Combined mapping was superior to blue dye alone in identification of the SLN, but accuracy and false-negative rates were similar.

Purpose: Metastatic breast cancer is a leading cause of mortality in women, partly on account of brain metastases. However, the mechanisms by which cancer cells cross the blood-brain barrier remain undeciphered. Most molecular studies predicting metastatic risk have been performed on primary breast cancer samples. Here we studied metastatic lymph-nodes from patients with breast cancers to identify markers associated with the occurrence of brain metastases. Results: Transcriptomic analyses identified CDKN2A/p16 as a gene potentially associated with brain metastases. Materials and Methods: Fifty-two patients with HER2-overexpressing or triple-negative breast carcinoma with lymph nodes and distant metastases were included in this study. Transcriptomic analyses were performed on laser-microdissected tumor cells from 28 metastatic lymph-nodes. Supervised analyses compared the transcriptomic profiles of women who developed brain metastases and those who did not. As a validation series, we studied metastatic lymph-nodes from 24 other patients. Immunohistochemistry investigations showed that p16 mean scores were significantly higher in patients with brain metastases than in patients without (7.4 vs. 1.7 respectively, p < 0.01). This result was confirmed on the validation series. Multivariate analyses showed that the p16 score was the only variable positively associated with the risk of brain metastases (p = 0.01).

The radiological findings of ultrasound, CT and MR of a case of bilateral subacromial bursitis with macroscopic rice bodies is described. The previous literature is also reviewed.

Objective: To assess the accuracy of sentinel lymph node biopsy (SLNB) using combined isotope and blue dye mapping technique. Method: Prospective analysis of 50 cases of SLNB in patients with breast cancer. Accuracy was assessed by comparing the histology of sentinel lymph node (SLN) with axillary dissection specimen. Results: Sentinel lymph nodes were localized in 47 cases (94%) and correctly predicted the axillary status in all cases (100% accuracy) with no false negative result. Frozen section analysis of SLN was associated with a 33% false negative rate. Immunohistochemical staining did not improve the detection of metastasis compared with haematoxylin-eosin paraffin sections. Conclusions: Sentinel lymph node biopsy is highly accurate in staging the nodal involvement in breast cancer using the combined mapping technique.Key words: breast cancer, sentinel lymph node.All patients with operable breast cancer (< 4 cm) were eligible for sentinel node biopsy. All malignancy was

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