Intra-operative assessment of sentinel lymph nodes for breast cancer surgery: An update

Barkur, Surekha; Notingher, Ioan; Rakha, Emad A.

doi:10.1016/j.suronc.2021.101678

Cited by 6 publications

(4 citation statements)

References 66 publications

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“…Several breast cancer studies showed that micrometastasis in the sentinel LN was associated with a significantly lower incidence of proximal downstream axillary LN and a fairly good prognosis. 30 , 31 Although the number of studies is limited and the results are inconclusive, similar findings were suggested in lung cancer. 32 , 33 , 34 , 35 Hence, micrometastatic lesions may be in a state of dormancy, during which proliferation and colonization processes do not progress.…”

Section: Discussionmentioning

confidence: 80%

Role of invasive mediastinal nodal staging in survival outcomes of patients with non-small cell lung cancer and without radiologic lymph node metastasis: a retrospective cohort study

Kim,

Jeon,

et al. 2024

eClinicalMedicine

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Section: Discussionmentioning

confidence: 80%

Role of invasive mediastinal nodal staging in survival outcomes of patients with non-small cell lung cancer and without radiologic lymph node metastasis: a retrospective cohort study

Kim,

Jeon,

et al. 2024

eClinicalMedicine

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“…Is necessary to determine the total lymph node burden by ALND and provide a reference for systematic treatment? Research results have shown that [ 3 , [65] , [66] , [67] ], the proportion of 1–2 positive SLN patients with total over three ALNs metastasis after receiving ALND is 5.7–18.9 %, indicating that more than 80 % of these patients have a lower risk of non-SLNM because the number of metastatic ALNs is ≤ 3. In the RxPONDER study, the axillary management of patients with 1–2 positive SLN was determined by a physician, and ALND was not required.…”

Section: Discussionmentioning

confidence: 99%

Non-sentinel lymph node metastases risk factors in patients with breast cancer with one or two sentinel lymph node macro-metastases

Xu,

Zhao,

Wang

et al. 2023

Heliyon

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“…Several techniques have been developed for assessing SLNs intra-operatively [ 14 ]. Frozen section histology and imprint cytology are fast and technically inexpensive but have relatively low sensitivities (44–96%) and require the availability of experienced pathologists [ 15 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Intraoperative spectroscopic evaluation of sentinel lymph nodes in breast cancer surgery

Barkur,

Boitor,

Mihai

et al. 2024

Breast Cancer Res Treat

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Background and objectives Sentinel lymph node (SLN) biopsy is a standard procedure for patients with breast cancer and normal axilla on imaging. Positive SLNs on histological examination can lead to a subsequent surgery for axillary lymph node clearance (ALNC). Here we report a non-destructive technique based on autofluorescence (AF) imaging and Raman spectroscopy for intra-operative assessment of SLNs excised in breast cancer surgery. Methods A microscope integrating AF imaging and Raman spectroscopy modules was built to allow scanning of lymph node biopsy samples. During AF-Raman measurements, AF imaging determined optimal sampling locations for Raman spectroscopy measurements. After optimisation of the AF image analysis and training of classification models based on data from 85 samples, the AF-Raman technique was tested on an independent set of 81 lymph nodes comprising 58 fixed and 23 fresh specimens. The sensitivity and specificity of AF-Raman were calculated using post-operative histology as a standard of reference. Results The independent test set contained 66 negative lymph nodes and 15 positive lymph nodes according to the reference standard, collected from 78 patients. For this set of specimens, the area under the receiver operating characteristic (ROC) curve for the AF-Raman technique was 0.93 [0.83–0.98]. AF-Raman was then operated in a regime that maximised detection specificity, producing a 94% detection accuracy: 80% sensitivity and 97% specificity. The main confounders for SLN metastasis were areas rich in histiocytes clusters, for which only few Raman spectra had been included in the training dataset. Discussion This preliminary study indicates that with further development and extension of the training dataset by inclusion of additional Raman spectra of histiocytes clusters and capsule, the AF-Raman may become a promising technique for intra-operative assessment of SLNs. Intra-operative detection of positive biopsies could avoid second surgery for axillary clearance.

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Intra-operative assessment of sentinel lymph nodes for breast cancer surgery: An update

Cited by 6 publications

References 66 publications

Role of invasive mediastinal nodal staging in survival outcomes of patients with non-small cell lung cancer and without radiologic lymph node metastasis: a retrospective cohort study

Role of invasive mediastinal nodal staging in survival outcomes of patients with non-small cell lung cancer and without radiologic lymph node metastasis: a retrospective cohort study

Non-sentinel lymph node metastases risk factors in patients with breast cancer with one or two sentinel lymph node macro-metastases

Intraoperative spectroscopic evaluation of sentinel lymph nodes in breast cancer surgery

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