Prognostic value of micrometastases in sentinel lymph nodes of patients with breast carcinoma: a cohort study

Gobardhan, Paul D.; Elias, Sjoerd G.; Madsen, Eva; Bongers, Vivian; Ruitenberg, H. J. M.; Perre, C. I.; Dalen, Thijs van

doi:10.1093/annonc/mdn535

Cited by 53 publications

(43 citation statements)

References 26 publications

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“…Meticulous histopathologic preparations of SLN provide crucial information regarding the distribution of ITC and microfoci in SLN [20,21]. Approximately 10-20% of all patients show microscopic foci within SLN (pN micro ) [22][23][24][25][26][27][28]. Data about pN ITC in SLN are more heterogeneous because such findings are necessarily dependent on the number and width interval of sections that are cut [29,30].…”

Section: Growth Time Of Involved Lymph Nodes Versus Ptmentioning

confidence: 99%

Positive lymph nodes do not metastasize

Engel¹,

Emeny²,

Hölzel

2011

Cancer Metastasis Rev

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Our understanding of the role of lymph nodes (LN) in the metastasization process (MET) is marginal. Positive LNs (pLN) are the most important prognostic factor and lymph node dissection (LND) is still standard practice in primary treatment. However, up to now, there is almost no evidence that elective LND has a survival benefit. Based on many clinical and experimental findings, we propose that tumor foci in regional LN are incapable of metastasization and can therefore not infiltrate further LN and organs. Available data demonstrate a very early infiltration of MET capable tumor cells from the primary tumor into regional LN, and thereafter an increased probability of subsequent LN infiltrations. Disparate growth rates of the first versus subsequent infiltrating tumors as well as the asymptotic growth and prognosis of large tumor foci in LN explain many clinical observations for solid tumors. The consequence of the hypothesis "pLN do not metastasize" would impact clinical treatment and research and contribute to understanding the mounting evidence against LND.

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Section: Growth Time Of Involved Lymph Nodes Versus Ptmentioning

confidence: 99%

Positive lymph nodes do not metastasize

Engel¹,

Emeny²,

Hölzel

2011

Cancer Metastasis Rev

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“…Nodal involvement has a significant impact on tumor staging, treatment, and prognosis. However, in breast cancer, most studies show no change in survival or only a slightly reduced survival in patients with nodal micrometastasis compared with those without (2)(3)(4). Thus, lymphatic mapping and SLN localization have emerged as accurate and minimally invasive procedures for identifying clinically node-negative patients.…”

mentioning

confidence: 99%

99mTc-Tilmanocept: A Novel Molecular Agent for Lymphatic Mapping and Sentinel Lymph Node Localization

Surasi

O’Malley

Bhambhvani

2015

Journal of Nuclear Medicine Technology

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AlabamaCE credit: For CE credit, you can access the test for this article, as well as additional JNMT CE tests, online at https://www.snmmilearningcenter.org. Complete the test online no later than June 2018. Your online test will be scored immediately. You may make 3 attempts to pass the test and must answer 80% of the questions correctly to receive 1.0 CEH (Continuing Education Hour) credit. SNMMI members will have their CEH credit added to their VOICE transcript automatically; nonmembers will be able to print out a CE certificate upon successfully completing the test. The online test is free to SNMMI members; nonmembers must pay $15.00 by credit card when logging onto the website to take the test.Preoperative lymphatic mapping in conjunction with intraoperative γ-probe detection is widely used for sentinel node localization in melanoma, breast cancer, and other malignancies. 99m Tc-radiocolloids have been the standard radiotracers used for sentinel node mapping. 99m Tc-tilmanocept is a receptorbinding molecular imaging agent approved by the U.S. Food and Drug Administration for lymphatic mapping and lymph node localization in breast cancer, melanoma, clinically nodenegative squamous cell carcinoma of the oral cavity, and other solid tumors. It has several advantages over conventional radiocolloids, including rapid injection site clearance, high sentinel node extraction, and low distal node accumulation, which can lead to efficient resource use.

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“…7 In addition, the increasing use of IHC staining for H&E-negative sentinel nodes results in further detection of micrometastatic disease. 2,9 With the increased detection of micrometastatic disease, our management of such patients is becoming more important. The larger numbers in the ACOSOG Z010 and Z0010 trials will, we hope, allow for further subgroup analysis to better account for confounding factors such as lymphovascular invasion and tumor grade, as well as separate the pN 1mic from the pN0 i?…”

mentioning

confidence: 99%