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

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.

Influence of Imaging Features and Technique on US-guided Tattoo Ink Marking of Axillary Lymph Nodes Removed at Sentinel Lymph Node Biopsy in Women With Breast Cancer

2021 ◽  
Vol 3 (5) ◽  
pp. 583-590
Author(s):  
Marlen Pajcini ◽  
Irene Wapnir ◽  
Jacqueline Tsai ◽  
Joanne Edquilang ◽  
Wendy DeMartini ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Nodes ◽  
Lymph Node Biopsy ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Biopsy ◽  
Initial Biopsy

Abstract Objective To describe tattoo ink marking of axillary lymph nodes (TIMAN) and the elements leading to successful removal at sentinel lymph node biopsy (SLNB). Methods An IRB-approved retrospective image review was conducted of breast cancer patients who underwent SLNB after TIMAN from February 2013 to August 2017, noting patient and tattooed lymph node (TLN) features, initial biopsy type, time to surgery, if the TLN was identified at surgery, and correlation with the SLN. Cases were divided into two groups: the presurgical group, which had primary surgery, and the pre-neoadjuvant chemotherapy (NACT) group, which underwent surgery after completing NACT. Results Of 30 patients who underwent 32 TIMAN procedures, 10 (33.3%) were presurgical and 20 (66.7%) were pre-NACT. The average lymph node (LN) depth from the skin was 1.6 cm, with an average of 0.3 mL of tattoo ink injected. Of 32 procedures, 29 (90.6%) had US images demonstrating the injection. Of these, 10 (34.5%) were injected in the LN cortex surface and 19 (65.5%) in the middle cortex. Seven (24.1%) were injected in the LN lateral aspect, 12 (41.4%) in the mid aspect, and 10 (34.5%) in the medial aspect. Of 32 LNs, 28 (87.5%) were tattooed immediately after initial biopsy and 4 (12.5%) at a later date. At SLNB, all 32 (100%) TLNs were identified, all correlated with the SLN, and 10 (31.3%) were positive for cancer. Conclusion Using an average of 0.3 mL of tattoo ink, all TLNs were successfully identified for removal at surgery, despite variability in LN and injection factors.

Predictors of positive axillary lymph nodes after sentinel lymph node biopsy in breast cancer

2001 ◽  
Vol 182 (4) ◽  
pp. 316-320 ◽  
Author(s):  
Shahab F Abdessalam ◽  
Emmanuel E Zervos ◽  
Manju Prasad ◽  
William B Farrar ◽  
Lisa D Yee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Nodes ◽  
Lymph Node Biopsy ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Biopsy

scholarly journals An AN OBSERVATIONAL STUDY OF SLN MAPPING IN PATIENTS OF LOCALLY ADVANCED BREAST CANCER FOLLOWING NCT

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Ankur Garg ◽  
Udbhav Kathpalia ◽  
Shweta Bansal ◽  
Manoj Andley ◽  
Sudipta Saha
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Locally Advanced ◽  
Lymph Node Biopsy ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Biopsy ◽  
Neo Adjuvant Chemotherapy

Background : Locally advanced breast carcinoma (LABC) includes a wide range of clinical scenarios- advanced primary tumors (T4), advanced nodal disease and inflammatory carcinomas(1). Traditionally, treatment of LABC included a combination of Chemotherapy, Radiation and Surgery(2). However, there has been a shift to Neoadjuvant Chemotherapy in recent times.(3) Histological status and the number of axillary lymph nodes with metastasis is one of the most important prognostic factors and most powerful predictor of recurrence and survival in patients of breast carcinoma and remains so, even after neo-adjuvant chemotherapy. (3) Information derived from the sentinel lymph node is considered valuable, with less discomfort to the patient when compared with axillary dissection.(4) However, its role in detecting nodal metastasis after neo-adjuvant chemotherapy in LABC is still debatable and definitive studies to evaluate its role are still evolving. (5) Materials and Methods: Patients of LABC were evaluated using ultrasonography (USG) of axilla. Neo-adjuvant chemotherapy (NACT) was administered and patients were reassessed by USG of axilla. Thirty patients with node negative axillary status were subjected to Sentinel lymph node mapping using isosulfan blue followed by Modified Radical Mastectomy and Axillary Lymph Node Dissection. Histopathological evaluation of stained and unstained lymph nodes done and the data, thus obtained, was statistically analysed.   Results: Sentinel lymph node biopsy performed using Isosulfan Blue dye alone, after neo-adjuvant chemotherapy predicts the status of axillary lymph nodes with low accuracy.   Conclusions: Further studies would be required to establish the role of sentinel lymph node biopsy in patients with LABC after NACT.

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