scholarly journals Extramedullary Haematopoiesis in Axillary Lymph Nodes of Breast Carcinoma Patients Receiving Neoadjuvant Chemotherapy: A Potential Diagnostic Pitfall

Pathobiology ◽  
2018 ◽  
Vol 86 (2-3) ◽  
pp. 167-172 ◽  
Author(s):  
Nahla M. Badr ◽  
Claudia Roberts ◽  
Abeer M. Shaaban
Keyword(s):  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Extramedullary Haematopoiesis ◽  
Diagnostic Pitfall

Positron emission tomography/computed tomography (PET/CT) as a biomarker of pathologic response to neoadjuvant chemotherapy in breast carcinoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e21147-e21147
Author(s):  
Catherine M. Kelly ◽  
Clare Smith ◽  
Susan Conlon ◽  
Reem Salman ◽  
John McCaffrey ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Breast Cancer Subtype ◽  
Standardized Uptake Value ◽  
Predictive Biomarkers ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Pet Ct

e21147 Background: Pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast carcinoma is prognostic. Predictive biomarkers for pCR include early response to NAC, estrogen receptor (ER) negativity, HER2 positivity, and high Ki67. We assessed whether absence of fluoro-deoxy glucose (FDG) uptake measured by standardized uptake value (SUV) after NAC would predict pCR. Methods: We identified 23 patients (pts) who had PET/CT scanning pre and post NAC. We examined breast cancer subtype, chemotherapy (CT) regimen, number of cycles of CT given, clinical and pathological staging data and changes in SUV in the breasts and lymph nodes pre and post NAC. pCR was defined as no residual cancer in the breast or axillary lymph nodes. Results: Median age at diagnosis was 46 years (IQR; 37 to 56). Median tumor size at diagnosis was 30mm (IQR; 25 to 43) and 19 pts (83%) had node positive breast cancer. Most tumors were ductal (n=22) with 1 lobular cancer. Preoperatively 95% received all CT. All HER2+ pts received Trastuzumab. Anthracycline/taxane based regimens were most frequently given in 22 cases, 1 received lapatinib/trastuzumab. Five tumors (21.7%) were ER+/HER2+; 14 (60.9%) ER+/HER2-; 2 (8.7%) ER-/HER2+ and 2 (8.7%) were ER-/HER2-. All tumors were high (n=9, 39.1%) or intermediate grade (n=14, 61%). SUV was significantly lower post NAC (p=0.035). We observed no SUV uptake in breast or lymph nodes in 15 cases (65.2%) post NAC, these corresponded to; ER+HER2+ 4/5 (80%); ER+HER2- 7/15 (46.7%); ER-HER2- 2/2(100%), ER-HER2+ 2/2(100%). Absent SUV uptake post NAC was associated with a pCR (breast and lymph nodes) in 5/15 (33%) of pts (ER+HER2+ n=1, ER+HER2- n=1, ER-HER2- n=2, ER-HER2+ n=1). Ten of 15 tumors (67%) had no SUV uptake in the breast post NAC and 7 (47%) were associated with a pCR. There was a trend toward increased odds of pCR with no SUV uptake post NAC (OR 2.76; 95% CI 0.85 to 8.94: P= 0.09). Overall rate of pCR was 21.7% (n=5). Conclusions: A non-statistically significant trend toward increased odds of pCR with no SUV uptake post NAC was observed. Larger subtype-specific breast cancer cohorts will be required to determine the value of PET/CT as a predictive biomarker for pCR.

Touch imprint cytology of axillary lymph nodes after neoadjuvant chemotherapy in patients with breast carcinoma

Cancer ◽  
2003 ◽  
Vol 99 (6) ◽  
pp. 346-351 ◽  
Author(s):  
Paresh Jain ◽  
Rajive Kumar ◽  
Mona Anand ◽  
Sonal Asthana ◽  
Suryanarayana V. S. Deo ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Imprint Cytology ◽  
Touch Imprint Cytology

Imprint Cytology of Axillary Lymph Nodes in Breast Carcinoma Following Neoadjuvant Chemotherapy

2010 ◽  
Vol 54 (5) ◽  
pp. 685-691 ◽  
Author(s):  
Aneeth Jegaraj ◽  
Dharanipragada Kadambari ◽  
Krishnamachari Srinivasan ◽  
Neelaiah Siddaraju
Keyword(s):  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Imprint Cytology

Challenges to I-125 Seed Localization of Metastatic Axillary Lymph Nodes Following Neoadjuvant Chemotherapy

2019 ◽  
Vol 1 (3) ◽  
pp. 223-229 ◽  
Author(s):  
Brenda Hyde ◽  
Jennifer Geske ◽  
Christine Lee
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Axillary Lymph Nodes ◽  
Time Interval ◽  
Axillary Lymph ◽  
Entire Study ◽  
Institutional Review ◽  
Seed Localization ◽  
Iodine 125 ◽  
Mean Time

Abstract Objective The objective of this retrospective study is to characterize challenges with ultrasound (US)-guided localization of clipped metastatic axillary lymph nodes after neoadjuvant chemotherapy. Methods After institutional review board approval, our radiology database was searched for all radioactive seed localizations (RSLs), which use a low-dose radioactive isotope, Iodine-125, performed for clipped axillary lymph nodes between January 1, 2016, and December 31, 2018. The details of each procedure were reviewed. RSL was defined to be successful if US-guidance was used, and postlocalization imaging showed the seed was no more than 1 cm away from the target. Cause and subsequent management of unsuccessful localizations were documented. Results During the study period, 139 clipped axillary lymph nodes (in 138 women and 1 man) were scheduled for preoperative RSL. The overall success rate of RSL was 106/139 (76%). The number of unsuccessful localizations was 10/37 (27%) in 2016, 7/39 (18%) in 2017, and 16/63 (25%) in 2018, with a total unsuccessful case frequency of 33/139 (24%) over the entire study period. The mean time interval between marker placement and localization was 6.0 months (range 0.4–18.1 months). The coil biopsy marker was the most frequently used marker. Conclusions Preoperative US-guided I-125 seed localization of clipped metastatic axillary lymph nodes is suboptimal or unsuccessful 24% of the time. Other options for non-US imaging-guided localizations, such as tomosynthesis, are available for consideration when US detection is unsuccessful.

scholarly journals Atypical axillary lymphadenopathy mimicking an occult breast carcinoma in a patient diagnosed with sarcoidosis: case report

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Paula Clarke ◽  
Carolina Nazareth Valadares ◽  
Douglas de Miranda Pires ◽  
Nayara Carvalho de Sá
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Axillary Lymph Nodes ◽  
Breast Lesions ◽  
Axillary Lymph ◽  
Axillary Lymphadenopathy ◽  
Granulomatous Lymphadenitis ◽  
Occult Breast Carcinoma

Introduction: Occult breast carcinoma is a rare presentation of breast cancer, with histological evidence of axillary lymph node involvement and clinical and radiological absence of malignant breast lesions. Its survival is similar to that of the usual presentation. The treatment consists of modified radical mastectomy or axillary drainage with breast irradiation, resulting in similar survival, associated with systemic therapy according to the staging. Neoadjuvant therapy should be considered in N2-3 axillary cases. Differential diagnoses of axillary lymphadenopathies include: non-granulomatous causes (reactive, lymphoma, metastatic carcinoma) and granulomatous causes (infectious – toxoplasmosis, tuberculosis, sarcoidosis, atypical mycobacteria). Objectives: To report the case of a patient who needed a differential diagnosis among the various causes of axillary lymphadenopathy. Methods: This is a literature review conducted in the PubMed database, using the keywords "granulomatous lymphadenitis", "breast sarcoidosis", "occult breast cancer". Inclusion and exclusion criteria were applied. Case report: V.F.S., female, 51 years old, was referred to an evaluation of axillary lymphadenopathy in May 2019. She was followed by the department of pulmonology due to mediastinal sarcoidosis since 2017. Physical examination indicated breasts without changes. Axillary lymph nodes had increased volume and were mobile and fibroelastic. Mammography revealed only axillary lymph nodes with bilaterally increased density, and the ultrasound showed the presence of atypical bilateral lymph nodes. Neither presented breast lesions. Axillary lymph node core biopsy was compatible with granulomatous lymphadenitis. This result corroborates the diagnosis of sarcoidosis affecting peripheral lymph nodes. The patient was referred back to the department of pulmonology, with no specific treatment since she is oligosymptomatic. Discussion: Despite the context of benign granulomatous disease, malignancy overlying the condition of sarcoidosis must be ruled out. The biopsy provided a safe and definitive diagnosis, excluding the possibility of occult breast carcinoma. The patient will continue to undergo breast cancer screening as indicated for her age and usual risk. Conclusion: In the presentation of axillary lymphadenopathy, the mastologist must know the various diagnoses to be considered. The most feared include lymphoma and carcinoma metastasis with occult primary site. A proper workup can determine the diagnosis and guide the appropriate treatment.

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