scholarly journals What Is the Optimal Method to Predict Axillary Lymph Node Metastases in Breast Cancer Patients? - Is Sentinel Lymph Node Biopsy Ready to Be an Alternative to Complete Axillary Dissection?

1999 ◽  
Vol 29 (12) ◽  
pp. 595-595
Author(s):  
T. Fukutomi
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Axillary Dissection ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Optimal Method ◽  
Axillary Lymph Node Metastases ◽  
Node Biopsy ◽  
Node Metastases

Are Breast Cancer Nomograms Still Valid to Predict the Need for Axillary Dissection?

Oncology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Vilma Madekivi ◽  
Antti Karlsson ◽  
Pia Boström ◽  
Eeva Salminen
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Axillary Dissection ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Axillary Lymph Node Metastases ◽  
Node Negative ◽  
Node Metastases ◽  
External Population

Background: Nomograms can help in estimating the nodal status among clinically node-negative patients. Yet their validity in external cohorts over time is unknown. If the nodal stage can be estimated preoperatively, the need for axillary dissection can be decided. Objectives: The aim of this study was to validate three existing nomograms predicting 4 or more axillary lymph node metastases. Method: The risk for ≥4 lymph node metastases was calculated for n = 529 eligible breast cancer patients using the nomograms of Chagpar et al. [Ann Surg Oncol. 2007;14:670–7], Katz et al. [J Clin Oncol. 2008;26(13):2093–8], and Meretoja et al. [Breast Cancer Res Treat. 2013;138(3):817–27]. Discrimination and calibration were calculated for each nomogram to determine their validity. Results: In this cohort, the AUC values for the Chagpar, Katz, and Meretoja models were 0.79 (95% CI 0.74–0.83), 0.87 (95% CI 0.83–0.91), and 0.82 (95% CI 0.76–0.86), respectively, showing good discrimination between patients with and without high nodal burdens. Conclusion: This study presents support for the use of older breast cancer nomograms and confirms their current validity in an external population.

Evaluating One Day versus Two Days Preoperative Lymphoscintigraphy Protocols for Sentinel Lymph Node Biopsy in Breast Cancer

2015 ◽  
Vol 81 (5) ◽  
pp. 454-457 ◽  
Author(s):  
Michael G. Mount ◽  
Nicholas R. White ◽  
Christophe L. Nguyen ◽  
Richard K. Orr ◽  
Robert B. Hird
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Axillary Lymph Node ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Axillary Lymph Node Metastases ◽  
Node Biopsy ◽  
Node Negative Breast Cancer

Sentinel lymph node biopsy (SLNB) is used to detect axillary lymph node metastases in breast cancer. Preoperative radiocolloid injection with lymphoscintigraphy (PL) is performed before SLNB. Few comparisons between 1- and 2-day PL protocols exist. Opponents of a 2-day protocol have expressed concerns of radiotracer washout to nonsentinel nodes. Proponents cite lack of scheduling conflicts between PL and surgery. A total of 387 consecutive patients with clinically node-negative breast cancer underwent SLNB with PL. Lymphoscintigraphy images were obtained within 30 minutes of radio-colloid injection. Axillary lymph node dissection was performed if the sentinel lymph node (SLN) could not be identified. Data were collected regarding PL technique and results. In all, 212 patients were included in the 2-day PL group and 175 patients in the 1-day PL group. Lymphoscintigraphy identified an axillary sentinel node in 143/212 (67.5%) of patients in the 2-day group and 127/175 (72.5%) in the 1-day group ( P = 0.28). SLN was identified at surgery in 209/212 (98.6%) patients in the 2-day group and 174/175 (99.4%) in the 1-day group ( P = 0.41). An average of 3 SLN was found at surgery in the 2-day group compared with 3.15 in the 1-day group ( P = 0.43). SLN was positive for metastatic disease in 54/212 (25.5%) patients in the 2-day group compared with 40/175 (22.9%) in the 1-day group ( P = 0.55). A 2-day lymphoscintigraphy protocol allows reliable detection of the SLN, of positive SLN and equivalent SLN harvest compared with a 1-day protocol. The timing of radiocolloid injection before SLNB can be left at the discretion of the surgeon.

scholarly journals Controversial Indications for Sentinel Lymph Node Biopsy in Breast Cancer Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Hazem Assi ◽  
Eman Sbaity ◽  
Mahmoud Abdelsalam ◽  
Ali Shamseddine
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Recurrent Breast Cancer ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Complication Rates ◽  
Breast Cancer Patients ◽  
Node Biopsy

Sentinel lymph node biopsy (SLNB) emerged in the 1990s as a new technique in the surgical management of the axilla for patients with early breast cancer, resulting in lower complication rates and better quality of life than axillary lymph node dissection (ALND). Today SLNB is firmly established in the armamentarium of clinicians treating breast cancer, but several questions remain. The goal of this paper is to review recent work addressing 4 questions that have been the subject of debate in the use of SLNB in the past few years: (a) What is the implication of finding micrometastases in the sentinel nodes? (b) Is ALND necessary in all patients who have a positive SLNB? (c) How accurate is SLNB after neoadjuvant therapy? (d) Can SLNB be used to stage the axilla in locally recurrent breast cancer following breast surgery with or without prior axillary surgery?

Axillary Regional Recurrence after Sentinel Lymph Node Biopsy for Breast Cancer

2006 ◽  
Vol 72 (10) ◽  
pp. 939-942
Author(s):  
David K. Rosing ◽  
Christine E. Dauphine ◽  
M. Perla Vargas ◽  
Katherine Gonzalez ◽  
Melissa Burla ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Cancer Patients ◽  
Axillary Dissection ◽  
Breast Conservation ◽  
Lymph Node Biopsy ◽  
Breast Cancer Patients ◽  
Node Biopsy

The accuracy of sentinel lymph node biopsy (SLNB) staging in breast cancer has been demonstrated in studies comparing it with axillary dissection. There is a 5 per cent false-negative rate, but this does not always correlate with axillary recurrence. Our purpose was to determine the rate of axillary lymphatic recurrence in breast cancer patients who had a negative SLNB. We conducted a cohort study of breast cancer patients who underwent SLNB between 2001 and 2005. Only patients who had a negative SLNB were included. Patient demographics and tumor factors were reviewed. Outcomes measured were axillary and systemic recurrence and survival. Eighty-nine patients with a mean age of 54.4 ± 9.9 years were included. Eighty-nine per cent of cases had infiltrating ductal carcinoma histology. Mean tumor size was 19 ± 14 mm. Breast conservation surgery was done in 65 cases and mastectomy in 24. A mean of 2.3 ± 2.4 SLN were found. After a median follow-up of 2.15 years, 1 (1%) patient developed a lymphatic recurrence in the axilla. SLNB provides accurate staging of breast cancer. Patients with negative SLNB do not require axillary dissection.

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