Decision analysis to assess the efficacy of routine sentinel lymphadenectomy in patients undergoing prophylactic mastectomy

Abstract

The polyimide HFPE‐II‐52 was developed at NASA Glenn Research Center for use as a matrix in high temperature composite materials. The unique properties of such composites stem largely from the performance of the matrix at high temperature. Thus, as part of a larger effort to study high temperature composite materials, the linear viscoelastic properties of HFPE are measured and a mathematical model of the properties is developed. In particular, storage, loss, and stress relaxation moduli were obtained from cyclic and transient loading experiments. A Prony series was fit to the relaxation modulus data. As a cross check, the fit to the relaxation modulus was converted to storage and loss moduli and compared with those measured directly. Effects of postcuring and of moisture on the properties are investigated as well. These results provide researchers with a constitutive model for HFPE‐II‐52 and provide some insight into the performance of HFPE matrix composites at high temperatures. © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 100: 3255–3263, 2006

The value of breast MRI in high‐risk patients with newly diagnosed breast cancer to exclude invasive disease in the contralateral prophylactic mastectomy: Is there a role to choose wisely patients for sentinel node biopsy?

“…However, it is well known that the risk of axillary node involvement with metastatic disease in women undergoing CPM is overall low reported less than 1% [16]. Therefore, the utility of SLNB during CPM remains controversial [6,8,[12][13][14][15][16][17]. The argument favoring routine SLNB in conjunction with CPM is centered on the inability to perform SLNB surgery once a mastectomy has been performed, committing patients whom IC is found to ALND for lymph node stating, which is associated which greater morbidity when compared with SLNB [9][10][11].…”

“…Currently SLNB has been an accepted method for identifying metastasis in patients with early stage of breast carcinoma with significantly lower morbidity than ALND [9][10][11]. However, the role of the utility of SLNB in patients undergoing PM is still controversial [6,7,[12][13][14][15][16][17].…”

Sentinel lymph node biopsy at the time of mastectomy does not increase the risk of lymphedema: implications for prophylactic surgery

“…Opponents of SLNB note that although SLNB results in lower morbidity than ALND, the procedure may be associated with post-operative complications including lymphedema, seroma formation, limited arm mobility, and sensory morbidity [12, 15, 17, 19, 24, 25, 41–45]. In fact, studies have reported an incidence of lymphedema following SLNB in the range of 3.5–11 % [12, 21–23].…”

Clinical Cancer Genetics Part 2

“…16 In a large retrospective matched control analysis of 483 carriers from North America and Europe, with 6 years of follow-up, 49% of patients developed breast cancer in the observation arm versus 2% in the mastectomy arm, with both patients who failed in the surgical arm undergoing a limited subcutaneous mastectomy. 17 In a psychosocial model evaluating who undergoes risk-reduction surgery, the authors found that 23% of carriers will undergo a mastectomy, 51% will undergo a BSO, and those most likely to have both surgeries are the women who have already had one form or another. 17 In a psychosocial model evaluating who undergoes risk-reduction surgery, the authors found that 23% of carriers will undergo a mastectomy, 51% will undergo a BSO, and those most likely to have both surgeries are the women who have already had one form or another.…”