Actual False-Negative Rate Prompts the Routine Use of Ultrasound Scan Before and After Sentinel Node Biopsy in Melanoma

2008 ◽  
Vol 15 (10) ◽  
pp. 2976-2977 ◽  
Author(s):  
Carlo Riccardo Rossi ◽  
Sandro Pasquali ◽  
Simone Mocellin
Keyword(s):  
Sentinel Node ◽  
Sentinel Node Biopsy ◽  
False Negative ◽  
False Negative Rate ◽  
Ultrasound Scan ◽  
Node Biopsy ◽  
Negative Rate ◽  
Before And After

scholarly journals Sentinel node biopsy in vulvar cancer: A critical appraisal

2017 ◽  
Vol 03 (01) ◽  
pp. 005-011
Author(s):  
Neville Hacker ◽  
Ellen Barlow
Keyword(s):  
Sentinel Node ◽  
Sentinel Node Biopsy ◽  
Vulvar Cancer ◽  
False Negative ◽  
False Negative Rate ◽  
Groin Dissection ◽  
Loss Of Life ◽  
Risks And Benefits ◽  
Node Biopsy ◽  
Negative Rate

AbstractSince the incorporation of inguinal-femoral lymphadenectomy into the management of patients with vulvar cancer in the mid-20th century, there have been attempts to modify or eliminate the groin dissection to decrease the risk of lower limb lymphedema. Early attempts were significantly flawed and resulted in much unnecessary loss of life because recurrence in an undissected groin is usually fatal. The best compromise yet to decrease the risk of lymphedema is sentinel node biopsy, but accumulated evidence now suggests that the false-negative rate for this procedure, if used for lesions up to 4 cm in diameter, is between 5% and 10%. Most women, properly informed of risks and benefits, are not prepared to take a 1% risk of dying from recurrent vulvar cancer to avoid lymphedema. This is the risk involved, assuming a false-negative rate of 5% and an incidence of positive nodes of 20%. For this reason, sentinel node biopsy should not be considered to be standard practice for patients with early vulvar cancer.

Post-neoadjuvant chemotherapy sentinel node biopsy and axillary sampling for node negative (N0) axilla.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1108-1108
Author(s):  
Vani Parmar ◽  
Nita S. Nair ◽  
Rohini W Hawaldar ◽  
Vaibhav Vanmali ◽  
Aruna Laxman Prabhu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Sentinel Node ◽  
Sentinel Node Biopsy ◽  
False Negative ◽  
False Negative Rate ◽  
Advanced Breast ◽  
Node Negative ◽  
Node Biopsy ◽  
Negative Rate

1108 Background: Post neoadjuvant chemotherapy (NACT) sentinel node biopsy (SNB) is not a standard of care due to the wide variability in false negative rate (FNR), varying from 5.7% to 33%. In operable breast cancer (OBC), FNR of less than 10% is acceptable. We attempted to find out the reliability of low axillary sampling(LAS), with dissection limited below the first intercostobrachial nerve, to correctly identify the node negative axilla in the post NACT clinically node negative (N0) patients. Methods: Women with large operable (LOBC) and locally advanced breast cancer (LABC), post-NACT clinically N0, underwent concomitant blue dye-colloid guided SNB and LAS. The identification rate, FNR, and negative predictive value (NPV) of both procedures were compared. Results: Post-NACT 209 eligible women underwent combined LAS and SNB procedure. At presentation, the tumors were large (median 5.0 cm) with 70% clinically palpable nodes. All patients received 4 cycles of neo-adjuvant anthracycline-based chemotherapy and were clinically node negative after chemotherapy. SNB was defined as blue and/or hot node plus palpable node(s). A blue or hot node (median 2 nodes) was identified in 93.8%, and median of 5 sentinel nodes were removed. The false negative rate of SNB was 15.3% (95% CI 8.7%-25.3%). The LAS technique comparatively had nodal yield in 98.5% with median 8 nodes removed; and FNR 8.5% (95% CI, 4.2%-16.6%, p=0.19). Comparative NPV for LAS and SNB were 94.6% and 91.8% respectively. Conclusions: Axillary sampling results for FNR and NPV are similar if not superior to SNB and could be a reliable method of axillary nodal evaluation in advanced breast cancers following neo-adjuvant chemotherapy.

The Predictive Value of Sentinel Lymph Node Biopsy in Locally Advanced Breast Cancer Patients who Have Undergone Neoadjuvant Chemotherapy

2007 ◽  
Vol 73 (10) ◽  
pp. 977-980 ◽  
Author(s):  
Maki Yamamoto ◽  
Rita S. Mehta ◽  
Choong H. Baick ◽  
Min-Ying Su ◽  
Karen T. Lane ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Sentinel Node ◽  
Sentinel Node Biopsy ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
False Negative ◽  
False Negative Rate ◽  
Axillary Node ◽  
Node Biopsy

With the increasing usage of neoadjuvant chemotherapy (NAC) in locally advanced breast cancer (LABC), there is the need to investigate the routine axillary node dissections performed in this group of patients. Controversy exists about the utility of sentinel node biopsy (SNB), either before or after NAC. With the addition of trastuzumab in the treatment of Her2/neu-positive LABC patients, the validity of SNB in this subset population needs to be investigated. A retrospective study of 20 patients who underwent NAC for LABC was undertaken. The pathology of the axillary nodes, sentinel nodes, and primary tumor after neoadjuvant chemotherapy were examined. Twenty patients underwent NAC with doxorubicin and cyclophosphamide, followed sequentially by paclitaxel and carboplatin, with or without trastuzumab based on Her2/neu status. Post chemotherapy, 20 patients underwent mastectomy or lumpectomy with SNB with axillary node dissections. The overall accuracy of SNB was 95 per cent with a false-negative rate of 14 per cent (1/7). In Her2/neu-positive patients, overall accuracy was 100 per cent (8/8) and a false-negative rate of zero per cent. Sentinel node biopsy is a viable option in patients who have undergone NAC. Her2/neu-positive patients who had undergone NAC with trastuzumab had comparable accuracy for sentinel node biopsy in predicting axillary node status.

Two-Center Evaluation of Dynamic Sentinel Node Biopsy for Squamous Cell Carcinoma of the Penis

2009 ◽  
Vol 27 (20) ◽  
pp. 3325-3329 ◽  
Author(s):  
Joost A.P. Leijte ◽  
Ben Hughes ◽  
Niels M. Graafland ◽  
Bin K. Kroon ◽  
Renato A. Valdés Olmos ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Learning Curve ◽  
Sentinel Node ◽  
Cell Carcinoma ◽  
Sentinel Node Biopsy ◽  
Squamous Cell ◽  
False Negative ◽  
False Negative Rate ◽  
Node Negative ◽  
Node Biopsy

Purpose Sentinel node biopsy is used to evaluate the nodal status of patients with clinically node-negative penile carcinoma. Its use is not widespread, and the majority of patients with clinically node-negative disease undergo an elective inguinal lymph node dissection. Reservations about the use of sentinel node biopsy include the fact that most current results come from one institution and the supposedly long learning curve associated with the procedure. The purpose of this study was to address these issues by analyzing results from two centers and by evaluating the learning curve. Patients and Methods All patients undergoing sentinel node biopsy for penile carcinoma at two centers were included. The sentinel node identification rate, false-negative rate, and morbidity of the procedure were calculated. Results from the first 30 procedures were assessed for a potential learning curve. Results A total of 323 patients with penile squamous cell carcinoma, which included 611 clinically node-negative groins, were scheduled for sentinel node biopsy. A sentinel node was found in 572 of the 592 groins (97%) that proceeded to sentinel node biopsy. In 79 groins, a sentinel node was positive for tumor. Six inguinal node recurrences occurred after a negative sentinel node procedure, all within 15 months after sentinel node biopsy. The combined false-negative rate was 7%. Complications occurred in 4.7% of explored groins. None of the false-negative procedures occurred in the initial 30 procedures. Conclusion Sentinel node biopsy is a suitable procedure to stage clinically node-negative penile cancer, and it has a low complication rate. No learning curve was demonstrated in this study.

Sign in / Sign up

Export Citation Format

Share Document