scholarly journals Magnetic-Guided Axillary UltraSound (MagUS) Sentinel Lymph Node Biopsy and Mapping in Patients with Early Breast Cancer. A Phase 2, Single-Arm Prospective Clinical Trial

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4285
Author(s):  
Allan Jazrawi ◽  
Eirini Pantiora ◽  
Shahin Abdsaleh ◽  
Daniel Vasiliu Bacovia ◽  
Staffan Eriksson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Minimally Invasive ◽  
Early Breast Cancer ◽  
Neoadjuvant Treatment ◽  
Superparamagnetic Iron Oxide ◽  
Standard Of Care ◽  
Lymph Node Biopsy ◽  
Axillary Ultrasound

Lymph Node Dissection (SLND) is standard of care for diagnosing sentinel lymph node (SLN) status in patients with early breast cancer. Study aim was to determine whether the combination of Superparamagnetic iron oxide nanoparticles (SPIO) MRI-lymphography (MRI-LG) and a Magnetic-guided Axillary UltraSound (MagUS) with biopsy can allow for minimally invasive, axillary evaluation to de-escalate surgery. Patients were injected with 2 mL of SPIO and underwent MRI-LG for SN mapping. Thereafter MagUS and core needle biopsy (CNB) were performed. Patients planned for neoadjuvant treatment, the SLN was clipped and SLND was performed after neoadjuvant with the addition of isotope. During surgery, SLNs were controlled for signs of previous biopsy or clip. The primary endpoint was MagUS SLN detection rate, defined as successful SLN detection of at least one SLN of those retrieved in SLND. In 79 patients, 48 underwent upfront surgery, 12 received neoadjuvant and 19 had recurrent cancer. MagUS traced the SLN in all upfront and neoadjuvant cases, detecting all patients with macrometastases (n = 10). MagUS missed only one micrometastasis, outperforming baseline axillary ultrasound AUS (AUC: 0.950 vs. 0.508, p < 0.001) and showing no discordance to SLND (p = 1.000). MagUS provides the niche for minimally invasive axillary mapping that can reduce diagnostic surgery.

scholarly journals Sentinel lymph node biopsy after neoadjuvant treatment of breast cancer using blue dye, radioisotope, and indocyanine green: Prospective cohort study

2020 ◽  
Vol 59 ◽  
pp. 156-160
Author(s):  
Prakasit Chirappapha ◽  
Tanet Chatmongkonwat ◽  
Panuwat Lertsithichai ◽  
Wiriya Pipatsakulroj ◽  
Chanika Sritara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Indocyanine Green ◽  
Neoadjuvant Treatment ◽  
Lymph Node Biopsy ◽  
Blue Dye ◽  
Node Biopsy

scholarly journals Sentinel Lymph Node Biopsy in Early Breast Cancer Using the Indocyanine Green Fluorescence Technique: A Validation Study

2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Loh Soon Khang ◽  
Suraya Baharudin ◽  
Juliana Abdul Latiff ◽  
Siti Aishah Mahamad Dom ◽  
Shahrun Niza Suhaimi
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Early Breast Cancer ◽  
Detection Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Lymph Node Biopsy ◽  
Blue Dye ◽  
Node Biopsy

INTRODUCTION: Introduction: Sentinel lymph node biopsy (SLNB) is now recognized as the standard of care for early breast cancer patients with negative axillary lymph nodes. Various approaches for Sentinel Lymph Node (SLN) identification using either the blue dye method or scintigraphy alone or their combination have been proposed. However, this method is costly and may not be applicable in certain developing countries. SLNB involving the use of indocyanine green (ICG) offers several advantages, and it is valid and safe when in direct comparison with the blue dye method and scintigraphy. Hence, we performed SLNB using this method in early breast cancer as the first center that involves the use of ICG in Malaysia. We performed validation study on this method with the aims to determine its sensitivity and safety profile. MATERIALS AND METHODS: This is a validation and non-randomised prospective observational study involving 20 patients underwent SLNB wherein ICG is used for localisation. The patients were recruited according to the recommendations stipulated in the Malaysia Clinical Practice Guideline. RESULT: The average number of SLNs removed per patient was 4.0 (range, 3–6) with sentinel lymph nodes detection rate at 98.75% (79/80). The false negative rate is at 5%. No adverse events were observed in all cases. CONCLUSION: The ICG fluorescence method is simple, reliable and safe. Moreover, it demonstrates a high SLN detection rate with a low false-negative rate, and it does not require a special instrument for radioisotope use.

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