Sentinel Lymph Node Biopsy in Breast Cancer: A Comprehensive Literature Review

Salem, Ahmed

doi:10.1016/j.jsurg.2009.07.011

Cited by 17 publications

(9 citation statements)

References 65 publications

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“…Its use was not recommended in pregnancy, after neo-adjuvant chemotherapy, after previous breast and axillary surgery, and for infiltrating multicentric and multifocal carcinomas. Authors have since concluded that a combination technique improves the SLN identification rate in both early and advanced breast disease [48]. We can conclude that the accuracy of SLNB in metastatic breast cancer is comparable to that obtained in unifocal disease [50].…”

Section: Cosmetic Surgery For Older Womenmentioning

confidence: 52%

“…The sentinel node (SN) is the first node to drain through the lymphatics from the primary tumour making the axillary lymph nodes the most frequent site of metastasis from breast neoplasms. Due to the widespread use of mammography, breast cancers are consistently being diagnosed at the earliest stages of disease resulting in a reduced axillary involvement with only 10% of tumours equal to or less than 1 cm demonstrating axillary metastases [48].…”

Section: Feasibility and Reliability Of Slnb In Older Womenmentioning

confidence: 99%

“…Rare complications of this technique have been reported and are usually attributed to the injection dye used. The most common are pulmonary oedema and anaphylactic reactions in approximately 1-3% of patients [48]. Since the first report of SLNB for breast cancer, this technique has proven to be feasible and has been deemed appropriate for use in place of axillary dissection with a high degree of accuracy, a low false-negative rate, low morbidity, and a low axillary relapse rate [49].…”

Section: Cosmetic Surgery For Older Womenmentioning

confidence: 99%

“…Since the first report of SLNB for breast cancer, this technique has proven to be feasible and has been deemed appropriate for use in place of axillary dissection with a high degree of accuracy, a low false-negative rate, low morbidity, and a low axillary relapse rate [49]. Demographically, the application of SLNB in patients with breast cancer has progressively increased from 26.5% in 1998 to 65.5% in 2005 according to 1 study [48]. SLNB has thus now become the new standard of care for nodal staging in early-stage breast disease [43,47].…”

Section: Cosmetic Surgery For Older Womenmentioning

confidence: 99%

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Choices in Surgery for Older Women with Breast Cancer

2012

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Breast cancer is a major cause of mortality worldwide. As the population ages and life expectancy increases, the burden of cancer on health services will increase. Older patients with breast cancer are becoming more suitable for surgery; tailored surgical techniques and increasing healthy life expectancy alongside improved assessment of patients are aiding this trend. Surgery is also becoming a favoured treatment of personal choice for older patient with breast cancer. Evidence shows that surgery is almost always feasible for the older patient with outcomes (survival, progression, and recurrence rates) comparable to younger groups and superior to nonsurgical treatments. We aim to describe the current status of surgery for the older patient with breast cancer, showing it is an option that should not be denied. Surgery should always be considered regardless of age, after evaluation of comorbidities.

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Section: Cosmetic Surgery For Older Womenmentioning

confidence: 52%

Section: Feasibility and Reliability Of Slnb In Older Womenmentioning

confidence: 99%

Section: Cosmetic Surgery For Older Womenmentioning

confidence: 99%

Section: Cosmetic Surgery For Older Womenmentioning

confidence: 99%

See 2 more Smart Citations

Choices in Surgery for Older Women with Breast Cancer

2012

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“…This rate is likely to increase over time thanks to earlier diagnosis of breast cancer due to the widespread use of screening mammography, as the risk of axillary metastases is close to 10% in tumors of less than 1 cm [21,22]. Noteworthy, in patients with SN micrometastasis the rate of tumor-positive nodes at completion ALND drops down to 0% and 2.8% when the tumor size is less than 1 cm and between 1 and 2 cm, respectively [23,24]. Moreover, the selection of patients eligible for systemic adjuvant treatment is currently influenced by various patient-and tumor-related factors, such that axillary lymph node status, as well as the extent of lymph node involvement, no longer determines this decision analysis [25].…”

Section: Discussionmentioning

confidence: 99%

No Axillary Lymph Node Dissection in Breast Cancer Patients with Sentinel Lymph Node Micrometastasis

Gipponi¹,

Fregatti²,

Murelli³

et al. 2014

ABCR

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Follow-up data of a series of 75 breast cancer patients with sentinel node (SN) micrometastases only (between 0.2 and 2 mm) and favorable histopathological features of the primary tumor (well-differentiated, T1 tumors without lymphovascular invasion) who refused completion axillary lymph node dissection (ALND) or who were unsuitable for surgery were assessed in order to detect the rate of axillary recurrence after an adjuvant chemoand/or hormonal adjuvant treatment was given. The great majority of patients (81.3%) did not undergo ALND due to the existence of favorable histopathologic factors while the rest were equally distributed among over 75-year-old women (10.6%) and patients at a high surgical risk due to comorbid conditions (9.3%). Sixty-six patients (88%) underwent conservative treatment (lumpectomy followed by adjuvant breast radiotherapy) while the remaining nine patients (12%) had total mastectomy; 72 out of 75 patients (96%) received some forms of adjuvant chemo-and/or hormone-therapy. After a median follow-up of 38 months (range 12 -84 months), nine out of 75 patients (12%) had a disease relapse, only one of them (1.3%) being affected by an axillary recurrence in the untreated axilla three years after primary surgery. On these grounds, completion ALND could be safely omitted in patients with SN micrometastasis and favorable histopathological characteristics of the primary neoplasm due to the very low rate of axillary recurrence with no detrimental effect on survival.

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Sentinel lymph node biopsy in breast cancer patients treated with neoadjuvant chemotherapy

Pecha

Kolařík

Kozevnikova

et al. 2011

Cancer

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BACKGROUND: Sentinel lymph node biopsy (SLNB) is a widely used staging method for patients with early breast cancer. Neoadjuvant chemotherapy modifies the anatomical conditions in the breast and axilla, and thus SLNB remains controversial in patients treated preoperatively. The aim of this study was to demonstrate the reliability and accuracy of this procedure in this particular group of patients. METHODS: The retrospective study analyzed medical records of patients diagnosed with primary breast cancer between the years 2005 and 2009. Of the patients treated by neoadjuvant therapy, 343 underwent lymphatic mapping to identify sentinel lymph nodes, and these were included in the analysis. RESULTS: The overall detection rate of sentinel lymph nodes was 80.8%. It was strongly influenced by clinical lymph node status (significantly higher success rate in lymph node-negative patients); higher detection rates were also associated with age <50 years, estrogen receptor positivity, lower proliferation index, and absent lymphovascular space invasion. The false-negative rate was 19.5% and was only marginally significantly dependent on lymphovascular space invasion. The overall accuracy of the method was 91.5%. CONCLUSIONS: By using the present technique, sentinel lymph node biopsy cannot be recommended as a reliable predictor of axillary lymph node status when performed at the authors' institution after neoadjuvant chemotherapy. Infrequent use of blue dye for lymphatic mapping, low number of resected sentinel lymph nodes, and absence of any selection among patients included in the study could be the main factors responsible for the low detection rate and high false-negative rate. Cancer 2011;117:4606-

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Sentinel Lymph Node Biopsy in Breast Cancer: A Comprehensive Literature Review

Cited by 17 publications

References 65 publications

Choices in Surgery for Older Women with Breast Cancer

Choices in Surgery for Older Women with Breast Cancer

No Axillary Lymph Node Dissection in Breast Cancer Patients with Sentinel Lymph Node Micrometastasis

Sentinel lymph node biopsy in breast cancer patients treated with neoadjuvant chemotherapy

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