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sentinel lymph node, DCIS

Brigid K Killelea, Jessica B Long, Weixiong Dang, Sarah S Mougalian, Suzanne B Evans, Cary P Gross, Shi-Yi Wang
PURPOSE: To examine the associations between sentinel lymph node biopsy (SLNB) and complications among older patients who underwent breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS). METHODS: We identified women from the Surveillance, Epidemiology, and End Results-Medicare dataset aged 67-94 years diagnosed during 1998-2011 with DCIS who underwent BCS as initial treatment. We assessed incidence of complications, including lymphedema, wound infection, seroma, or pain, within 9 months of diagnosis...
March 7, 2018: Annals of Surgical Oncology
Dean B Percy, Jin-Si Pao, Elaine McKevitt, Carol Dingee, Urve Kuusk, Rebecca Warburton
BACKGROUND AND OBJECTIVES: The purpose of this study was to assess the number of lymph nodes removed at SLNB, and what factors might bias a surgeon's decision to remove additional nodes. METHODS: A prospectively maintained database was reviewed. All patients that had SLNB for primary treatment of breast cancer between January 2012 and March 2016 were identified. Clinicopathologic factors were used to compare the number of LNs and rates of node positivity. RESULTS: One thousand six hundred and three patients were included...
February 26, 2018: Journal of Surgical Oncology
Saed Ramzi, Elaine L Hyett, Abigail S Wheal, Peter J Cant
True invasive tubular breast carcinoma (TBC) is unlikely to metastasize to axillary nodes, yet it is routinely subjected to sentinel lymph node biopsy (SLNB), even if the diagnosis was suspected preoperatively. The positive predictive value (PPV) of core biopsy for TBC and the incidence and predictors of axillary metastasis in invasive breast carcinomas identified as tubular-rich on core biopsy are unknown. Prospective patient and tumor data regarding postoperatively confirmed TBCs, and tubular-rich carcinoma identified on preoperative core biopsy between January 2005 and May 2016 was analyzed retrospectively...
February 24, 2018: Breast Journal
Yasuhiro Fukui, Shinichiro Kashiwagi, Koji Takada, Wataru Goto, Yuka Asano, Tamami Morisaki, Satoru Noda, Tsutomu Takashima, Naoyoshi Onoda, Masahiko Ohsawa, Kosei Hirakawa, Masaichi Ohira
A 67-year-old female was referred to our hospital because she was pointed out mass in her right breast by her previous doctor. Core needle biopsy examination was performed at that time which revealed invasive ductal carcinoma. There'reno palpable masses in her breast or any superficial lymph nodes on her visiting our hospital. Breast ultrasonography images showed multiple nodules in C area of right breast. Breast enhanced MRI image revealed multiple enhanced nodules which showed rapid arising and plateau or slowly decreasing pattern in time intensity curve...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Yang Yang Huang, Amelie Maurel, Saud Hamza, Lee Jackson, Zeyad Al-Ogaili
INTRODUCTION: To assess the impact of delayed vs immediate pre-operative lymphoscintigraphy (LSG) for sentinel lymph node biopsy in a single Australian tertiary breast cancer centre. METHODS: Retrospective cohort study analysing patients with breast cancer or DCIS who underwent lumpectomy or mastectomy with pre-operative LSG and intra-operative sentinel lymph node biopsy from January 2015 to June 2016. RESULTS: A total of 182 LSG were performed...
November 9, 2017: Journal of Medical Imaging and Radiation Oncology
Emil Villiam Holm-Rasmussen, Maj-Britt Jensen, Eva Balslev, Niels Kroman, Tove Filtenborg Tvedskov
OBJECTIVES: The risk of axillary metastases in breast cancer patients with only ductal carcinoma in situ (DCIS) is low. Thus, axillary staging with sentinel lymph node biopsy (SLNB) should only be used according to the current guidelines to avoid over-treatment and unnecessary morbidity. In the present study, the use of SLNB in patients with DCIS was evaluated nationally and compared across Danish departments. MATERIAL AND METHODS: A register-based study was conducted using the Danish Breast Cancer Group database...
December 2017: European Journal of Cancer
Luca Sorrentino, Alessandra Sartani, Daniela Bossi, Rosella Amadori, Manuela Nebuloni, Marta Truffi, Matteo Bonzini, Eliana Riggio, Diego Foschi, Fabio Corsi
Sentinel lymph node biopsy for ductal carcinoma in situ (DCIS) of the breast is not standard of care. However, nodal involvement for DCIS patients is reported. Aim of our study was to identify preoperative features predictive of nodal involvement in DCIS patients. We have retrospectively reviewed 175 patients with a preoperative diagnosis of DCIS following a vacuum-assisted breast biopsy, and undergoing surgery with sentinel node biopsy. Variables distribution was compared between patients upstaged to invasive cancer at final pathology and patients with a confirmed DCIS, and between positive vs negative sentinel node patients...
October 11, 2017: Breast Journal
Eugene T Shin, Amy S Joehlin-Price, Doreen M Agnese, Debra L Zynger
Objectives: There is little information regarding sentinel lymph node (SLN) frozen-section examination in patients with a history of ductal carcinoma in situ (DCIS). We evaluated the usage, clinical impact, and pathology resources used for SLN cryosectioning in mastectomy cases with a DCIS history. Methods: Mastectomies with SLNs submitted from 2012 to 2013 at a tertiary care center were analyzed. Medicare reimbursement was used to estimate pathology health care expenditures of intraoperative frozen sections...
November 2, 2017: American Journal of Clinical Pathology
Lea Lowenfeld, Salman Zaheer, Crystal Oechsle, Megan Fracol, Jashodeep Datta, Shuwen Xu, Elizabeth Fitzpatrick, Robert E Roses, Carla S Fisher, Elizabeth S McDonald, Paul J Zhang, Angela DeMichele, Rosemarie Mick, Gary K Koski, Brian J Czerniecki
HER2-directed therapies are less effective in patients with ER(pos) compared to ER(neg) breast cancer, possibly reflecting bidirectional activation between HER2 and estrogen signaling pathways. We investigated dual blockade using anti-HER2 vaccination and anti-estrogen therapy in HER2(pos)/ER(pos) early breast cancer patients. In pre-clinical studies of HER2(pos) breast cancer cell lines, ER(pos) cells were partially resistant to CD4(+) Th1 cytokine-induced metabolic suppression compared with ER(neg) cells...
2017: Oncoimmunology
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
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...
October 2017: Annals of Surgical Oncology
Nancy Panko, Anwar A Jebran, Ameer Gomberawalla, Mark Connolly
BACKGROUND Phyllodes tumor (PT) is a rare neoplasm of the breast. Concomitant PT with invasive ductal carcinoma (IDC) is an even rarer occurrence. When ductal carcinoma in situ (DCIS) or IDC are detected within the specimen, the management changes from wide local excision to further staging work-up, including sentinel node biopsy and radiation. CASE REPORT We report the case of a 70-year-old presented with right breast mass whose pathology showed benign PT with concomitant IDC and DCIS. The patient elected for a wide excision of the mass with sentinel lymph node biopsy, which did not show any involvement...
July 20, 2017: American Journal of Case Reports
Marios Konstantinos Tasoulis, Tyler Hughes, Gildy Babiera, Anees B Chagpar
BACKGROUND: Sentinel lymph node biopsy (SLNB) should be performed in patients with ductal carcinoma in situ (DCIS) undergoing mastectomy. Yet, the same logic is controversial in the setting of prophylactic mastectomy. METHODS: Surgeons were surveyed as to their practices. Statistical analyses were performed to identify associated factors. RESULTS: 238 surgeons responded to the survey. 73.1% of respondents stated they would always perform SLNB in the setting of mastectomy for DCIS, but only 6...
September 2017: American Journal of Surgery
Muna M Baslaim, Enaam M Junainah, Hadeel H Ahmad, Anmar F Semilan, Ahmed O Al-Ghamdi, Noora O Rahimuddin, Budoor A Salman
INTRODUCTION: Glycogen Rich Clear Cell Carcinoma (GRCC) is a rare variant of breast carcinomas and believed to be linked with a poor prognosis. CASE SUMMARY: We are presenting a 60-year-old Saudi lady with a 2cm GRCC carcinoma associated with clear cell ductal carcinoma in situ (DCIS) and no axillary lymph node involvement. The tumor was Estrogen and Progesterone receptors (ER & PR) positive and HER 2-neu negative. She underwent mastectomy with sentinel lymph node biopsy followed by hormonal therapy...
2017: International Journal of Surgery Case Reports
Katrina B Mitchell, Heather Lin, Yu Shen, Alfred Colfry, Henry Kuerer, Simona F Shaitelman, Gildy V Babiera, Isabelle Bedrosian
BACKGROUND: The National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO) provide guidelines regarding axillary nodal evaluation in ductal carcinoma in situ (DCIS), but data regarding national compliance with these guidelines remains incomplete. METHODS: We conducted a retrospective review of the National Cancer Data Base (NCDB) analyzing all surgical approaches to axillary evaluation in patients with DCIS. Logistic regression analysis was used to assess the multivariate relationship between patient demographics, clinical characteristics, and probability of axillary evaluation...
February 7, 2017: BMC Surgery
Cathelijne Heymans, James van Bastelaar, Ruben G J Visschers, Yvonne L J Vissers
BACKGROUND: Patients with a preoperative needle-biopsy diagnosis of ductal carcinoma in situ (DCIS) may have an indication for a sentinel lymph node biopsy if invasive carcinoma is found. We investigated how often a positive sentinel node and invasive carcinoma occurred in patients with a preoperative diagnosis of DCIS and whether this influenced the adjuvant regime. MATERIALS AND METHODS: From 2005 to 2014, the records of 240 patients with needle-biopsy diagnosis of DCIS were retrospectively reviewed for postoperative pathology outcomes of the sentinel node and breast, and decisions on adjuvant treatment...
June 2017: Clinical Breast Cancer
S J Zhu, X S Chen, J Y Wu, O Huang, J R He, L Zhu, W G Chen, Y F Li, X C Fei, K W Shen
Objective: To evaluate the choice of surgical treatment of ductal carcinoma in situ (DCIS) and its impact on long-term outcomes. Methods: A retrospective analysis of the clinicopathological features and treatment protocol of DCIS patients who underwent surgical treatment in Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine from January 2009 to August 2016 was done. The factors which could affect surgical treatment were analyzed by χ(2) test and Logistic regression...
February 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Lea Lowenfeld, Rosemarie Mick, Jashodeep Datta, Shuwen Xu, Elizabeth Fitzpatrick, Carla S Fisher, Kevin R Fox, Angela DeMichele, Paul J Zhang, Susan P Weinstein, Robert E Roses, Brian J Czerniecki
Purpose: Vaccination with HER2 peptide-pulsed DC1s stimulates a HER2-specific T-cell response. This randomized trial aimed to establish safety and evaluate immune and clinical responses to vaccination via intralesional (IL), intranodal (IN), or both intralesional and intranodal (ILN) injection.Experimental Design: Fifty-four HER2(pos) patients [42 pure ductal carcinoma in situ (DCIS), 12 early invasive breast cancer (IBC)] were enrolled in a neoadjuvant HER2 peptide-pulsed DC1 vaccine trial. Patients were randomized to IL (n = 19), IN (n = 19), or ILN (n = 16) injection...
June 15, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Valentina Bonev, Carlos Chavez De Paz Villanueva, Naveenraj Solomon, Maheswari Senthil, Mark E Reeves, Carlos Garberoglio, Sharon S Lum
When ductal carcinoma in situ (DCIS) is found on core needle biopsy, rates of upgrade to invasive cancer of 25 per cent and nodal positivity of 10 per cent have been reported. Sentinel lymph node dissection (SLND) is recommended when mastectomy is performed for DCIS. We investigated the role of SLND in DCIS patients undergoing partial and total mastectomy (TM). During the study period 2004 to 2013, 170 patients with DCIS were identified with a median age of 60 years (range 26-84 years). Of these, 58.2 per cent had partial mastectomy (PM) alone, 10...
October 2016: American Surgeon
Hiba El Hage Chehade, Hannah Headon, Umar Wazir, Houssam Abtar, Abdul Kasem, Kefah Mokbel
BACKGROUND: Recent discussion has suggested that some cases of ductal carcinoma in situ (DCIS) with high risk of invasive disease may require sentinel lymph node biopsy (SLNB). METHODS: Systematic literature review identified 48 studies (9,803 DCIS patients who underwent SLNB). Separate analyses for patients diagnosed preoperatively by core sampling and patients diagnosed postoperatively by specimen pathology were conducted to determine the percentage of patients with axillary nodal involvement...
January 2017: American Journal of Surgery
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