Each recording underwent a second analysis at 2 weeks following the first analysis to evaluate reproducibility. The effect of data sampling (5-min segment/hour), the system sensitivity to detect 5 ms increase in Q-T, and the ability to assess circadian variation were also evaluated. Results: The fully AQA resulted in identical QT for the first and second analyses, but with obvious errors in Q-T measurements. Compared to the complete onscreen MOR, the 24-hour mean Q-T was longer with AQA (416 Ϯ 41 vs 387 Ϯ 30 ms, p < .001, r = .3). The reproducibility of automatic analysis with complete MOR was very good (Q-T: 387 Ϯ 30 vs 387 Ϯ 30 ms), coefficient of variation (CV) = 0.2%, r = .986, p < .001. The 5-minute mean Q-T intervals correlated well with the hourly mean Q-T intervals (r = .994, p < .001, CV = 1 ms) and both showed a similar circadian variation. The system was sensitive to detect a 5 ms change in Q-T intervals (5 Ϯ 2 ms, CV = 0.6%, r = .998, p < .001). Conclusions. The fully automatic Q-T analysis is not an acceptable method, while the automatic analysis with MOR is a highly sensitive and reproducible method. Data sampling by analyzing 5-minute segments per hour is also sensitive and reproducible. The 12-lead digital Holter technique is suitable for Q-T analysis and may have advantage compared to the serial recordings of large number of standard 12-lead ECGs in the evaluation of drug effects on the Q-T interval.
IntroductionThe lymphatic channels are the routes by which cancer metastasizes. This study investigates whether a correlation exists between the number of channels and the likelihood of metastasis from the primary breast cancer site to the sentinel lymph node (SLN). Further, it examines the relationship of primary tumor characteristics with respect to these channels and SLN metastasis.Materials and MethodsThis study was a retrospective review of a large database of 695 patients with primary invasive breast carcinoma undergoing selective sentinel lymphadenectomy at a single institution from November 1997 to June 2005. Only patients with successful preoperative lymphoscintigraphy (with either channels or nodes identified) and pathology-determined SLN status were included. There were 532 patients who fit our study criteria.ResultsOne hundred thirty-seven patients (24.8%) had one or more positive SLNs. A comparison of the percentages of positive SLN versus negative SLN for the different channel groups showed 0 channels, 25/137 (18.2%) with positive SLN vs 62/395 (15.7%) with negative SLN, p = .4865; 1 channel, 78/137 (56.9%) with positive SLN vs 244/395 (61.8%) with negative SLN, p = .3182; 2 or more channels, 34/137 (24.8%) with positive SLN vs 89/395 (22.5%) with negative SLN, p = .5845. No significant statistical relationship was found between number of lymphatic channels and frequency of SLN metastasis. The quadrant, type, and size of the tumor were also found to have no significant statistical relationship with the number of lymphatic channels. Metastasis was significantly associated with tumor size greater than 15 mm, poor tubular formation, and lymphovascular invasion.ConclusionAn increased number of lymphatic channels identified by preoperative lymphoscintigraphy does not appear to predict a higher likelihood of metastasis within the sentinel lymph node for all types of breast cancer. Metastasis to the sentinel lymph nodes is governed by the primary characteristics of the tumor rather than the number of lymphatic channels.
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