Abstract P3-03-16: Intraoperative evaluation of sentinel lymph nodes after neoadjuvant systemic therapy in breast cancer

2019 ◽  
Author(s):  
S Sahoo ◽  
M Mir ◽  
V Sarode ◽  
Y Fang ◽  
Y Peng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Systemic Therapy ◽  
Sentinel Lymph Nodes ◽  
Intraoperative Evaluation ◽  
Neoadjuvant Systemic Therapy

scholarly journals Challenge for Diagnostic Assessment of Deep Learning Algorithm for Metastases Classification in Sentinel Lymph Nodes on Frozen Tissue Section Digital Slides in Women with Breast Cancer

2020 ◽  
Author(s):  
Young-Gon Kim ◽  
In Hye Song ◽  
Hyunna Lee ◽  
Dong Hyun Yang ◽  
Namkug Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Deep Learning ◽  
Lymph Nodes ◽  
Learning Algorithm ◽  
Medical Center ◽  
Characteristic Curve ◽  
Lobular Carcinoma ◽  
Sentinel Lymph Nodes ◽  
Neoadjuvant Systemic Therapy ◽  
Frozen Tissue

Abstract Assessing the status of metastasis in sentinel lymph nodes (SLNs) by pathologists is an essential task for the accurate staging of breast cancer. However, histopathological evaluation of sentinel lymph nodes by a pathologist is not easy and is a tedious and time-consuming task. The purpose of this study is to review a challenge competition (HeLP 2018) to develop automated solutions for the classification of metastases in hematoxylin and eosin–stained frozen tissue sections of SLNs in breast cancer patients. A total of 297 digital slides were obtained from frozen SLN sections, which include post–neoadjuvant cases (n = 144, 48.5%) in Asan Medical Center, South Korea. The slides were divided into training, development, and validation sets. All of the imaging datasets have been manually segmented by expert pathologists. A total of 10 participants were allowed to use the Kakao challenge platform for six weeks with two P40 GPUs. The algorithms were assessed in terms of the AUC (area under receiver operating characteristic curve). The top three teams showed 0.986, 0.985, and 0.945 AUCs for the development set and 0.805, 0.776, and 0.765 AUCs for the validation set. Micrometastatic tumors, neoadjuvant systemic therapy, invasive lobular carcinoma, and histologic grade 3 were associated with lower diagnostic accuracy. In a challenge competition, accurate deep learning algorithms have been developed, which can be helpful in making frozen diagnosis of intraoperative sentinel lymph node biopsy. Whether this approach has clinical utility will require evaluation in a clinical setting.

scholarly journals Twenty-year experience of examining biopsies of signal lymph nodes in breast cancer

2020 ◽  
Vol 16 (1) ◽  
pp. 12-20 ◽  
Author(s):  
V. F. Semiglazov ◽  
P. V. Krivorotko ◽  
E. K. Zhiltsova ◽  
S. V. Kanaev ◽  
E. S. Trufanova ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Diagnostic Accuracy ◽  
Medical Research ◽  
Systemic Therapy ◽  
False Positive ◽  
Ministry Of Health ◽  
National Medical ◽  
Neoadjuvant Systemic Therapy ◽  
Oncology Center

Biopsy of signal (sentinel) lymph nodes (LN) has been performed at the N.N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia, for almost 20 years. In the first few years, contrast-visual method (1 % blue isosulfan and triphenyl methane control) was used in 640 patients with early (T1–2N0M0) breast cancer. In 150 patients from this cohort, standard axillary dissection was performed irrespectively of the results of signal (sentinel) biopsy. The rate of false positive responses varied between 4.6 and 6.6 %. Since 2012, radioisotope method of visualization of signal LN with intratumor administration of 99mТс-technephyte colloid particles has been used (in 708 patients with T1–3N0M0 breast cancer). This type of signal LN biopsy had the following diagnostic characteristics: sensitivity was 58.9 %, specificity was 96.2 %, diagnostic accuracy was 87.1 %.In parallel with this study, in 2016 a study of diagnostic accuracy and safety of biopsy of axillary LN after neoadjuvant systemic therapy was started. The study included 263 patients with T1N1–3M0, T2–3N0–3M0, T4N0–1M0 breast cancer. To evaluate clinical status of axillary LN, ultrasound, single-photon emission computed tomography, mammography at baseline and after completion of neoadjuvant chemotherapy ± targeted therapy (trastuzumab) were performed. In some patients, in the recent years a double method of signal LN labeling (radioisotope and fluorescent methods) was used.In patients with baseline cN+-status, the rate of false positive signal LN biopsy conclusions was 13.6 %, in patients with baseline cN0-status it was 7.7 %.The study of double contrast of axillary LN and targeted label of metastatic LN prior to neoadjuvant systemic therapy continues. In total, various modifications of biopsy of signal LN were performed in 2,000 patients with breast cancer.The study protocol was approved by the biomedical ethics committee of N.N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia.All patients gave written informed consent to participate in the study.

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