scholarly journals Comparison of Rare Types of Breast Cancer

2021 ◽  
pp. 9-17
Author(s):  
Osman Erdogan ◽  
Alper Parlakgumus ◽  
Ugur Topal ◽  
Kemal Yener ◽  
Umit Turan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Radical Mastectomy ◽  
Treatment Modalities ◽  
Breast Carcinomas ◽  
Term Survival ◽  
Prognostic Features ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aims: Mucinous, medullary, and papillary carcinomas are rarely encountered types of breast cancer. This study aims to contribute to the literature by comparing the clinical and prognostic features and treatment alternatives of rare breast carcinomas. Study Design: Thirty-four patients with rare breast cancer out of a total of 1368 patients who underwent surgery for breast cancer in our clinic between January 2011 and December 2020 were included in the study. Methodology: The patients were assigned into three groups, i.e., medullary carcinoma group (Group 1), mucinous carcinoma group (Group 2) and papillary carcinoma group (Group 3). Demographic and clinical features, treatment modalities used, surgical approaches, pathological features of tumors and survival were compared between the groups. Results: Thirty-four patients were included in the study. The mean age of the patients in Group 3 was higher, though it was not statistically significant. Modified radical mastectomy was more frequently performed in all the groups. The number of the lymph nodes removed through axillary dissections and the number of the positive lymph nodes were similar in all the groups. The tumors in all the groups were also of comparable sizes (30 mm in Group 1, 42.5 mm in Group 2 and 30 mm in Group 3; p:0.464). Estrogen receptors were negative in a significantly higher rate of Group 1(66.7% of Group 1, p<0,001). A significantly higher rate of Group 1 received postoperative chemotherapy (93,3% of Group 1,p:0.001), but the rate of the patients receiving hormonotherapy in this group was significantly lower (26.7% of Group, p<0,001). The patients with medullary cancer had significantly longer survival than those with mucinous cancer and those with papillary cancer (76.2 in Group 1, 54.5 in Group 2 and 58.4 in Group 3; p:0.005). Conclusion: While rare subtypes of breast carcinoma did not affect opting for surgical treatment, selection of oncological therapy was affected depending on the hormone receptor status of these tumors. The long-term survival differed between rare breast tumors. In view of the unique clinical pictures of the tumors, the patients should be evaluated individually, and the evaluation should be associated with theevidence-based principles available for more common breast carcinomas.

Preoperative prediction of the axillary lymph nodes status in patients with breast cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10547-10547
Author(s):  
E. Angelidou ◽  
G. Sotiropoulou ◽  
E. Poulianou ◽  
E. Politi ◽  
H. Koutselini
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Cancer Cells ◽  
Axillary Lymph ◽  
Versus Group ◽  
Node Positive ◽  
Positive Rate ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

10547 Background: We developed a preoperative score-system (S) and evaluated prospectively its predictive value for the axillary(a) status of patients (p) with breast cancer. Our aim was to select preoperatively (p) with negative axilla, who could possibly avoid the standard (a) surgery. (S) uses preoperative clinical, epidemiological and immunocytological data, obtained from the FNA-smears of (p)‘ tumors, and attempts to guide the choice of (a) treatment, as an alternative to the method of sentinel lymph node. Methods: (S) is calculated by adding the preoperative values of clinical tumor size, (p) age, nuclear grade (NG), type of the cancer cells and the immunocytochemical positiveness of the biomarkers p53, HER2 and MIB1. Values range from 1–4 for size (1–10, 11–15, 16–20, 20–30 mm), 1 to 4 for age (70 and over, 51–69, 41–50, 40 years or less), 1–3 for NG1–3, 1–2 for type of cancer cells (lobular, ductal) respectively and 0–3 for the expression (1 point for every positive biomarker) or absence (0) of p53, HER2 and MIB1 in the FNA of the primary tumors of the (p). (S) ranges from 4 to 16.We applied (S) to 224 (p), with clinically negative axilla. These (p) underwent modified radical mastectomy or lumpectomy and standard (a) dissection level I and II. The number of the infiltrated nodes was identified in each case. Results: (S) of 4 - 8 (57 patients, group 1) identify (p) with free nodes ( node positive rate 0%). (S) of 9 and 10 (67 patients, group 2) carry an average node positive rate of 65,67%, of which 31,34% involves the invasion of 1 node, 23,88% of 2–3 and 10,44% of 4 or more nodes (P < 0.001, group 1 versus group 2). (S) of 11 and more (100 patients, group 3) identify (p) with an average node positive rate of 83%, of which 55% involves the invasion of 4 or more nodes (P < 0.001, group 3 versus group 1). (S) allows the separation of (p) into two (a) management groups. Group 1 are those (p), who possibly have free lymph nodes and therefore may need no (a) surgery at all, whereas group 2 and 3 may be considered for standard (a) dissection, because they present with increased possibility infiltrated nodes. Conclusion: (S) was studied to aid the selection of (p) towards reasonable (a) treatment choices for the benefit of (p). (S) might serve as a guideline in the clinical practice to reduce the postoperative morbidity of the breast cancer (p). No significant financial relationships to disclose.

scholarly journals Palliative esophagectomy in unexpected metastatic disease: sense or nonsense?

2018 ◽  
Vol 26 (7) ◽  
pp. 552-557 ◽  
Author(s):  
Lieven P Depypere ◽  
Johnny Moons ◽  
Toni E Lerut ◽  
Willy Coosemans ◽  
Hans Van Veer ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Nodes ◽  
Metastatic Disease ◽  
Palliative Resection ◽  
Oligometastatic Disease ◽  
Group 3 ◽  
Group 2 ◽  
Curative Esophagectomy ◽  
Group 1 ◽  
Single Organ

Background Despite integrated positron emission tomography and computed tomography screening before and after neoadjuvant treatment in patients with locally advanced esophageal cancer, unexpected metastatic disease is still found in some patients during surgery. Should then esophagectomy be aborted or is there a place for palliative resection? Methods Between 2002 and 2015, 681 patients with potentially resectable esophageal cancer were sheduled for neoadjuvant therapy and subsequent esophagectomy. In 552 patients, a potentially curative esophagectomy was performed. In 12 patients, unexpected disease was discovered during surgery but esophagectomy was performed with synchronous resection of metastases; 10 of them had oligometastatic disease (≤4 single-organ metastases). Esophagectomy was not performed in 117 patients (because of disease progression in 50); 14 were also single-organ oligometastatic. Data of 10 single-organ oligometastatic patients who underwent esophageal resection (group 1) were compared those of 10 non-resected but treated counterparts (group 2) and with 228 patients who underwent potentially curative esophagectomy with persistent pathological lymph nodes (group 3). Results Five oligometastatic esophagectomy patients had lung metastases: 1 peritoneal, 2 adrenal, 1 pleural, and 1 pancreatic. Two oligometastatic non-resected patients had lung, 5 liver, and 3 brain metastases. Median overall survival was 21.4, 12.1, and 20.2 months in the respective groups (group 1 vs. group 2  p = 0.042; group 2 vs. group 3  p = 0.002; group 1 vs. group 3  p = 0.88). Conclusions Survival is longer in patients undergoing palliative esophagectomy with unexpected single-organ oligometastatic disease and comparable to survival in patients with persistent pathological lymph nodes. Palliative resection in these patients seems to be justified.

Tositumomab and Iodine I 131 Tositumomab (the BEXXAR® Therapeutic Regimen) Shows Efficacy in Elderly Patients (pts) with Relapsed/Refractory Low-Grade (LG), Follicular, and Transformed Non-Hodgkin’s Lymphoma (NHL).

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2630-2630
Author(s):  
Stephanie A. Gregory ◽  
Andrew Zelenetz ◽  
Susan J. Knox ◽  
Julie Vose ◽  
John P. Leonard ◽  
...  
Keyword(s):  
Bone Marrow Involvement ◽  
Response Rates ◽  
Hematologic Toxicity ◽  
Low Grade ◽  
Age Group ◽  
Prognostic Features ◽  
Prior Therapy ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Objective: Pts are first diagnosed with NHL at a median age of 60 yrs. There is increasing support for the idea that physicians should evaluate older pts for cancer treatment on the basis of their health status and cognitive function rather than on chronologic age. Five core clinical trials and an expanded-access program included 995 pts with relapsed/refractory LG follicular or transformed NHL treated with BEXXAR. Data were analyzed to establish the efficacy and safety of BEXXAR as a function of age. Safety data have been presented previously (Gregory et al. Blood. 2003;102. Abstract 1485). Overall toxicity and acute hematologic toxicity associated with BEXXAR in older pts is similar to that observed in pts ≤60 yrs. Methods: BEXXAR efficacy was analyzed by age: group 1 pts, ≤60 yrs (n=586); group 2 pts, >60–≤70 yrs (n=250); group 3 pts, >70 yrs (n=159). Median age at time of BEXXAR was 58 yrs (range, 21–88 yrs). Inclusion criteria included KPS ≥60, platelet count ≥100,000/mm3, ANC ≥1,500 cells/mm3, bone marrow involvement ≤25%, and no impaired renal, hepatic, or cardiac function. Results: All 3 pt groups had received multiple therapies for NHL before receiving BEXXAR (1–3 prior treatments, 63%–65%; ≥4 prior treatments, 34%–37%). In addition to the known poorer prognosis with older age, pts in groups 2 and 3 more frequently had other poor prognostic features, ie, transformed histology and prior radiotherapy (P <.001). Complete response rates (CR+CCR) to the most recent pre-BEXXAR therapy decreased with increasing age (group 1, 21%; group 2, 12%; group 3, 7%), and progressive disease as the initial “response” to prior therapy increased with age (group 1, 20%; group 2, 29%; group 3, 33%). Table 1 shows response rates and CR post- BEXXAR for the 3 groups. Post-BEXXAR CR+CCR rates were higher for pts in every age group compared with CR rates to prior therapy. These rates were nearly doubled for pts >60–≤70 yrs (23% vs 12%) and tripled for pts >70 yrs (23% vs 7%). Conclusions: Of all previously treated pts >60 yrs, ≥50% achieved a response post-BEXXAR. Nearly 25% of pts >60 yrs achieved a CR, with a median duration of CR of 32.3 mos. Response rates and durations of response are somewhat better in younger pts than in pts >60 yrs, but pts >60 yrs presented with poorer prognostic features (as above). Overall toxicity and acute hematologic toxicity associated with BEXXAR in older pts is similar to that observed in pts ≤60 yrs (Gregory et al. Blood. 2003;102. Abstract 1485). BEXXAR can be administered safely and effectively to older pts with low-grade follicular or transformed NHL. Table 1 Response results to BEXXAR by age, N = 995 Age groups Overall response, % CR, % Median CR duration, mos ≤ 60 66 37 59.1 (n=586) 95% CI = 45.8, NR) 60 to ≤70 N = 250 50 23 21.8 (n=250) (95% CI = 15.7, 69.1) >70 54 23 36.4 (n=159) (95% CI = 22.6, NR)

scholarly journals EVALUATION OF PATIENT'S PERCEPTION AND HEALING, FOLLOWING CONVENTIONAL AND PARALLELING TECHNIQUE OF FRENECTOMY USING SCALPEL AND OTHER MODALITY

2020 ◽  
Vol 6 (1) ◽  
pp. 21-27
Author(s):  
Dr. Ira Gupta ◽  
Saranik Sarkar ◽  
Rohit Gupta ◽  
Nidhi Gupta ◽  
Janardhana Amaranath B. J. ◽  
...  
Keyword(s):  
Wound Healing ◽  
Gingival Recession ◽  
Conventional Technique ◽  
Treatment Modalities ◽  
Group 3 ◽  
Group 2 ◽  
Patient’S Perception ◽  
Better Than ◽  
Group 1 ◽  
Operative Wound

Background: Frenum that encroaches on the margin of the gingiva may interfere with plaque removal and can lead to gingival recession and midline diastema. Thus, to maintain proper oral hygiene and prevent gingival recession, frenectomy is done. Frenectomy can be accomplished by conventional frenectomy technique, which has certain disadvantages. To overcome those drawbacks, paralleling technique of frenectomy has been introduced. Both the techniques can be performed by using various treatment modalities. Aim: The purpose of this clinical study was to compare the bleeding during surgery, post-operative wound healing and patient's perception towards the conventional frenectomy technique with scalpel, paralleling frenectomy technique with scalpel and paralleling technique with electrocautery. Materials and method: A total of 30 subjects with gingival or papillary frenal attachment were selected and equally divided into three groups. Group 1 was treated by conventional technique with scalpel, Group 2 by paralleling technique with scalpel and Group 3 by paralleling technique with electrocautery. Various parameters such as bleeding during surgery, patient's perception towards the various techniques and post-operative wound healing were evaluated. Results: The results showed that bleeding during surgery was minimum in group 3 as compared to other two groups. Patient's perception towards paralleling technique with scalpel, was found better than the other groups. At 7th day, though there was a difference in the healing but at 21st day wound healing was almost similar in all the three groups. Conclusion: Based on our findings and clinical outcome, paralleling technique with scalpel provided better patient's perception and an efficient and satisfactory option for frenectomy.  

scholarly journals Roles of neutrophil/lymphocyte ratio in prognosis and in differentiation of potential beneficiaries in HER2-positive breast cancer with trastuzumab therapy

2019 ◽  
Author(s):  
Nianhua Ding ◽  
Juan Huang ◽  
Ningsha Li ◽  
Jiaqi Yuan ◽  
Shouman Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Her2 Positive ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Trastuzumab Treatment ◽  
Her2 Positive Breast Cancer ◽  
Group 3 ◽  
Group 2 ◽  
Group 1 ◽  
Positive Breast Cancer

Abstract Purpose: The relationship of neutrophil/lymphocyte ratio (NLR) with prognosis of HER2-positive breast cancer (BC) are not well studied. We aimed to assess the prognostic role of NLR in HER2-positive BC patients treated with or without trastuzumab.Methods: The clinical data of 843 HER2-positive BC patients from July 2013 to July 2018 were collected. The difference among variables was calculated by chi-square test. The associations between clinicopathological factors, NLR and disease-free survival (DFS) were analyzed by univariate and multivariate analyses.Results : Patients were divided into three groups. In group 1 containing 255 patients without trastuzumab treatment, pretreatment NLR showed no predictive value. Patients with trastuzumab treatment were divided into two groups on equal, according to pretreatment NLR values, low NLR (group 2) and high NLR (group 3). Patients in group 2 showed significantly higher 3-year DFS rate than patients in group 1 and group 3 (95.3% vs. 91.6% vs. 90.5%, respectively, P = 0.011); patients in the group 1 and group 3 had similar 3-year DFS outcome. Multivariate analysis showed high pretreatment NLR was significantly associated with shorter DFS (HR = 2.917, 95% CI=1.055-8.062, P = 0.039) in HER2-positive BC patients treated with trastuzumab. Conclusion : Among HER2-positive trastuzumab-treated BC patients, low pretreatment NLR value was associated with better DFS, and it might help to differentiate potential beneficiaries of trastuzumab treatment.

scholarly journals Alterations in ALK/ROS1/NTRK/MET drive a group of infantile hemispheric gliomas

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Ana S. Guerreiro Stucklin ◽  
Scott Ryall ◽  
Kohei Fukuoka ◽  
Michal Zapotocky ◽  
Alvaro Lassaletta ◽  
...  
Keyword(s):  
Tyrosine Kinases ◽  
Receptor Tyrosine Kinases ◽  
Therapeutic Strategies ◽  
Low Grade ◽  
High Grade ◽  
Term Survival ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Infant gliomas have paradoxical clinical behavior compared to those in children and adults: low-grade tumors have a higher mortality rate, while high-grade tumors have a better outcome. However, we have little understanding of their biology and therefore cannot explain this behavior nor what constitutes optimal clinical management. Here we report a comprehensive genetic analysis of an international cohort of clinically annotated infant gliomas, revealing 3 clinical subgroups. Group 1 tumors arise in the cerebral hemispheres and harbor alterations in the receptor tyrosine kinases ALK, ROS1, NTRK and MET. These are typically single-events and confer an intermediate outcome. Groups 2 and 3 gliomas harbor RAS/MAPK pathway mutations and arise in the hemispheres and midline, respectively. Group 2 tumors have excellent long-term survival, while group 3 tumors progress rapidly and do not respond well to chemoradiation. We conclude that infant gliomas comprise 3 subgroups, justifying the need for specialized therapeutic strategies.

Increased intensification and total dose of cyclophosphamide in a doxorubicin-cyclophosphamide regimen for the treatment of primary breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-22.

1997 ◽  
Vol 15 (5) ◽  
pp. 1858-1869 ◽  
Author(s):  
B Fisher ◽  
S Anderson ◽  
D L Wickerham ◽  
A DeCillis ◽  
N Dimitrov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Total Dose ◽  
Primary Breast Cancer ◽  
National Surgical Adjuvant Breast ◽  
Significant Difference ◽  
Bowel Project ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

PURPOSE The National Surgical Adjuvant Breast and Bowel Project (NSABP) initiated a randomized trial (B-22) to determine if intensifying but maintaining the total dose of cyclophosphamide (Cytoxan, Bristol-Myers Squibb Oncology, Princeton, NJ) in a doxorubicin (Adriamycin, Pharmacia, Kalamazoo, MI)-cyclophosphamide combination (AC), or if intensifying and increasing the total dose of cyclophosphamide improves the outcome of women with primary breast cancer and positive axillary nodes. PATIENTS AND METHODS Patients (N = 2,305) were randomized to receive either four courses of standard AC therapy (group 1); intensified therapy, in which the same total dose of cyclophosphamide was administered in two courses (group 2); or intensified and increased therapy, in which the total dose of cyclophosphamide was doubled (group 3). The dose and intensity of doxorubicin were similar in all groups. Disease-free survival (DFS) and overall survival were determined using life-table estimates. RESULTS There was no significant difference in DFS (P = .30) or overall survival (P = .95) among the groups through 5 years. At 5 years, the DFS of women in group 1 was similar to that of women in group 2 (62% v 60%, respectively; P = .43) and to that of women in group 3 (62% v 64%, respectively; P = .59). The 5-year survival of women in group 1 was similar to that of women in group 2 (78% v 77%, respectively; P = .86) and to that of women in group 3 (78% v 77%, respectively; P = .82). Grade 4 toxicity increased in groups 2 and 3. Failure to note a difference in outcome among the groups was unrelated to either differences in amount and intensity of cyclophosphamide or to dose delays and intervals between courses of therapy. CONCLUSION Intensifying or intensifying and increasing the total dose of cyclophosphamide failed to significantly improve either DFS or overall survival in any group. It was concluded that, outside of a clinical trial, dose-intensification of cyclophosphamide in an AC combination represents inappropriate therapy for women with primary breast cancer.

scholarly journals Comparison of Clinical Characteristics and Outcomes in Patients with STEMI in Croatia and Kosovo

2020 ◽  
Vol 1 (1) ◽  
pp. 24-28
Author(s):  
Koshi Rreze ◽  
◽  
Strozzi Maja ◽  
Milicic Davor ◽  
Elezi Shpend ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Interventional Procedure ◽  
Statistical Significance ◽  
Treatment Modalities ◽  
Drug Eluting Stent ◽  
Term Survival ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

INTRODUCTION The aim of our study was to compare clinical characteristics, risk factors, treatment modalities and medium-term outcomes in STEMI patients in two different countries, Croatia and Kosovo. MATERIAL AND METHODS The study included 77 consecutive patients from two regional hospitals, included in the STEMI network of University Clinical Center Zagreb, Croatia (group 1), and 75 STEMI consecutive patients treated in regional Hospital Gjakova, Kosovo (group 2). Standard laboratory tests were performed in both study groups. Patients were treated by the standard protocol of the country and hospital where they were treated. Immediate clinical outcomes and 6 months follow up results regarding MACE were compared. RESULTS There was no significant difference between groups in basic clinical characteristic except for diabetes mellitus, (x2 = 6.96, P = 0.008, P <0.01) and glycaemia control (U’ = 1530, P = 0.013).No significant difference between two groups in laboratory findings. There was a difference in percent of patients treated with primary PCI, 71 in gr 1 and 55 in group 2, reaching statistical significance (x2 test 8,261, p = 0.0045). In patients treated with PCI, there was no difference in “door to balloon time” (DTB) between groups. There was a remarkable difference in proportion of drug eluting stent (DES) implantation (3.5% in group 1, 29.1% in group 2 (x2 test 13.5, P = 0.0002).The difference partly derives from the relatively large number of balloon interventions in group 2. There was 2 deaths in group 1 in early hospital period, both during interventional procedure, one of the patients was in cardiogenic shock. There was no early mortality in group 2. In 6 month clinical follow up there were 3 deaths in group 2, all in patient with no revascularization, and no death in group 1. CONCLUSION We compared the clinical characteristics, treatment strategies and outcomes, in STEMI patients from two countries. After initial mortality, patients from Croatia had a better mid-term survival after recovery from their AMI compared to patients from Kosovo. Use of revascularization procedures was beneficial, but it was less often performed in Kosovo

scholarly journals Roles of neutrophil/lymphocyte ratio in prognosis and in differentiation of potential beneficiaries in HER2-positive breast cancer with trastuzumab therapy

2020 ◽  
Author(s):  
Nianhua Ding ◽  
Juan Huang ◽  
Ningsha Li ◽  
Jiaqi Yuan ◽  
Shouman Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Her2 Positive ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Trastuzumab Treatment ◽  
Her2 Positive Breast Cancer ◽  
Group 3 ◽  
Group 2 ◽  
Group 1 ◽  
Positive Breast Cancer

Abstract Purpose The relationship of neutrophil/lymphocyte ratio (NLR) to prognosis of HER2-positive breast cancer (BC) is not well studied. We aimed to assess the prognostic role of NLR in HER2-positive BC patients treated with or without trastuzumab. Methods The clinical data of 843 HER2-positive BC patients from July 2013 to July 2018 were collected. The difference among variables was calculated by chi-square test. The associations between clinicopathological factors, NLR and disease-free survival (DFS) were analyzed by univariate and multivariate analyses. Results Patients were divided into three groups. In group 1 containing 255 patients without trastuzumab treatment, pretreatment NLR showed no predictive value. Patients with trastuzumab treatment were divided into two groups on equal, according to pretreatment NLR values, low NLR (group 2) and high NLR (group 3). Patients in group 2 showed significantly higher 3-year DFS rate than patients in group 1 and group 3 (95.3% vs. 91.6% vs. 90.5%, respectively, P = 0.011); patients in the group 1 and group 3 had a similar 3-year DFS outcome. Multivariate analysis showed high pretreatment NLR was significantly associated with shorter DFS (HR = 2.917, 95% CI=1.055-8.062, P = 0.039) in HER2-positive BC patients treated with trastuzumab. Conclusion Among HER2-positive trastuzumab-treated BC patients, low pretreatment NLR value was associated with better DFS, and it might help to differentiate potential beneficiaries of trastuzumab treatment.

scholarly journals Near-Infrared Fluorescence Imaging of Breast Cancer and Axillary Lymph Nodes After Intravenous Injection of Free Indocyanine Green

2021 ◽  
Vol 11 ◽  
Author(s):  
Pierre Bourgeois ◽  
Isabelle Veys ◽  
Danielle Noterman ◽  
Filip De Neubourg ◽  
Marie Chintinne ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Fluorescence Imaging ◽  
Near Infrared ◽  
Ex Vivo ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Group 3 ◽  
Group 2 ◽  
Near Infrared Fluorescence Imaging ◽  
Group 1

BackgroundNear-infrared fluorescence imaging (NIRFI) of breast cancer (BC) after the intravenous (IV) injection of free indocyanine green (fICG) has been reported to be feasible. However, some questions remained unclarified.ObjectiveTo evaluate the distribution of fICG in BC and the axillary lymph nodes (LNs) of women undergoing surgery with complete axillary LN dissection (CALND) and/or selective lymphadenectomy (SLN) of sentinel LNs (NCT no. 01993576 and NCT no. 02027818).MethodsAn intravenous injection of fICG (0.25 mg/kg) was administered to one series of 20 women undergoing treatment with mastectomy, the day before surgery in 5 (group 1) and immediately before surgery in 15 (group 2: tumor localization, 25; and pN+ CALND, 4) as well as to another series of 20 women undergoing treatment with tumorectomy (group 3). A dedicated NIR camera was used for ex vivo fluorescence imaging of the 45 BC lesions and the LNs.ResultsIn group 1, two of the four BC lesions and one large pN+ LN exhibited fluorescence. In contrast, 24 of the 25 tumors in group 2 and all of the tumors in group 3 were fluorescent. The sentinel LNs were all fluorescent, as well as some of the LNs in all CALND specimens. Metastatic cells were found in the fluorescent LNs of the pN+ cases. Fluorescent BC lesions could be identified ex vivo on the surface of the lumpectomy specimen in 14 of 19 cases.ConclusionsWhen fICG is injected intravenously just before surgery, BC can be detected using NIRFI with high sensitivity, with metastatic axillary LNs also showing fluorescence. Such a technical approach seems promising in the management of BC and merits further investigation.

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