Is Complete Axillary Dissection Necessary for all Patients with Positive Findings on Sentinel Lymph Node Biopsy? Validation of a Breast Cancer Nomogram for Predicting the Likelihood of a Non-Sentinel Lymph Node

Amanti, C.; Lombardi, A.; Maggi, Stefano; Moscaroli, Alessandra; Russo, Maria Francesca; Maglio, Riccardo; Provenza, Giuseppe; Romano, Camilla; Pezzatini, Massimo; Scopinaro, Francesco; Stefano, Domenica Di

doi:10.1177/030089160909500204

Cited by 12 publications

(3 citation statements)

References 13 publications

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“…Postoperative RT is recommended for patients initially diagnosed as having a high risk of loco-regional recurrence, regardless of their response to PST. PST To determine on the type of surgery required by examining possible pCR [48] IBTR To determine whether RT or re-excision is necessary [49] SLNB To determine whether ALND is required by predicting non-SLN metastasis [50][51][52][53][54] 20…”

Section: Post-operative Radiation Therapy In Patients Receiving Pstmentioning

confidence: 99%

Identifying Gaps in the Locoregional Management of Early Breast Cancer: Highlights from the Kyoto Consensus Conference

et al. 2011

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A consensus conference was held to investigate issues related to the local management of early breast cancer. Here, we highlight the major topics discussed at the conference and propose ideas for future studies. Regarding axillary management, we examined three major issues. First, we discussed whether the use of axillary reverse mapping could clarify the lymphatic system of breast and whether the ipsilateral arm might help avoid lymphedema. Second, the use of an indocyanine green fluorescent navigation system was discussed for intraoperative lymphatic mapping. These new issues should be examined further in practice. Finally, some agreement was reached on the importance of "four-node diagnosis" to aid in the diagnostic accuracy of sentinel nodes. Regarding breast treatment, there was general agreement that the clinical value of surgical margins in predicting local failure was dependent on the tumor's intrinsic biology and subtypes. For patients treated with preoperative chemotherapy, less extensive excision may be feasible in those who respond to systemic therapy in an acceptable manner. Most trials of preoperative chemotherapy lack outcome data on local recurrence. Therefore, there is a need for such data for overview analysis. We also agreed that radiation after mastectomy may be beneficial in node-positive cases where more than four nodes are involved. Throughout the discussions for both invasive and noninvasive disease, the investigation of nomograms was justified for major issues in the decision-making process, such as the presence or absence of microinvasion and the involvement of nonsentinel nodes in sentinel node-positive patients.

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Section: Post-operative Radiation Therapy In Patients Receiving Pstmentioning

confidence: 99%

Identifying Gaps in the Locoregional Management of Early Breast Cancer: Highlights from the Kyoto Consensus Conference

et al. 2011

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“…Initially, we used the MSKCC nomogram retrospectively on our case series and obtained a good discrimination. The area under the receiver operating characteristic (ROC) curve, the test most widely used to validate a nomogram like this, was 0.75, above the threshold of 0.70 3 . We then tested four other methods: a French approach from the Tenon Hospital of Paris 4 , an American approach from Stanford University 5 , a British approach from Cambridge 6 , and the last one, more recent, derived by a multicentric study in Turkey 7 .…”

Section: Introductionmentioning

confidence: 96%

Non-Sentinel Lymph Node Metastases in Breast Cancer Patients with a Positive Sentinel Lymph Node: Validation of Five Nomograms and Development of a New Predictive Model

Lombardi

Maggi

Russo

et al. 2011

Tumori

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“…A sentinel lymph node biopsy (SLNB) is suggested if B‐mode ultrasonography (USG) features are not suspicious and in suspicious cases if the histopathology result shows no evidence of metastatic nodal involvement. If histopathology results or B‐mode USG strongly indicates malignant involvement, then axillary lymph node dissection (ALND) is recommended (Amanti et al, 2009; Van la Parra et al, 2009). As such, this pathway indicates that the accuracy of ultrasound scans is insufficient when it comes to identifying involved lymph nodes (Fernández et al, 2011; Mainiero et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Fusion of B‐mode and shear wave elastography ultrasound features for automated detection of axillary lymph node metastasis in breast carcinoma

et al. 2022

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In this study, we evaluate and compare the diagnostic performance of ultrasound for non-invasive axillary lymph node (ALN) metastasis detection. The study was based on fusing shear wave elastography (SWE) and B-mode ultrasonography (USG) images.These images were subjected to pre-processing and feature extraction, based on bidimensional empirical mode decomposition and higher order spectra methods. The resulting nonlinear features were ranked according to their p-value, which was established with Student's t-test. The ranked features were used to train and test six classification algorithms with 10-fold cross-validation. Initially, we considered Bmode USG images in isolation. A probabilistic neural network (PNN) classifier was able to discriminate positive from negative cases with an accuracy of 74.77% using 15 features. Subsequently, only SWE images were used and as before, the PNN classifier delivered the best result with an accuracy of 87.85% based on 47 features.Finally, we combined SWE and B-mode USG images. Again, the PNN classifier delivered the best result with an accuracy of 89.72% based on 71 features. These three tests indicate that SWE images contain more diagnostically relevant information when compared with B-mode USG. Furthermore, there is scope in fusing SWE and B-mode USG to improve non-invasive ALN metastasis detection.

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Is Complete Axillary Dissection Necessary for all Patients with Positive Findings on Sentinel Lymph Node Biopsy? Validation of a Breast Cancer Nomogram for Predicting the Likelihood of a Non-Sentinel Lymph Node

Cited by 12 publications

References 13 publications

Identifying Gaps in the Locoregional Management of Early Breast Cancer: Highlights from the Kyoto Consensus Conference

Identifying Gaps in the Locoregional Management of Early Breast Cancer: Highlights from the Kyoto Consensus Conference

Non-Sentinel Lymph Node Metastases in Breast Cancer Patients with a Positive Sentinel Lymph Node: Validation of Five Nomograms and Development of a New Predictive Model

Fusion of B‐mode and shear wave elastography ultrasound features for automated detection of axillary lymph node metastasis in breast carcinoma

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