the definitive pathological diagnosis following the surgical procedure. The present study sought to identify the factors associated with invasive disease in cases diagnosed as DCIS on needle biopsy by analyzing (18)F-fluorodeoxyglucose-proton emission tomography (FDG-PET) findings. The present study retrospectively investigated the cases of 24 consecutive patients with primary breast cancer who were preoperatively diagnosed with DCIS by needle biopsy...
August 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28774472/preoperative-sentinel-lymph-node-identification-biopsy-and-localisation-using-contrast-enhanced-ultrasound-ceus-in-patients-with-breast-cancer-a-systematic-review-and-meta-analysis
#8
REVIEW
A Nielsen Moody, J Bull, A-M Culpan, T Munyombwe, N Sharma, M Whitaker, S Wolstenhulme
AIM: To evaluate whether contrast-enhanced ultrasound (CEUS)-guided core biopsy of the sentinel lymph node (SLN) could identify metastatic nodes preoperatively and reduce the number of surgical SLN biopsies in patients with breast cancer and normal axillary B-mode ultrasound; and to establish whether CEUS SLN identification and localisation is a viable alternative to standard lymphatic mapping using isotope and blue dye. MATERIALS AND METHODS: A search of several electronic databases was performed and identified studies were assessed using QUADAS-2 for methodological quality...
August 1, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28767441/socioeconomic-deprivation-worsens-the-outcomes-of-italian-women-with-hormone-receptor-positive-breast-cancer-and-decreases-the-possibility-of-receiving-standard-care
#9
Francesca Di Salvo, Nicola Caranci, Teresa Spadea, Nicolas Zengarini, Pamela Minicozzi, Hade Amash, Mario Fusco, Fabrizio Stracci, Fabio Falcini, Claudia Cirilli, Giuseppina Candela, Rosanna Cusimano, Rosario Tumino, Milena Sant, For The Socioeconomic Inequalities And Oncological Outcomes Italian Working Group
BACKGROUND: Socioeconomic factors influence access to cancer care and survival. This study investigated the role of socioeconomic status on the risk of breast cancer recurrence and on the delivery of appropriate cancer care (sentinel lymph node biopsy and breast-conserving surgery plus radiotherapy), by patients' age and hormone receptor status. METHODS: 3,462 breast cancer cases diagnosed in 2003-2005 were selected from 7 Italian cancer registries and assigned to a socioeconomic tertile on the basis of the deprivation index of their census tract...
July 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28766883/identification-of-sentinel-lymph-nodes-by-contrast-enhanced-ultrasonography-with-sonazoid-in-patients-with-breast-cancer-a-feasibility-study-in-three-hospitals
#10
Kenzo Shimazu, Toshikazu Ito, Kumiko Uji, Tomohiro Miyake, Toyokazu Aono, Kazuyoshi Motomura, Yasuto Naoi, Atsushi Shimomura, Masafumi Shimoda, Naofumi Kagara, Seung Jin Kim, Shinzaburo Noguchi
The aim of this prospective study was to evaluate the feasibility of periareolar injection of the contrast agent Sonazoid (SNZ) followed by ultrasonography (US) for the identification of sentinel lymph node (SLN) in breast cancer patients with clinically negative node. Patients (n = 100) with T1-2N0M0 breast cancer received a periareolar injection of SNZ followed by US to identify contrast-enhanced SLN. Each contrast-enhanced SLN underwent fine needle aspiration cytology (FNAC) followed by SLN biopsy with a conventional method using blue dye and/or radiocolloid (B/R)...
August 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28766234/localizing-the-clipped-node-in-patients-with-node-positive-breast-cancer-treated-with-neoadjuvant-chemotherapy-early-learning-experience-and-challenges
#11
Toan T Nguyen, Tina J Hieken, Katie N Glazebrook, Judy C Boughey
BACKGROUND: Placement of a clip in the positive node in patients presenting with node-positive breast cancer treated with neoadjuvant chemotherapy (NAC) allows resection of the clipped node at SLN surgery and improves the accuracy of surgical staging. We sought to evaluate our experience with SLN surgery with resection of the clipped node since incorporation into our practice. METHODS: With Institutional Review Board approval, we evaluated all breast cancer patients with a percutaneous biopsy-positive axillary lymph node, clipped at the time of diagnosis, who underwent NAC followed by surgery...
August 1, 2017: Annals of Surgical Oncology
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
#12
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
#13
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/28766207/use-of-sentinel-lymph-node-dissection-after-neoadjuvant-chemotherapy-in-patients-with-node-positive-breast-cancer-at-diagnosis-practice-patterns-of-american-society-of-breast-surgeons-members
#14
Abigail S Caudle, Isabelle Bedrosian, Denái R Milton, Sarah M DeSnyder, Henry M Kuerer, Kelly K Hunt, Elizabeth A Mittendorf
BACKGROUND: The accuracy of sentinel lymph node dissection (SLND) in clinically node-positive patients who receive neoadjuvant chemotherapy has been investigated in clinical trials. This survey was designed to assess familiarity and impact of these trial findings into practice. METHODS: American Society of Breast Surgeons members were invited by e-mail to complete an anonymous online survey. A total of 642 members responded (21% of 3090 eligible members). Results were summarized as proportions based on the number of responses to each question...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766201/selective-use-of-sentinel-lymph-node-surgery-in-patients-undergoing-prophylactic-mastectomy-using-intraoperative-pathology
#15
Brittany L Murphy, Amy E Glasgow, Gary L Keeney, Elizabeth B Habermann, Judy C Boughey
BACKGROUND: Routine sentinel lymph node (SLN) surgery during prophylactic mastectomy (PM) is unnecessary, because most PMs do not contain cancer. Our institution utilizes intraoperative pathology to guide the surgical decision for resection of SLNs in PM. The purpose of this study was to review the effectiveness of this approach. METHODS: We identified all women aged ≥18 years who underwent bilateral PM (BPM) or contralateral PM (CPM) at our institution from January 2008 to July 2016...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766197/predicting-nodal-positivity-in-women-70%C3%A2-years-of-age-and-older-with-hormone-receptor-positive-breast-cancer-to-aid-incorporation-of-a-society-of-surgical-oncology-choosing-wisely-guideline-into-clinical-practice
#16
Jessemae L Welsh, Tanya L Hoskin, Courtney N Day, Elizabeth B Habermann, Matthew P Goetz, Judy C Boughey
PURPOSE: One of the Society of Surgical Oncology Choosing Wisely guidelines recommends avoiding routine sentinel lymph node (SLN) surgery in clinically node-negative women ≥70 years of age with hormone receptor-positive (HR+) breast cancer. We sought to assess the impact of tumor stage and grade on nodal positivity, and to develop a model to identify patients at low-risk of nodal positivity to aid adoption of the guideline. METHODS: We identified women ≥70 years of age with HR+ cN0 invasive breast cancer in the National Cancer Database (NCDB; 2010-2013) and examined the impact of tumor stage and grade on nodal positivity to identify low-risk combinations...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28766131/outcome-following-sentinel-lymph-node-biopsy-guided-decisions-in-breast-cancer-patients-with-conversion-from-positive-to-negative-axillary-lymph-nodes-after-neoadjuvant-chemotherapy
#17
Young-Joon Kang, Wonshik Han, Soojin Park, Ji Young You, Ha Woo Yi, Sungmin Park, Sanggeun Nam, Joo Heung Kim, Keong Won Yun, Hee Jeong Kim, Sei Hyun Ahn, Seho Park, Jeong Eon Lee, Eun Sook Lee, Dong-Young Noh, Jong Won Lee
PURPOSE: Many breast cancer patients with positive axillary lymph nodes achieve complete node remission after neoadjuvant chemotherapy. The usefulness of sentinel lymph node biopsy in this situation is uncertain. This study evaluated the outcomes of sentinel biopsy-guided decisions in patients who had conversion of axillary nodes from clinically positive to negative following neoadjuvant chemotherapy. METHODS: We reviewed the records of 1247 patients from five hospitals in Korea who had breast cancer with clinically axillary lymph node-positive status and negative conversion after neoadjuvant chemotherapy, between 2005 and 2012...
August 1, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28763628/the-value-of-18f-fdg-pet-ct-imaging-in-breast-cancer-staging
#18
Ulkem Yararbas, Neslihan Çetin, Levent Yeniay, Aziz Murat Argon
The National Comprehensive Cancer Network (NCCN) guidelines recommend assessment with positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro- D-glucose integrated with computed tomography (18F-FDG PET/CT) in staging of breast cancer, starting from the stage IIIA. Previously, PET/CT contributed to the accurate staging from the stage IIB. Our aim is to evaluate the contribution of 18F-FDG PET/CT in staging of breast cancer patients. A total of 234 patients were retrospectively evaluated. PET/CT was performed preoperatively in 114/234 and postoperatively in 120/234 patients...
August 1, 2017: Bosnian Journal of Basic Medical Sciences
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
#19
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
#20
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
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