Diagnostic value of preoperative axillary lymph node ultrasound assessment in patients with breast cancer qualified for sentinel lymph node biopsy.

Nowikiewicz, Tomasz; Nowak, Adam; Wiśniewska, Magdalena; Wiśniewski, Michał; Zegarski, Wojciech

doi:10.5114/wiitm.2015.52264

Cited by 7 publications

(8 citation statements)

References 21 publications

(16 reference statements)

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“…claim that the intraoperative analysis of a tissue sample does not contribute to excessive prolongation of BCT 26 . However, according to other authors and to our own previous findings, the use of the intraoperative analysis does significantly increase duration of the surgical procedure 8–11 .…”

Section: Discussionmentioning

confidence: 49%

“…Other diagnostic methods can also be used for the intraoperative assessment of surgical margins, including: radiology studies (mammography – MMG, ultrasound scan – USS, magnetic resonance – MRI, or optical coherence elastography – OCE), fluorescent techniques (using indocyanine green and IRDye800CW), optical techniques (based on the light spectrum analysis), isotopic methods (using 111 In or 89 Zr) and other pathologic techniques ( touch imprint cytology , macroscopic margin assessment ) 7,11,12 . The extent of their use depends on preferences of a given breast cancer treatment center.…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes of an intraoperative surgical margin assessment using the fresh frozen section method in patients with invasive breast cancer undergoing breast-conserving surgery – a single center analysis

Nowikiewicz

Śrutek

Głowacka-Mrotek

et al. 2019

Sci Rep

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Breast conserving treatment (BCT) is a safe standard therapeutic method in patients with early invasive breast cancer. However, it is associated with an increased risk of residual neoplastic tissues in surgical margins. The aim of this study was to assess the outcome of the use of the intraoperative pathologic analysis by the frozen section (FS) method for evaluation of the extent of the primary lumpectomy. The study concerns a retrospective analysis of a group of 1102 patients who underwent BCT between Jan 2015 and Dec 2016. The assessment focused on the frequency of the intraoperative pathologic analysis of the primary lumpectomy extent (fresh frozen section method). The influence of the BCT specimen analysis method on the free margins width, as well as the rate and the cause of reoperation were evaluated. The intraoperative lumpectomy evaluation was performed in 45.8% (505/1102) of patients (Group I), while in the remaining 54.2% of the cases it was decided to abandon this procedure (Group II). Although in 72 (14.3%) patients the intraoperative analysis gave negative results, the margins contained residual tumor tissue (vs. 16.9% in Group II). In Group I, conversion from the previously planned BCT to mastectomy was necessary in 5.9% (30/505) patients (vs. 9.7% in Group II). The duration of surgery was 48.9 ± 17.3 minutes (Group I) and 42.9 ± 13.6 minutes (Group II). In patients undergoing BCT, the use of the intraoperative pathologic analysis by the FS method resulted in a reduction of the total number of reoperations performed due to residual tumor found in the margins following the primary lumpectomy. However, it statistically significantly extended the duration of the surgery.

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Section: Discussionmentioning

confidence: 49%

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of an intraoperative surgical margin assessment using the fresh frozen section method in patients with invasive breast cancer undergoing breast-conserving surgery – a single center analysis

Nowikiewicz

Śrutek

Głowacka-Mrotek

et al. 2019

Sci Rep

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“…According to our previous analyses, the lowest rates of metastasis in sentinel lymph nodes can be found in patients who have undergone a USS scan (with correct results) directly prior to SLNB procedure. This concerns the sensitivity as well as the specificity of the study being evaluated [16].…”

Section: Discussionmentioning

confidence: 99%

“…This is especially noticeable in patients with significant breast density, including the presence of suspicious microcalcifications [13–15]. Postoperative ultrasonography surveillance is feasible in breast cancer patients, especially following conserving procedures (SLNB, BCT) [13, 16].…”

Section: Introductionmentioning

confidence: 99%

Analysis of the causes of false negative and false positive results of preoperative axillary ultrasound in patients with early breast cancer – a single-centre study

Nowikiewicz

Nowak²,

Wiśniewska

et al. 2018

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IntroductionProperly planned and performed diagnostic tests allow the optimal treatment option to be chosen for the patient. They also allow qualification for the correct surgical procedure.Aim of the studyIn this study we evaluated the clinical value of preoperative ultrasound scan (USS) testing performed during primary disease staging in patients with early breast cancer qualified to sentinel lymph node biopsy (SLNB).Material and methodsThe group of breast cancer patients who underwent SLNB from March 2012 to May 2013. As well as the standard procedure of the preoperative diagnostics model, in each patient the USS of axillary lymph nodes was performed additionally. The results were compared with the data from postoperative pathological reports. We attempted to define the factors influencing the possibility of obtaining false positive and false negative USS results.ResultsThe analysis comprised 172 patients. In 14.4% of cases with normal USS result the pathological result was different from the expected one (pN1). In 42.3% of patients with suspicious axillary lymph nodes the result of the pathological report was positive. The sensitivity of the USS testing was 89.3%, and the specificity was 34.4%, PPV – 85.6%, NPV – 42.3%.ConclusionsUltrasonographic assessment of axillary lymph nodes in breast cancer patients qualified for SLNB is a test with high sensitivity and high predictive value of the positive test result. The possibility of a result contrary to the actual nodal status may result primarily from the technical limitations of USS testing.

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“…In order to maintain the radical character of surgical treatment, diagnosing breast cancer requires the assessment of the status of lymph nodes within the axillary fossa at the side of the primary tumor lesion. The breast and axilla ultrasound examination is the most frequently performed radiological test, repeatable and easily accessible, to check regional lymph node status [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Imaging methods for the local lymphatic system of the axilla in early breast cancer in patients qualified for sentinel lymph node biopsy

Nowikiewicz¹,

Kurylcio

Polkowski

et al. 2016

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Breast cancer is the most common malignancy in women in well-developed countries. Despite a constant increase in its incidence, the percentage of patients diagnosed with the disease in the non-invasive stage is also rising. This allows more frequently for the use of breast-preserving surgical techniques, involving the breast and the regional lymphatic system.According to current guidelines of expert panels and research societies, the recommended method of identifying the sentinel lymph node is the use of an isotope marker with a dye (a combined isotope and dye method). Cooperation with a nuclear medicine unit is essential (performing a preoperative lymphoscintigraphic scan to identify the lymphatic drainage basin and sentinel lymph node). In the case of smaller centers treating breast cancer, it can be associated with a number of difficulties, including organizational ones, and also increasing general treatment costs.A possible solution to these problems is to use alternative techniques of visualizing the sentinel lymph node, which do not require a radiotracer. In this paper we discuss the currently available methods of mapping the lymphatic system of the axillary region in patients with early breast cancer. The review is limited to reporting on methods of proven (based on clinical research) high diagnostic value.

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Diagnostic value of preoperative axillary lymph node ultrasound assessment in patients with breast cancer qualified for sentinel lymph node biopsy.

Cited by 7 publications

References 21 publications

Clinical outcomes of an intraoperative surgical margin assessment using the fresh frozen section method in patients with invasive breast cancer undergoing breast-conserving surgery – a single center analysis

Clinical outcomes of an intraoperative surgical margin assessment using the fresh frozen section method in patients with invasive breast cancer undergoing breast-conserving surgery – a single center analysis

Analysis of the causes of false negative and false positive results of preoperative axillary ultrasound in patients with early breast cancer – a single-centre study

Imaging methods for the local lymphatic system of the axilla in early breast cancer in patients qualified for sentinel lymph node biopsy

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