scholarly journals Histopathological and Tumor Characteristics Associated with False Negative Axillary Ultrasonography Results in Breast Cancer

2019 ◽  
Vol 21 (3) ◽  
pp. 232
Author(s):  
Merve Gursoy ◽  
Gulten Sezgin ◽  
Emine Merve Horoz ◽  
Berna Dirim Mete ◽  
Nezahat Erdogan
Keyword(s):  
Lymph Nodes ◽  
Primary Tumor ◽  
False Negative ◽  
Axillary Lymph ◽  
Tumor Characteristics ◽  
Negative Group ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
Significant Difference ◽  
The Mean

Aims: As the false-negative rates of axillary ultrasonography (AUS) (21%-48%) are not optimal, the demand for axillary surgery remains even if AUS is negative. The aim of this study is to determine the histopathological and tumor characteristics associated with false-negative AUS results.Materials and methods: Patients with normal AUS were divided into two groups as true-negative and false-negative according to the histopathology results of axillary lymph nodes. Two groups were compared in terms of age, histological grade of the primary tumor, histological size of the primary tumor, histological type, lymphovascular invasion (LVI), and ultrasonography BI-RADS classification of the primary tumor. The number of metastatic lymph nodes, size of the largest metastatic lymph node and the number of micrometastatic lymph nodes were also noted in the false-negative group.Results: There were 152 patients with normal preoperative AUS in the study group. The false-negative AUS rate was 20.4%. The incidence of invasive lobular carcinoma (ILC) and the mean tumor size was significantly greater in the false-negative group. Micrometastasis was present in 3 patients (3/31, 9.6%), the mean of the largest metastatic lymph nodes was 12.5 mm, the mean total number of malignant lymph nodes was 1.9 in the false-negative group. In 25/31 (80.6%) of the patients, there were less than or equal to 2 metastatic lymph nodes. The presence of LVI was higher in the false-negative group. There was no significant difference between the groups in terms of the other parameters.Conclusion: Before stating that the axilla is normal on ultrasonography, a careful evaluation should be made in patients with a mass >2 cm in size and/ or ILC diagnosis

scholarly journals Use of Quantitative Morphological and Functional Features for Assessment of Axillary Lymph Node in Breast Dynamic Contrast-Enhanced Magnetic Resonance Imaging

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Roberta Fusco ◽  
Mario Sansone ◽  
Vincenza Granata ◽  
Maurizio Di Bonito ◽  
Franca Avino ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Axillary Lymph Node ◽  
Morphological Features ◽  
Axillary Lymph ◽  
Dynamic Features ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
Significant Difference ◽  
Functional Features

Background. Axillary lymph-node assessment is considered one of the most important prognostic factors concerning breast cancer survival. Objective. We investigated the discriminative power of morphological and functional features in assessing the axillary lymph node. Methods. We retrospectively analysed data from 52 consecutive patients who undergone DCE-MRI and were diagnosed with primary breast carcinoma: 94 lymph nodes were identified. Per each lymph node, we extracted morphological features: circularity, compactness, convexity, curvature, elongation, diameter, eccentricity, irregularity, radial length, entropy, rectangularity, roughness, smoothness, sphericity, spiculation, surface, and volume. Moreover, we extracted functional features: time to peak (TTP), maximum signal difference (MSD), wash-in intercept (WII), wash-out intercept (WOI), wash-in slope (WIS), wash-out slope (WOS), area under gadolinium curve (AUGC), area under wash-in (AUWI), and area under wash-out (AUWO). Selection of important features in predicting metastasis has been done by means of receiver operating characteristic (ROC) analysis. Performance of linear discriminant analysis was analysed. Results. All morphological features but circularity showed a significant difference between median values of metastatic lymph nodes group and nonmetastatic lymph nodes group. All dynamic parameters except for MSD and WOS showed a statistically significant difference between median values of metastatic lymph nodes group and nonmetastatic lymph nodes group. Best results for discrimination of metastatic and nonmetastatic lymph nodes were obtained by AUGC (accuracy 75.8%), WIS (accuracy 71.0%), WOS (accuracy 71.0%), and AUCWO (accuracy 72.6%) for dynamic features and by compactness (accuracy 82.3%), curvature (accuracy 71.0%), radial length (accuracy 71.0%), roughness (accuracy 74.2%), smoothness (accuracy 77.2%), and speculation (accuracy 72.6%) for morphological features. Linear combination of all morphological and/or of all dynamic features did not increase accuracy in metastatic lymph nodes discrimination. Conclusions. Compactness as morphological feature and area under time-intensity curve as dynamic feature were the best parameters in identifying metastatic lymph nodes on breast MRI.

Clinical Significance of Subtype Classification in Metastatic Lymph Nodes of Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy

2015 ◽  
Vol 30 (2) ◽  
pp. 174-183 ◽  
Author(s):  
Noriko Nemoto ◽  
Yukiko Shibahara ◽  
Hiroshi Tada ◽  
Keiko Uchida ◽  
Keely M. McNamara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Clinical Outcomes ◽  
Primary Tumor ◽  
Breast Cancer Patients ◽  
Ki 67 ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph

Background Neoadjuvant chemotherapy has been increasingly utilized in the treatment of breast cancer patients. However, there are no established surrogate markers predicting the response to subsequent adjuvant therapy and clinical outcome of patients. In particular, whether primary or lymph nodes metastasis should be evaluated for these analyses has remained unknown. Therefore, in this study, we first evaluated the differences in biomarkers between primary and metastatic cancer tissues in the patients undergoing neoadjuvant chemotherapy. We then correlated the findings with the clinical outcomes of these patients. Methods We examined 49 patients receiving neoadjuvant chemotherapy and subsequent surgery with lymph node metastasis. Estrogen receptor (ER), progesterone receptor (PgR), human epidermal growth factor receptor 2 (HER2) and Ki-67 were all immunohistochemically evaluated in core needle biopsy samples from primary and metastatic tumors following chemotherapy. Results No statistically significant differences in these markers were detected between the primary tumor and metastatic lymph nodes following therapy, but the Ki-67 labeling index was significantly higher in metastatic lymph nodes than in primary tumor (p = 0.017). The patients associated with luminal A type carcinoma in their lymph nodes following chemotherapy demonstrated significantly better clinical outcomes (disease-free survival: p = 0.0045, overall survival: p = 0.0006) than those who were not. Conclusion These data indicate that subtype classification following chemotherapy, in the metastatic lymph nodes rather than primary tumor could predict long-term outcomes of patients undergoing neoadjuvant chemotherapy.

Validation study of sentinel lymph node mapping using radio- and dye-guided methods in gastric cancer: 431 cases at a single institution.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 76-76
Author(s):  
M. Niihara ◽  
H. Takeuchi ◽  
S. Kamiya ◽  
T. Kaburagi ◽  
T. Oyama ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Early Gastric Cancer ◽  
Lymph Nodes ◽  
False Negative ◽  
Tumor Diameter ◽  
Remnant Gastric Cancer ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph

76 Background: Some papers have reported that sentinel lymph node (SLN) concept can be applied in patients with early gastric cancer, in particular clinically T1N0M0 or T2N0M0 with a tumor diameter of 4cm or less. Little is, however, available on the SLN study with the other criteria than listed above. The aim of the present work was to investigate the accuracy of the SLN biopsy of gastric cancer with various stages and evaluate the indication for SLN navigated gastrectomy. Methods: A total of 431 consecutive patients were diagnosed with operable gastric cancer during the period April 1999 through December 2007. Reasons for inclusion were, in principle, T1N0M0 or T2N0M0 gastric cancer. However, several patients diagnosed preoperatively with T3N0M0, T2N1M0, remnant gastric cancer, multiple gastric cancers and additional treatment after endoscopic therapy were also enrolled in this study according to their request. All patients underwent a radical gastrectomy with SLN mapping with an informed consent. The SLNs were identified using both radio-guided and dye-guided method. Results: Detection rate of hot and/or blue node was 95.8% (413/431). The accuracy of metastatic status based on SLN was 97.6% (403/413). In six of 10 false-negative cases, some clinical backgrounds and problems were present; scirrhous gastric cancer, the tumor penetration of serosa, multiple lesions, remnant gastric cancer after partial resection and the technical issue of tracer injection. Nine of these 10 false-negative cases had the metastatic lymph nodes within only the sentinel basins. Specifically, in the group of clinically T1N0M0 untreated gastric cancer with a tumor diameter of 4 cm or less, there were only 3 false- negative cases. In addition, all the metastatic lymph nodes of the 3 cases located within the sentinel basins. Conclusions: Our study suggested that SLN concept for untreated early gastric cancer could be validated. The sentinel basin dissection might be used to advantage to improve curativity for gastric cancer. No significant financial relationships to disclose.

scholarly journals Lymph node retrieval after resection of rectal cancer following preoperative chemoradiotherapy

Medicina ◽  
2010 ◽  
Vol 46 (5) ◽  
pp. 299 ◽  
Author(s):  
Tadas Latkauskas ◽  
Paulius Lizdenis ◽  
Rasa Jančiauskienė ◽  
Darius Pranys ◽  
Algimantas Tamelis ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Nodes ◽  
Advanced Rectal Cancer ◽  
Control Group ◽  
Study Group ◽  
Preoperative Radiochemotherapy ◽  
Metastatic Lymph Nodes ◽  
Tumor Bearing ◽  
Metastatic Lymph ◽  
The Mean

Background. According to the current guidelines of proper TNM staging, 12 lymph nodes per specimen are crucial. This study assessed the role of preoperative radiochemotherapy on the number of lymph nodes detected in the tumor-bearing specimen. Material and methods. Retrospective data of 138 patients who underwent surgery for stage II and III rectal cancer without preoperative radiochemotherapy during the period of 2004–2006 (control group) were compared with prospective data of 38 patients who received preoperative radiochemotherapy during the period of 2007–2008 (study group). The number of patients with metastatic lymph nodes, number of lymph nodes per specimen, number of metastatic lymph nodes per specimen, and the size of the tumor between the groups were compared. Results. Positive lymph nodes were detected in 88 (64%) patients in the control group as compared with 9 (21%) patients in the study group (P<0.05). The mean number of lymph nodes per specimen in the control group was 13.5, while in the study group, the mean number of lymph nodes per specimen was 6.29 (P<0.05). There was a significant difference in the mean number of metastatic lymph nodes per specimen between the groups (5.12 in the control group versus 2.11 in the study group; P<0.05). The mean size of the tumor was 4.37 cm in the control group and 2.45 cm in the study group (P<0.01). Conclusions. Preoperative radiochemotherapy for advanced rectal cancer significantly decreased the number of lymph nodes detected in the tumor-bearing specimen. This also resulted in a significant decrease in the number of metastatic lymph nodes detected in the specimen, and fewer patients with stage III (N+) cancer were diagnosed. Preoperative radiochemotherapy could induce a significant downsizing and downstaging of advanced rectal cancer, but great care in operative and pathologic examination techniques must be taken to ensure appropriate staging.

scholarly journals Radiofrequency Ablation for Cervical Metastatic Lymph Nodes in Children and Adolescents With Papillary Thyroid Carcinoma: A Preliminary Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Lin Yan ◽  
Ying Zhang ◽  
Bo Jiang ◽  
Yukun Luo
Keyword(s):  
Radiofrequency Ablation ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Children And Adolescents ◽  
Papillary Thyroid ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
The Mean

ObjectiveTo evaluate the safety and efficacy of radiofrequency ablation (RFA) for metastatic lymph nodes (LNs) in children and adolescents with papillary Thyroid Carcinoma (PTC).Materials and MethodsFrom December 2014 to March 2018, 10 metastatic LNs(mean volume 0.30 ± 0.38 ml, range 0.06-1.23ml) in 5 children and adolescents (3 females, 2 males; mean age 15.60 ± 2.97 years, range 12-19 years) with PTC treated by RFA were evaluated in this study. The mean number of surgical procedures performed before RFA was 1.2 (range 1-2) and the mean number of treated metastatic LNs per patient was 2 (rang 1-3). RFA was performed with an 18–gauge bipolar RF applicator under local anesthesia. Follow-up consisted of US and serum thyroglobulin (Tg) level at 1, 3, 6, 12 months and every 12 months thereafter.ResultsAll the patients were well tolerant to RFA procedure and no procedure-related complications occurred. During a mean follow-up time of 52.00 ± 21.44 months, the initial volume of LNs was 0.30 ± 0.38 ml, which significantly decreased to 0.01 ± 0.03 ml (P = 0.005) with a mean VRR of 99.28 ± 2.27%. A total of 9 metastatic LNs (90.00%) completely disappeared. After RFA, 2 patients developed newly metastases. One patient had additional RFA. The other one with multiple LN metastases underwent total thyroidectomy with central neck dissection.ConclusionAs a less invasive and effective technique, RFA may provide another alternative to the existing therapeutic modalities for cervical metastatic LNs in children and adolescents with PTC.

scholarly journals TRANSHIATAL ESOPHAGECTOMY IS NOT ASSOCIATED WITH POOR QUALITY LYMPHADENECTOMY

2019 ◽  
Vol 32 (4) ◽  
Author(s):  
Flávio Roberto TAKEDA ◽  
Francisco TUSTUMI ◽  
Bruna de Camargo NIGRO ◽  
Rubens Antonio Aissar SALLUM ◽  
Ulysses RIBEIRO-JUNIOR ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Primary Tumor ◽  
Pathological Complete Response ◽  
Neoadjuvant Chemoradiotherapy ◽  
Complete Response ◽  
Primary Tumor Site ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
Trimodal Therapy ◽  
Positive Lymph Nodes

ABSTRACT Background: Esophageal cancer neoadjuvant therapy followed by surgery increases the likelihood of treatment success. Aim: To evaluate variables that can influence the number of retrieved lymph nodes, the number of retrieved metastatic lymph nodes and lymphnodal recurrence in esophagectomy after neoadjuvant chemoradiotherapy. Methods: Patients of a single institute were evaluated after completion of trimodal therapy. Univariate and multivariate analyses were performed to evaluate variables that can influence in the number of retrieved lymph nodes and retrieved metastatic lymph nodes. Results: One hundred and forty-nine patients were included. Thoracoscopy access was considered an independent factor for the number of lymph nodes retrieved, but was neither related to the number of positive lymph nodes retrieved nor to lymphnodal recurrence. Pathological complete response on the primary tumor and male were independent variables associated with the number of positive lymph node retrieved. Pathological complete response on the primary tumor site did not statistically influence the likelihood of a lower number of lymph nodes retrieved. Conclusion: Patients submitted to esophagectomy after neoadjuvant chemoradiotherapy, thoracoscopic access is more accurate for pathological staging, even in a complete pathological response. With a proper patient selection, transhiatal surgery may preserve the quality of lymphadenectomy of the positive lymph nodes.

scholarly journals Treatment of false‐negative metastatic lymph nodes by a lymphatic drug delivery system with 5‐fluorouracil

2019 ◽  
Vol 8 (5) ◽  
pp. 2241-2251 ◽  
Author(s):  
Honoka Fujii ◽  
Sachiko Horie ◽  
Ariunbuyan Sukhbaatar ◽  
Radhika Mishra ◽  
Maya Sakamoto ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Lymph Nodes ◽  
Drug Delivery System ◽  
Delivery System ◽  
False Negative ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph

scholarly journals Expression of PD-1/PD-L1 in primary breast tumours and metastatic axillary lymph nodes and its correlation with clinicopathological parameters

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Chenxi Yuan ◽  
Zhaoyun Liu ◽  
Qian Yu ◽  
Xinzhao Wang ◽  
Mengxue Bian ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Primary Tumour ◽  
Clinicopathological Parameters ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Clinicopathologic Characteristics ◽  
Breast Tumours ◽  
Metastatic Lymph Nodes ◽  
Prognostic Features ◽  
Metastatic Lymph

Abstract The aim of this study was to compare the expression of PD-1/PD-L1 in primary breast tumours to that in metastatic axillary lymph nodes and to determine the correlation between the PD-1/PD-L1 status and clinicopathologic characteristics. In total, 47 paired breast tumour and metastatic axillary lymph node samples were collected in this study. Immunohistochemical technology was used to determine the positivity or negativity of PD-1/PD-L1. Other patient information was retrieved from medical records. Significant differences in PD-L1 expression were observed between primary breast tumours and paired axillary lymph nodes. We also observed that the presence of PD-1/PD-L1 positivity in metastatic lymph nodes was significantly associated with poor prognostic features, such as a high Ki-67 index (p = 0.048), a high TNM stage (p = 0.012), a large number of metastatic lymph nodes (p = 0.002), and a high histology grade (p = 0.029). Since heterogeneity exists, it is necessary to determine the PD-L1 status in both the primary tumour and metastatic lymph nodes.

Sign in / Sign up

Export Citation Format

Share Document