Immunohistochemical Investigation of Axillary Lymph Nodes for Micrometastases in Patients with Breast Cancer Using E29

The axillary lymph nodes from 31 mammary carcinoma patients who had undergone radical mastectomy and were negative for metastases at routine histologic examination of hilar sections, were investigated with E29, an anti-epithelial monoclonal antibody, to detect the presence of neoplastic epithelial cells. In 4 of 433 lymph nodes examined (0.9 %) this antibody revealed the presence of epithelial metastatic foci which had not been observed at routine histological examination or interpreted as histiocytes. The 4 lymph nodes belonged to 4 different patients.

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Development and validation of a nomogram to predict drainage duration in patients with breast cancer treated with modified radical mastectomy

Scientific Reports ◽

10.1038/s41598-021-82073-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Song Wu ◽

Zechang Xin ◽

Daxing Sui ◽

Zhengli Ou ◽

Haotian Bai ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Nodes ◽

Radical Mastectomy ◽

Postoperative Management ◽

The Body ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Modified Radical Mastectomy ◽

Suction Drain ◽

Postoperative Drainage

AbstractAppropriate drainage duration is vital for the postoperative rehabilitation of patients with breast cancer (BC) undergoing modified radical mastectomy (MRM). To provide better and individualized postoperative management for these patients, this study explored independent predictors of postoperative drainage duration in patients with BC. This was a single-center retrospective cohort study. Patients diagnosed with BC and treated with MRM from May 2016 to April 2020 were randomly divided into training (n = 729) and validation (n = 243) cohorts. Univariate and multivariate Cox analyses revealed that the body mass index, serum albumin level, hypertension, number of total dissected axillary lymph nodes, and ratio of positive axillary lymph nodes were independent predictors of postoperative drainage duration in the training cohort. Based on independent predictors, a nomogram was constructed to predict the median postoperative drainage duration and the probability of retaining the suction drain during this period. This nomogram had good concordance and discrimination both in the training and validation cohorts and could effectively predict the probability of retaining the suction drain during drainage, thus assisting clinicians in predicting postoperative drainage duration and providing individualized postoperative management for patients with BC.

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Surgical Treatment for Breast Cancer and Axillary Metastases

Acta medico-historica Adriatica ◽

10.31952/amha.19.1.7 ◽

2021 ◽

Vol 19 (1) ◽

pp. 125-136

Author(s):

Damir Grebić ◽

Aleksandra Pirjavec ◽

Domagoj Kustić ◽

Tihana Klarica Gembić

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Breast Conservation ◽

Radical Mastectomy ◽

Pectoralis Major ◽

Axillary Staging ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Early Stage Disease

Breast cancer (BC) is the most common malignancy to affect females. The first suggestions of BC and its treatment date back to Ancient Egypt, 1500-1600 B.C. Throughout history, the management of BC has evolved from extensive radical mastectomy towards less invasive treatments. Radical mastectomy was introduced by W.S. Halsted in 1894, involving the resection of the breast, regional lymph nodes, pectoralis major and minor. Despite its mutiloperative lymphatic mapping and the concept of sentinel lymph node (SLN) biopsy (SLNB) have been developed. SLNB has replaced axillary lymph node dissection (ALND) to be the standard procedure for axillary staging in patients with clinically node-negative BC. Many women have since been spared ALND, including those with negative SLNB or with SLNs involved with micrometastases (0.2-2 mm in size). In the last decade, evidence gathered from new clinical trials suggests that ALND may be safely omitted even in BC patients with 1 or 2 positive SLNs if adjuvant radiotherapy is delivered.ating effect, it had been the main surgical approach to BC patients until 1948, when Patey and Dyson proposed its modified form that conserved pectoralis major and minor and the level III of axillary lymph nodes. The latter was associated with less postoperative morbidity and improved quality of life. The idea of limited breast tissue resection was introduced in the 1970s by Umberto Veronesi and led to further minimizations of surgery in BC patients until breast conservation became the standard of care for early-stage disease. In the 1990s, intra

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Correlations between Clinical Control and Histopathologic Findings in Breast Cancer after Irradiation and Radical Mastectomy.

Tumori Journal ◽

10.1177/030089167506100407 ◽

1975 ◽

Vol 61 (4) ◽

pp. 365-376

Author(s):

Carlo Uslenghi ◽

Roberto Zucali ◽

Claudio Clemente ◽

Rado Kenda

Keyword(s):

Breast Cancer ◽

Survival Rate ◽

Lymph Nodes ◽

Local Control ◽

Clinical Course ◽

Radical Mastectomy ◽

Locoregional Therapy ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Histological Findings

154 cases of breast cancer (30 T1-T2; 124 T3-T4) treated by irradiation followed by radical mastectomy were subjected to histological revision in order to check the efficacy of radiotherapy in the local control of cancer and to seek correlations between the histological findings and the clinical course of the disease. The tumor disappeared completely only in 24 % of cases, the percentage being higher in the initially smaller tumors; the axillary lymph nodes showed disappearance of the metastases in a still smaller proportion of cases, namely 15–20%. Only in 16 cases (10% of cases) were the histological findings negative both at mammary and axillary levels. X-ray therapy and cobalt therapy were of equal value in the local control of the disease, despite the higher doses of cobalt. The patients operated on after radiotherapy had a decidedly better survival rate than those treated with irradiation only, since the former were selected because of their better clinical course and operated on because of this. Of the operated patients those whose axillary histology was negative presented a higher survival rate (75% of patients living) than those whose findings were positive (53%). Factors of negligible importance prognostically were: complete sterilization at mammary and axillary level after radiotherapy, persistence of florid cancer tissue at mammary level and histiocytosis of the axillary lymph nodes. In short, the result of locoregional therapy, even when successful, was not crucial in the general control of the disease, especially in advanced locoregional breast cancer (T3-T4 with axillary metastases).

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The accuracy of USG and USG guided FNAC axilla in predicting nodal metastasis in a clinically lymph node negative cancer breast patient

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20164548 ◽

2016 ◽

Vol 5 (1) ◽

pp. 196 ◽

Cited By ~ 1

Author(s):

Vaibhav Shrivastava ◽

Sanjay Singh ◽

Aklesh Kumar Maurya ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Predictive Value ◽

Breast Conservation ◽

Radical Mastectomy ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Breast Cancer Patients ◽

Node Negative

Background: Breast malignancies are the second most common cause of cancer-related mortality among women. As the size of the primary breast cancer increases, some cancer cells are shed into cellular spaces and transported via the lymphatic network of the breast to the regional lymph nodes, especially the axillary lymph nodes. Objective of the study was to determine the accuracy of USG and US-FNAC in detecting lymph node metastasis in a clinically lymph node negative CA Breast patient.Methods: This prospective study was conducted on 40 consecutive patients with biopsy proven breast cancer with clinically negative axilla, who had attending the OPD or IPD in our department of surgery, Swaroop Rani Nehru Hospital, Allahabad, during the period of 2014 to 2015. All of these patients were planned to undergo surgery (breast conservation or modified radical mastectomy with axillary clearance).Results: Sensitivity of the study = 97.77%, specificity = 25%, positive predictive value =92.01%, negative predictive value =50%, diagnostic accuracy =90%.Conclusions: Using axillary ultrasound and selective US-FNAC is a rapid, non-morbid method of staging the axilla in newly diagnosed breast cancer patients and should become a routine part of patient care because it can spare many patients particularly those who are undergoing axillary dissection.

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A Human Monoclonal Antibody Derived from Axillary Lymph Nodes of a Breast Cancer Patient

Hybridoma ◽

10.1089/hyb.1989.8.293 ◽

1989 ◽

Vol 8 (3) ◽

pp. 293-302 ◽

Cited By ~ 5

Author(s):

YASUHIRO TAMAKI ◽

TETSURO KOBAYASHI ◽

MASAHIKO HIGASHIYAMA ◽

TAKASHI SHIMANO ◽

TAKESADA MORI ◽

...

Keyword(s):

Breast Cancer ◽

Monoclonal Antibody ◽

Cancer Patient ◽

Lymph Nodes ◽

Breast Cancer Patient ◽

Human Monoclonal Antibody ◽

Axillary Lymph Nodes ◽

Axillary Lymph

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The importance of sentinel lymph node biopsy following neoadjuvant chemotherapy in patients with breast cancer: prospective multicentre trial

10.33699/pis.2021.100.6.271-277 ◽

2021 ◽

Vol 100 (6) ◽

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Lymph Nodes ◽

Histological Examination ◽

Ultrasound Examination ◽

Lymph Node Biopsy ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Node Biopsy

Introduction: The role of sentinel lymph node biopsy (SLNB) in patients with breast cancer after neoadjuvant chemotherapy (NAC) is currently under discussion. The aim of our study was to determine the false negativity rate (FNR) of SLNB, the accuracy of ultrasound examination in the evaluation of the status of lymph nodes and the accuracy of perioperative cryobiopsy of the sentinel lymph node (SLN). Methods: Prospective multicentre study, which took place in years 2018−2020 at three centres in the Czech Republic. A total of 59 patients were evaluated. Results: The FNR of SLNB in the group of patients with cN1 before NAC and ycN0 after NAC was 12.5%. The FNR of perioperative histological examination of the SLN was 38.5%. The FNR of ultrasound examination of axillary lymph nodes in patients after NAC was 35.5%, and the false positivity rate was 16.7%. The incidence of inflammatory complications in our cohort was 3.3%. Conclusion: The FNR of SLNB in the group of patients with cN1 before NAC and ycN0 after NAC exceeds the tolerable limit of 10%. The FNR of perioperative histological examination of the SLN is high; definitive histological examination of the SLN may change the original diagnostic-therapeutic plan. Ultrasound examination of the axillary lymph nodes in patients after NAC is a method with high false negativity and positivity and may not correspond with the perioperative finding. The incidence of inflammatory complications in our cohort in patients after NAC is comparable to literature data on the frequency of complications in patients without NAC.

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Assessment of axillary lymph nodes involvement in patients with breast cancer depending on the tumor size and its histological and nuclear grades

Vojnosanitetski pregled ◽

10.2298/vsp1205414b ◽

2012 ◽

Vol 69 (5) ◽

pp. 414-419 ◽

Cited By ~ 2

Author(s):

Toplica Bojic ◽

Nebojsa Djordjevic ◽

Aleksandar Karanikolic ◽

Sladjana Filipovic ◽

Miroslav Granic ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Nodes ◽

Tumor Size ◽

Histological Grade ◽

Radical Mastectomy ◽

Nuclear Grade ◽

Breast Cancer Surgery ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Breast Cancer Patients

Background/Aim. There are a lot of studies aiding to the opinion that the involvement degree of axilla lymph nodes grows depending on increase of breast tumor size, and its histological and nuclear grades. The aim of this study was to assess the risk of axillary lymph nodes involvement, as well as the relation between the tumor size, histological and nuclear grades in a group of female patients who underwent breast cancer surgery, including levels 1-3 axillary dissection. Methods. Investigation covered 900 patients operated on during 2005-2008 who underwent modified radical mastectomy including axillar dissection. We assessed a number of involved lymph nodes, depending on tumor macroscopic size (T), histological grade (HG) and nuclear grade (NG). Results. A total number of examined lymph nodes was 9977. The incidence of involved lymph nodes was from 18.6% with T1 tumor size up to 60.2% with T4 tumor size. Concerning histological grade, the number of involved lymph nodes ranged from 14.2% (HGI) to 45.1% (HGIII); while in terms of nuclear grade, the number of involved lymph nodes ranged from 17.4% (NGI) to 54.5% (NGIV). By using ?2-test for trend and odds ratio (OR), the results showed that the axillary lymph nodes involvement degree was increased with the increase of the tumor size and its histological and nuclear grades. The risk of axillary lymphatic nodes involvement was 1.43 times higher in the group of T2 tumors size compared to the smaller tumors T1 size, and even up to 6.62 times higher in case of T4 tumor size. It was also increasied from 1.79 times for HGII to even 4.98 times for HGIII, and from 1.44 times for NGII to 5.71 times for NGIV. Conclusion. In breast cancer patients, there is a strong correlation between tumor size, its histological and nuclear grades and the risk of axillary lymph nodes involvement.

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The Sentinel Lymph Node in T1N0 Breast Cancer

Tumori Journal ◽

10.1177/030089160008600419 ◽

2000 ◽

Vol 86 (4) ◽

pp. 327-328 ◽

Cited By ~ 1

Author(s):

Gian Paolo de Rubeis ◽

Alberto Bafile ◽

Valter Resta ◽

Roberto Vicentini

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Lymph Nodes ◽

Cancer Treatment ◽

Histological Examination ◽

Axillary Dissection ◽

Breast Cancer Treatment ◽

Axillary Lymph Nodes ◽

Axillary Lymph

The authors report their experience gathered from December 1998 to December 1999 in the use of the sentinel lymph node (SN) method in breast cancer treatment. In 20 out of 21 cases (95%) localization of the SN was obtained by scintigraphy while in 19 cases (90.5%) the SN was found during surgery. Histological examination of the axillary lymph nodes gave a 95% accuracy with only one negative SN associated with positive axillary lymph nodes out of a total of 19. However, the authors have subjected all patients to a complete three-level axillary dissection since they believe the method applied has not yet been fully validated.

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