Sentinel lymph node biopsy examination for breast cancer patients with clinically negative axillary lymph nodes after neoadjuvant chemotherapy

Kinoshita, Takayuki; Takasugi, M; Iwamoto, Eriko; Akashi‐Tanaka, Sadako; Fukutomi, Takashi; Terui, Shoji

doi:10.1016/j.amjsurg.2005.06.049

Cited by 35 publications

(23 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Further investigations are required. [23][24][25][26] We conducted this study to determine suitable criteria for the diagnosis of axillary lymph node metastases, in terms of node size, using mammary CT, the objective being to have criteria that are easy to understand and can be employed at any institution. Our results suggest that the most suitable criterion is to consider an axillary lymph node to be node-positive if it is greater than 5 mm in short-axis diameter, and the accuracy of this criterion was found to be favorable.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of axillary status in patients with breast cancer using thin-section CT

et al. 2008

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of axillary status in patients with breast cancer using thin-section CT

et al. 2008

Self Cite

View full text Add to dashboard Cite

show abstract

“…There was no difference in identification of sentinel lymph node according to age. Studies by Shen et al 7 and Kinoshita et al 8 included average age of 49 and 51.1 years respectively.…”

Section: Discussionmentioning

confidence: 99%

Sentinel lymph node biopsy in patients with locally advanced breast cancer after neoadjuvant chemotherapy

Aguiar¹,

Pinheiro²,

Mota³

et al. 2012

Acta Cir. Bras.

View full text Add to dashboard Cite

PURPOSE:To check the rate of sentinel lymph node (SLN) identification in patients with locally advanced breast cancer who underwent neoadjuvant chemotherapy comparing intraoperative contact cytology (imprint) and embedded in paraffin and validation of methods. METHODS: A cross-sectional validation of diagnostic test involving 34 patients from the outpatient clinic of the Maternity School Assis Chateaubriand. The patients had locally advanced breast cancer and were treated with neoadjuvant chemotherapy. Those with clinically negative axilla underwent SLN biopsy, studied by imprint and histopathology in paraffin. All patients underwent axillary dissection and its histopathological study. RESULTS:The SLN identification rate was 85.3% (29/34). The sensitivity of imprint associated with paraffin on detection of metastasis compared to histopathology of the axillary content was 84.62% and specificity of 100% with false-negative rate of 12.01% and an accuracy of 92.77%. CONCLUSION: The search for metastases in the SLN by imprint and histopathological analysis in paraffin compared to the gold standard (axillary dissection) had a low sensitivity with high rate of false negatives in our sample. Key words: Sentinel Lymph Node Biopsy. Breast Neoplasm. Neoadjuvant Therapy.RESUMO OBJETIVO: Verificar a taxa de identificação do linfonodo sentinela (LS) em pacientes portadoras de câncer na mama localmente avançado e que foram submetidos à quimioterapia neoadjuvante comparando a citologia de contato intraoperatória (imprint) e a inclusão em parafina e validação dos procedimentos. MÉTODOS: Estudo transversal de validação de teste diagnóstico envolvendo 34 pacientes oriundas do Ambulatório da MaternidadeEscola Assis Chateaubriand. As pacientes eram portadoras de câncer na mama localmente avançado e foram tratadas com quimioterapia neoadjuvante. Àquelas com axila clinicamente negativa foram submetidas à biopsia do LS, esse estudado por impint e histopatologia em parafina. Todas as pacientes foram submetidas a esvaziamento axilar e seu estudo histopatológico. RESULTADOS: A taxa de identificação do LS foi de 85,3% (29/34). A sensibilidade do imprint associada à parafina quanto à detecção de metástase comparado a análise histopatológica do conteúdo axilar foi de 84,62% e a especificidade de 100% com taxa de falsonegativo de 12,01% e acurácia de 92,77%. CONCLUSÃO: A pesquisa de metástases no linfonodo sentinela por imprint e análise histopatológica em parafina quando comparado ao padrão ouro (esvaziamento axilar) apresentou baixa sensibilidade com taxa elevada de falsos negativos em nossa amostra. Descritores: Biópsia de Linfonodo Sentinela. Neoplasias da Mama. Terapia Neoadjuvante. Sentinel lymph node biopsy in patients with locally advanced breast cancer after neoadjuvant chemotherapy

show abstract

“…The inclusion criteria were as follows: i) Female patients with operable breast cancer (invasive carcinoma and/or ductal carcinoma in situ); ii) age, ≥18 and ≤85 years; iii) scheduled for mastectomy either alone or in association with axillary clearance; iv) either sentinel lymph node biopsy or standard level I/II axillary node dissection (14); v) written hospital-approved informed consent by the patient; and vi) surgical wound classified class I (Surgical Wound Classification) (15). Patients were excluded if any of the following criteria were met: i) Undergoing surgery for modified radical mastectomy with immediate breast reconstruction, cosmetic breast operations, reduction, expansion, insertion of a prosthesis, duct ectasia, infective breast disease or implant; ii) surgical wounds identified as class II, III or IV using Centers for Disease Control surgical site infection Surgical Wound Classification (15); iii) inflammatory breast cancer or skin ulceration; iv) presence of physical or psychiatric conditions that could impair outcome assessment and intended follow-up (5); v) personal or family skin scar history; vi) received an experimental drug or used an experimental medical device within 30 days prior to the planned start of treatment; vii) employees of the assessor associated with the proposed study or other studies under the direction of that assessor; and viii) unlikely to comply with chemotherapy or complete the 25-week follow-up visit.…”

Section: Methodsmentioning

confidence: 99%

Retrospective observational cohort study on cosmetic outcome of using Ti‑Ni memory alloy wire for intradermal suture following mastectomy in patients with breast cancer

Qin

Sun

et al. 2017

Oncol Lett

View full text Add to dashboard Cite

Abstract. The method of suturing for incisions is crucial for the comprehensive treatment of clinical patients with breast cancer. Suturing is considered a major part of post-surgical recovery and may serve as a marker for evaluation of surgical outcome. The present study aimed to establish an effective means of suturing for patients who received modified radical surgery that helps to improve the cosmetic outcome of the incision. Enrolled patients were divided into an active and a control group. Ti-Ni memory alloy wire for intradermal suture in the active group and silk for interruption suture in the control group were applied to assess the different prognosis-associated factors. The Vancouver Scar Scale (VSS) was used to evaluate the wound size and the recovery time of the scars. The association between diabetes and the number of days of wound healing was also analyzed. The results indicated that the mean VSS score of the active group was decreased compared with that of the control group (P<0.001). The VSS scores of four main features (vascularity, pigmentation, pliability and height) between the two groups also statistically differed (P<0.001). Furthermore, the mean number of days of wound healing was significantly decreased for the active group compared with that for the control group (P=0.0026) in the patients with diabetes. In addition, the usage of Ti-Ni memory alloy wire was able to decrease the mean number of wound healing days between patients with diabetes and their non-diabetic counterparts (P=0.7009). The present study indicated that intradermal suture offers improved cosmetic outcome for patients undergoing mastectomy with or without axillary surgery. This technique may be useful for preventing scar overgrowth and for facilitating the recovery process in patients with diabetes. IntroductionIn 1882, Halsted pioneered the radical resection of the breast. Breast surgery methods have changed since and clinicians commonly perform breast-conserving surgery. However, the optimal approach for radical resection remains controversial (1). Along with social progress and improvements in the quality of life, patients with cancer, particularly patients with breast cancer have increasing requirements for the function and cosmetic outcome following surgery (2,3). A previous study identified that 61% of patients reported that the opinions of their partners of the scars were important to them (4). The way an incision is closed and managed post-operatively affects cosmetic outcome (5). Historically, in breast cancer surgery, simultaneously ensuring treatment effect, shrinking excision scope and attending to the cosmetic effect has been important (6). To improve the aesthetic results for female patients undergoing breast cancer surgery, surgical techniques have been developed to render scars less noticeable (7,8).In China, the majority of patients with breast cancer are treated with modified radical surgery using discontinuous silk suture, which leaves a very noticeable scar (9). A study on cosmetic surgery identified ...

show abstract

Sentinel lymph node biopsy examination for breast cancer patients with clinically negative axillary lymph nodes after neoadjuvant chemotherapy

Cited by 35 publications

References 18 publications

Evaluation of axillary status in patients with breast cancer using thin-section CT

Evaluation of axillary status in patients with breast cancer using thin-section CT

Sentinel lymph node biopsy in patients with locally advanced breast cancer after neoadjuvant chemotherapy

Retrospective observational cohort study on cosmetic outcome of using Ti‑Ni memory alloy wire for intradermal suture following mastectomy in patients with breast cancer

Contact Info

Product

Resources

About