Sentinel Lymph Node Biopsy in Breast Cancer: A Clinical Review and Update

Zahoor, Sheikh; Haji, Amyn; Battoo, Azhar Jan; Qurieshi, Mariya Amin; Mir, Wahid Abdul; Shah, Manjool

doi:10.4048/jbc.2017.20.3.217

Cited by 90 publications

(82 citation statements)

References 98 publications

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“…For example, in the field of breast cancer, several studies have reported on the learning curve for axillary SLN mapping during the early days of adoption of SLN biopsy 11–15 . Following extensive investigation of its safety and efficacy, SLN biopsy has become a standard staging tool in the surgical management of breast cancer 16 . In contrast, only two published poster presentations have assessed the learning curve for SLN dissection for gynecologic cancer.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13][14][15] Following extensive investigation of its safety and efficacy, SLN biopsy has become a standard staging tool in the surgical management of breast cancer. 16 In contrast, only two published poster presentations have assessed the learning curve for SLN dissection for gynecologic cancer. Desai et al 17 used the CUSUM method to assess the learning curve in 120 patients with endometrial carcinoma who underwent robot-assisted laparoscopy.…”

Section: Comparisons Between the Cases From The Early Period And Thmentioning

confidence: 99%

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Learning curve for sentinel lymph node mapping in gynecologic malignancies

Kim

Ryu²,

Min³

et al. 2020

Journal of Surgical Oncology

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Background and Objectives Only a few studies have reported the learning curve for sentinel lymph node (SLN) detection in gynecologic malignancies. We investigated the learning curve for SLN detection during robot‐assisted laparoscopic surgery for endometrial and cervical carcinomas. Methods This retrospective analysis included patients with stage IA to IIA1 cervical cancer or stage I to III endometrial cancer who underwent SLN mapping using indocyanine green during robot‐assisted laparoscopic surgery performed by a single surgeon. Learning curves were analyzed in consecutive cases using SLN detection rates and the cumulative sum (CUSUM) method. Results SLN mapping was achieved in 81.25% (65/80), 77.50% (62/80), and 66.25% (53/80) of the cases involving the right, left, and simultaneous bilateral pelvic areas, respectively. Learning curve analysis based on the cumulative detection rate showed initial fluctuations followed by stabilization; the time required for proficiency was discordant among the LN regions. However, the CUSUM method showed proficient mapping of the right, left, and bilateral SLNs after 27 to 28 cases. Conclusion At least 27 cases were required for SLN mapping proficiency in gynecologic cancer; the learning period could influence the surgical quality. Further studies are warranted to confirm the impact of this learning curve on disease outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Comparisons Between the Cases From The Early Period And Thmentioning

confidence: 99%

Learning curve for sentinel lymph node mapping in gynecologic malignancies

Kim

Ryu²,

Min³

et al. 2020

Journal of Surgical Oncology

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“…Another promising method which might provide a more accurate identification of patients who present ovarian cancer lymph node metastases even in apparently early stages of the disease is represented by the sentinel node detection [4]. The method, which has been widely implemented in cases diagnosed with early stage breast cancer, melanoma and even gynecological cancers (such as endometrial cancer or cervical cancer), is still under evaluation in patients with presumed early stage ovarian cancer, further studies being still needed before introducing it as part of the standard therapeutic protocol [4,[15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

The Risk of Para-Aortic Lymph Node Metastases in Apparent Early Stage Ovarian Cancer

et al. 2020

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Background and objectives: To identify the risk factors for para-aortic lymph node metastases in cases with presumed early stage ovarian cancer. Materials and methods: Between 2014 and 2019, 48 patients with apparent early stage ovarian cancer were submitted to surgery. In all cases, pelvic and para-aortic lymph node dissection was performed for staging purposes. Results: Among the 48 cases we identified nine cases with positive pelvic lymph nodes and 11 cases with positive para-aortic lymph nodes. The positivity of the retrieved lymph nodes was significantly correlated with the histopathological subtype represented by serous histology (p = 0.02), as well as with the degree of differentiation (p = 0.004). Conclusions: Patients with serous ovarian carcinomas in association with a poorer degree of differentiation are at risk of associated lymph node metastases even in presumed early stages of the disease. Therefore, lymph node dissection should be performed in such cases in order to provide adequate staging and tailoring of further treatment.

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“…In this respect, the concept of sentinel lymph node detection has been proposed, initially in the Eastern countries, and later on, but with a lower enthusiasm, in the Western countries. The method, successfully implemented by Cabanas in penile cancer patients and by Morton in malignant melanoma patients, has become nowadays the standard of care in early stage breast cancer as well as in melanoma [7][8][9][10][11] . In breast cancer and malignant melanoma patients, the method presents a particular interest due to the fact that it can provide an efficient staging of the disease and an adequate tailoring of the adjuvant oncologic treatment [10][11][12] .…”

Section: Introductionmentioning

confidence: 99%