Sentinel lymph node involvement—a predictor for axillary node status with breast cancer—Has the time come?

Koller, Marjory; Barsuk, Daphna; Zippel, Douglas; Engelberg, S; Ben-Ari, G; Papa, Moshe Z.

doi:10.1016/s0748-7983(98)92827-x

Cited by 95 publications

(44 citation statements)

References 7 publications

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“…Axillary lymph node dissection is used to obtain precise staging data, provide local control for patients with metastatic breast carcinoma and for selection of adjuvant therapy (5)(6)(7)(8)(9)(10)(11). Unfortunately, the only patients who are likely to derive therapeutic benefit from axillary lymph node dissection are those with positive nodes, approximately 40% of those undergoing axillary dissection (12)(13)(14)(15)(16). Axillary lymph node dissection is associated with considerable chronic morbidity including lymphedema, neurologic damage to the brachial plexus, joint stiffness and, rarely, angiosarcoma (17)(18)(19)(20).…”

Section: Abstract: Breast Carcinoma Cytopathology Imprint Metastatmentioning

confidence: 99%

Intraoperative Evaluation of Sentinel Lymph Nodes for Metastatic Breast Carcinoma by Imprint Cytology

et al. 2002

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Background: The increasing utilization of lymphatic mapping techniques for breast carcinoma has made intraoperative evaluation of sentinel lymph nodes attractive. Axillary lymph node dissection can be performed during the initial surgery if the sentinel lymph node is positive, potentially avoiding a second operative procedure. At present the optimal technique for rapid sentinel lymph node assessment has not been determined. Both frozen sectioning and intraoperative imprint cytology are used for rapid intraoperative sentinel lymph node evaluation at many institutions. The purpose of this study is to evaluate experience with imprint cytology for intraoperative evaluation of sentinel lymph nodes in patients with breast cancer. Methods: A retrospective review of the intraoperative imprint cytology results of 678 sentinel lymph node mappings for breast carcinoma was performed. Sentinel nodes were evaluated intraoperatively by either bisecting or slicing the sentinel node into 4 mm sections. Imprints were made of each cut surface and stained with H&E and/or Diff-Quik. Permanent sections were evaluated with up to four H&E stained levels and cytokeratin immunohistochemistry. Intraoperative imprint cytology results were compared with final histologic results. Results: The sensitivity of imprint cytology was 53%, specificity was 98%, positive predictive value was 94%, negative predictive value was 82% and accuracy was 84%. The sensitivity for detecting macrometastases ( more than 2mm) was significantly better than for detecting micrometastases (<2 mm), 81 versus 21%, respectively (P < 00001). Conclusions: The sensitivity and

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Section: Abstract: Breast Carcinoma Cytopathology Imprint Metastatmentioning

confidence: 99%

Intraoperative Evaluation of Sentinel Lymph Nodes for Metastatic Breast Carcinoma by Imprint Cytology

et al. 2002

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“…More recently, dye-guided methods using isosulfan blue (Lymphazurin), 1 indigocarmine, 2 and sulphan blue (patent blue violet), 3 and gamma probe-guided methods using RIs, 4-6 as well as combinations of the two (two-mapping procedures), [13][14][15][16] have been reported as methods for identifying SLNs in cases of breast cancer. Although dye-guided methods are inexpensive, the technique involves the demanding task of incision and dissection without inflicting extraneous damage on the tiny lymphatics through which the dye must be delivered to the LNs, and thus requires a highly skilled surgeon.…”

Section: Discussionmentioning

confidence: 99%

New method of sentinel node detection using a combination of contrast-enhanced ultrasound and dye guidance: an animal study

et al. 2006

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“…As a minimally invasive surgical technique for assessing the regional lymph node metastasis from malignancies, sentinel lymph node biopsy (SLNB) has been one of the standard procedures for breast cancer. [1][2][3] For example, the NSABP B-32 enrolled 5,611 patients with clinically negative axillary lymph nodes and operable invasive breast cancer. Their updated follow-up data in 2011 showed that sentinel lymph node (SLN)-negative patients received simple follow-up or conventional axillary lymph node dissection (ALND), and their local control rate, disease-free survival, and overall survival showed no significant differences.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and feasibility of the immunomagnetic separation based diagnosis for detecting sentinel lymph node metastasis from breast cancer

Zhi

Zhang

Meng

et al. 2015

IJN

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A purpose of this study was to establish a novel molecular diagnostic model and provide new insight into the intraoperative evaluation of the sentinel lymph node (SLN) metastasis in breast cancer. A total of 124 breast cancer patients who met the criteria of sentinel lymph node biopsy (SLNB) and underwent intraoperative biopsy were consecutively enrolled in this study. After the SLNs obtained from each patient were labeled, MOC-31 monoclonal antibody-mediated immunomagnetic separation (IMS) and flow cytometry were used to determine the expressions of breast cancer metastasis-related markers, including Mucin 1 (MUC1), CD44v6, and HER2. Alternatively, conventional intraoperative hematoxylin and eosin (HE) staining and cytokeratin immunohistochemistry (CK-IHC) were performed to detect potential SLN metastasis. The sensitivity, specificity, and false-negative rate of the three intraoperative diagnostic methods were compared and analyzed. A total of 55 positive-SLNs were found in 38 breast cancer patients using IMS, yielding a sensitivity of 86.4% (38/44), specificity of 94.7% (36/38), accuracy of 93.5% (116/124), false-positive rate of 2.5% (2/80), false-negative rate of 13.6% (6/44), positive predictive value of 95.5% (42/44), and negative predictive value of 93.0% (80/86). Patients with high expressions of CD44v6, MUC1, and HER2 in SLNs tended to have higher number of positive lymph nodes, among which the MUC1 and HER2 showed significant differences ( P <0.05). Therefore, compared with conventional HE staining and CK-IHC, IMS technology has remarkably higher sensitivity and specificity and relative lower false-negative rate, thus making it an effective and feasible intraoperative detection method of SLN for breast cancer diagnosis to some extent.

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Sentinel lymph node involvement—a predictor for axillary node status with breast cancer—Has the time come?

Cited by 95 publications

References 7 publications

Intraoperative Evaluation of Sentinel Lymph Nodes for Metastatic Breast Carcinoma by Imprint Cytology

Intraoperative Evaluation of Sentinel Lymph Nodes for Metastatic Breast Carcinoma by Imprint Cytology

New method of sentinel node detection using a combination of contrast-enhanced ultrasound and dye guidance: an animal study

Efficacy and feasibility of the immunomagnetic separation based diagnosis for detecting sentinel lymph node metastasis from breast cancer

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