Multi-center prospective study on sentinel node navigation surgery in early breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 606-606
Author(s):  
S. Imoto ◽  
M. Kitajima ◽  
T. Aikou ◽  
Y. Kitagawa
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adverse Events ◽  
Prospective Study ◽  
Sentinel Node ◽  
Early Breast Cancer ◽  
Lymphatic Mapping ◽  
Axillary Lymph ◽  
Navigation Surgery ◽  
Sentinel Node Navigation Surgery

606 Background: Sentinel node navigation surgery (SNNS) is a standard technique to identify lymph node metastases in clinically node-negative breast cancer. However, the dye and radiopharmaceuticals for lymphatic mapping commonly used in Western countries are not available in Japan. Methods: To assess the optimal lymphatic mapping and the outcome after SNNS, the Japanese society for SNNS conducted a non-randomized multi-center prospective study on SNNS in early breast cancer. Primary endpoint is to evaluate the success rates and adverse events associated with various lymphatic mapping and SNNS, and secondary endpoint is to observe the outcome of patients who underwent SNNS during 5 years. After the protocol was approved by institutional review board, SNNS had been registered between July 2004 and October 2005. Results: Fourteen hundred and sixty-eight cases had pre-registration from 65 investigators at 23 institutions. As 46 cases were withdrawn for some reasons and 11 cases were diagnosed as benign disease, 1,411 cases were finally entered in this study. Dyes used for lymphatic mapping were indigocarmine, indocyanin green, patent blue, and isosulfun blue, and radiopharmaceuticals were 99m-technetium-labelled tin colloid, human serum albumin, and phytate. In 19 cases, superparamagnetic iron oxide was used for MRI- guided SNNS. As of December 2006, 98% of clinical report forms were analyzed. Dye-guided SNNS was performed in 240 cases, radio-guided SNNS in 56 cases, and combined method in 1,016 cases. Overall success rate was 99%. SNNS alone was treated in 1,138 cases (82%) and SNNS followed by axillary lymph node dissection in 258 cases (12%). Breast-conserving surgery was undergone in 1,175 cases (85%) and total mastectomy in 217 cases (15%). Dye-induced allergic adverse events were not reported. Postoperative adverse events of bleeding, wound infection and seroma were observed in about 1 % of cases, respectively. Conclusions: Dye-guided and/or radio-guided SNNS proved reliable for lymphatic mapping in breast cancer. The prognosis of all cases will be observed until 2010. No significant financial relationships to disclose.

Sentinel Node Study in Early Breast Cancer

2000 ◽  
Vol 86 (4) ◽  
pp. 314-316 ◽  
Author(s):  
Luciano M. Feggi ◽  
Patrizia Querzoli ◽  
Napoleone Prandini ◽  
Stefano Corcione ◽  
Leonardo Bergossi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Particle Size ◽  
Lymph Node ◽  
Sentinel Node ◽  
Early Breast Cancer ◽  
False Negative ◽  
Blue Dye ◽  
Lower Sensitivity ◽  
Axillary Lymph ◽  
Surgical Scar

Since October 1997 60 patients with early breast cancer (T <3 cm) were studied. All patients underwent lymphoscintigraphy with two types of colloid: the first (17 pts) with a particle size <1000 nm; the second (43 pts) with a particle size <80 nm. The standard procedure consists of injection, on the day before surgery, of 70 MBq of the smaller nanocolloid in 0.4 cc saline divided over four sites, around the lesion or subdermally around the surgical scar. We utilize a low-energy, high-resolution LFOV camera for scintigraphy and a probe specific for the sentinel node during surgery. In 56/60 patients (93.3%) lymphoscintigraphy showed the sentinel node (SN). In two cases the SN was not detected presumably because of lymphatic interruption by an old surgical scar; in the other two cases the sites of injection were too close to the SN, thus masking it. In five cases (9%) the SN was not visualized with the surgical probe but in two of these drainage to the internal mammary chain was observed. The apparently lower sensitivity of intraoperative localization was due to the extra-axillary lymphatic drainage or to the vicinity of the SN to the primary lesion. The SN proved to be metastatic in 12 cases. No false-negative SNs were found. In five cases (10%) the radiolabeled lymph node was the only node containing tumor cells (micrometastases): this result depends on the combined use of hematoxylin-eosin and rapid cytokeratin staining. The application of blue dye was useful for easier identification of the SN but did not allow detection of more SNs. Our preliminary results are extremely encouraging. Considering that at the early stages of breast cancer the likelihood of lymph node metastases is low (20% in our series) and no false negative were reported in this study, we conclude that with SN biopsy axillary lymph node dissection can be avoided, making surgery less aggressive but maintaining accuracy.

Early recurrence of breast cancer after sentinel node navigation surgery: A multicenter prospective study in Japan

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11530-e11530
Author(s):  
S. Imoto ◽  
S. Morita ◽  
M. Kitajima ◽  
T. Aikou ◽  
Y. Kitagawa
Keyword(s):  
Breast Cancer ◽  
Prospective Study ◽  
Sentinel Node ◽  
Invasive Ductal Carcinoma ◽  
Primary Endpoint ◽  
Ductal Carcinoma ◽  
Early Recurrence ◽  
Regional Recurrence ◽  
Navigation Surgery ◽  
Sentinel Node Navigation Surgery

e11530 Background: To assess lymphatic mapping technique and prognosis after sentinel node navigation surgery (SNNS), the Japanese society for SNNS conducted a non-randomized multi-center prospective study on SNNS in early breast cancer. Primary endpoint is to evaluate the success rate and adverse events of SNNS, and secondary endpoint is to observe the outcome of patients who underwent SNNS during 5 years. Methods: We demonstrated the results of primary endpoint at 2007 ASCO annual meeting (#606). Fourteen hundred and sixty-eight cases had pre-registration from 65 investigators at 23 institutions between July 2004 and October 2005. As 46 cases were withdrawn for some reasons and 11 cases were diagnosed as benign disease, 1,411 cases were entered in this study and will be observed until 2010. At this meeting, early recurrence at 3 years follow-up is reported. Results: As of June 2008, 38 of the 1,138 cases (3%) treated with SNNS alone and 16 of the 258 (6%) cases treated with SNNS followed by axillary lymph node dissection (ALND) relapsed. Seven cases died of disease. From the patient background, 50 cases had invasive ductal carcinoma, one had non-invasive ductal carcinoma, and three had special type. Thirty-three cases had negative nodes, 3 had micrometastatic nodes, and 18 had macrometastatic nodes. Fifty-two cases received chemotherapy and/or endocrine therapy. Regional recurrence including axillary, parasternal, and/or supraclavicular nodes was found in 11 cases after SNNS and in 2 cases after SNNS followed by ALND. Conclusions: Annual regional recurrence rate after SNNS was about 0.3%. SNNS in breast cancer is reliable to optimize surgical management in the axilla without increase of regional recurrence. No significant financial relationships to disclose.

scholarly journals False-negative frozen section of sentinel nodes in early breast cancer (cT1-2N0) patients

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhu-Jun Loh ◽  
Kuo-Ting Lee ◽  
Ya-Ping Chen ◽  
Yao-Lung Kuo ◽  
Wei-Pang Chung ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Early Breast Cancer ◽  
False Negative ◽  
Disease Free Survival ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Frozen Sections ◽  
Sentinel Nodes ◽  
Tumor Emboli

Abstract Background Sentinel lymph node biopsy (SLNB) is the standard approach for the axillary region in early breast cancer patients with clinically negative nodes. The present study investigated patients with false-negative sentinel nodes in intraoperative frozen sections (FNSN) using real-world data. Methods A case–control study with a 1:3 ratio was conducted. FNSN was determined when sentinel nodes (SNs) were negative in frozen sections but positive for metastasis in formalin-fixed paraffin-embedded (FFPE) sections. The control was defined as having no metastasis of SNs in both frozen and FFPE sections. Results A total of 20 FNSN cases and 60 matched controls from 333 SLNB patients were enrolled between April 1, 2005, and November 31, 2009. The demographics and intrinsic subtypes of breast cancer were similar between the FNSN and control groups. The FNSN patients had larger tumor sizes on preoperative mammography (P = 0.033) and more lymphatic tumor emboli on core biopsy (P < 0.001). Four FNSN patients had metastasis in nonrelevant SNs. Another 16 FNSN patients had benign lymphoid hyperplasia of SNs in frozen sections and metastasis in the same SNs from FFPE sections. Micrometastasis was detected in seven of 16 patients, and metastases in nonrelevant SNs were recognized in two patients. All FNSN patients underwent a second operation with axillary lymph node dissection (ALND). After a median follow-up of 143 months, no FNSN patients developed breast cancer recurrence. The disease-free survival, breast cancer-specific survival, and overall survival in FNSN were not inferior to those in controls. Conclusions Patients with a larger tumor size and more lymphatic tumor emboli have a higher incidence of FNSN. However, the outcomes of FNSN patients after completing ALND were noninferior to those without SN metastasis. ALND provides a correct staging for patients with metastasis in nonsentinel axillary lymph nodes.

Expression of CXCR4 is associated with axillary lymph node status in patients with early breast cancer

The Breast ◽  
2006 ◽  
Vol 15 (4) ◽  
pp. 533-539 ◽  
Author(s):  
Y.-C. Su ◽  
M.-T. Wu ◽  
C.-J. Huang ◽  
M.-F. Hou ◽  
S.-F. Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Early Breast Cancer ◽  
Axillary Lymph Node ◽  
Lymph Node Status ◽  
Axillary Lymph ◽  
Axillary Lymph Node Status ◽  
Node Status

Developing and validating deep learning-based heterogeneous model to improve diagnostic performance of ultrasound elastography for axillary lymph node metastasis of early breast cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12583-e12583
Author(s):  
Jian Li ◽  
Cai Nian ◽  
Xie Ze-Ming ◽  
Zhou Jingwen ◽  
Huang Kemin
Keyword(s):  
Breast Cancer ◽  
Deep Learning ◽  
Lymph Node ◽  
Early Breast Cancer ◽  
Predictive Value ◽  
Axillary Lymph Node ◽  
Diagnostic Performance ◽  
Ultrasound Elastography ◽  
Axillary Lymph ◽  
Heterogeneous Model

e12583 Background: To improve the performance of ultrasound (US) for diagnosing metastatic axillary lymph node (ALN), machine learning was used to reveal the inherently medical hints from ultrasonic images and assist pre-treatment evaluation of ALN for patients with early breast cancer. Methods: A total of 214 eligible patients with 220 breast lesions, from whom 220 target ALNs of ipsilateral axillae underwent ultrasound elastography (UE), were prospectively recruited. Based on feature extraction and fusion of B-mode and shear wave elastography (SWE) images of 140 target ALNs using radiomics and deep learning, with reference to the axillary pathological evaluation from training cohort, a proposed deep learning-based heterogeneous model (DLHM) was established and then validated by a collection of B-mode and SWE images of 80 target ALNs from testing cohort. Performance was compared between UE based on radiological criteria and DLHM in terms of areas under the receiver operating characteristics curve (AUC), sensitivity, specificity, accuracy, negative predictive value, and positive predictive value for diagnosing ALN metastasis. Results: DLHM achieved an excellent performance for both training and validation cohorts. In the prospectively testing cohort, DLHM demonstrated the best diagnostic performance with AUC of 0.911(95% confidence interval [CI]: 0.826, 0.963) in identifying metastatic ALN, which significantly outperformed UE in terms of AUC (0.707, 95% CI: 0.595, 0.804, P<0.001). Conclusions: DLHM provides an effective, accurate and non-invasive preoperative method for assisting the diagnosis of ALN metastasis in patients with early breast cancer.[Table: see text]

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