The prognostic impact of occult nodal metastasis in early breast carcinoma

Park, Daehoon; Kåresen, Rolf; Naume, Bjørn; Synnestvedt, Marit; Beraki, Elsa; Sauer, Torill

doi:10.1007/s10549-009-0340-2

Cited by 24 publications

(28 citation statements)

References 32 publications

(55 reference statements)

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“…This finding is in close agreement with 2% to 9% false negatives reported in previous studies [26][27][28]. However, with further sectioning and staining, more micrometastases or ITCs can be detected, resulting in false-negative rates as high as 31% [29].…”

Section: False-negative Casessupporting

confidence: 92%

False-positive and false-negative sentinel node findings in 473 breast cancers

2012

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Section: False-negative Casessupporting

confidence: 92%

False-positive and false-negative sentinel node findings in 473 breast cancers

2012

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“…Indeed, most of the studies conducted so far suffered from limited sample sizes [2,3,6,7,11,15,21,26,30,[58][59][60]. Moreover, the accuracy of analysis has been extremely heterogeneous among studies, ranging from a single section in a single lymph node to the systematic analysis of all dissected axillary lymph nodes [4].…”

Section: Discussionmentioning

confidence: 99%

Sentinel Node and Bone Marrow Micrometastases and Nanometastases

Biganzoli

Pedriali

Querzoli

et al. 2010

Curr Breast Cancer Rep

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Step-sectioning and anti-cytokeratin immunohistochemistry allow detection of micrometastases and nanometastases down to the single cell level, but they are labor intensive and time consuming. Reverse-transcription polymerase chain reaction can be performed efficiently, but it cannot currently detect less than several thousand cancer cells per lymph node. Improvements in molecular assays are thus required for reliable use in clinical settings. Wholeaxilla dissection maximizes chances of detecting micrometastases and nanometastases. However, sentinel lymph node analysis provides an important fraction of this information in more convenient surgical and laboratory settings. Nanometastases have been shown to be a risk factor for event-free survival and for metastatic relapse. Thus, a re-evaluation of current TNM staging procedures appears needed. Corresponding therapeutic strategies should be tested accordingly in prospective clinical trials with adequate follow-up time. Microinvasion of the bone marrow is an independent prognostic indicator for disease recurrence and death from cancer, but bone marrow analyses are poorly suited to monitor disease course and response to therapy. The detection of circulating tumor cells has been shown to provide useful prognostic information, but it correlates poorly with bone marrow microinvasion, and the latter remains an independent, albeit hard to manage, prognostic determinant.

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“…The presence of micrometastatic breast lesions (Ͻ2 mm) is correlated with poor clinical prognosis and decreased patient survival rate (Alix-Panabieres et al, 2007;Park et al, 2009). However, using current imaging methods to detect breast tumor micrometastases or monitor response to therapies remains a significant clinical challenge.…”

Section: Introductionmentioning

confidence: 99%

Clearance and Biodistribution of Liposomally Encapsulated Nitroxides: A Model for Targeted Delivery of Electron Paramagnetic Resonance Imaging Probes to Tumors

Burks¹,

Legenzov²,

Rosen³

et al. 2011

Drug Metab Dispos

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ABSTRACT:Electron paramagnetic resonance (EPR) imaging using nitroxides as molecular probes is potentially a powerful tool for the detection and physiological characterization of micrometastatic lesions. Encapsulating nitroxides in anti-HER2 immunoliposomes at high concentrations to take advantage of the "self-quenching" phenomenon of nitroxides allows generation of robust EPR signals in HER2-overexpressing breast tumor cells with minimal background from indifferent tissues or circulating liposomes. We investigated the in vivo pharmacological properties of nitroxides encapsulated in sterically stabilized liposomes designed for long circulation times. We show that circulation times of nitroxides can be extended from hours to days; this increases the proportion of liposomes in circulation to enhance tumor targeting. Furthermore, nitroxides encapsulated in sterically stabilized anti-HER2 immunoliposomes can be delivered to HER2-overexpressing tumors at micromolar concentrations, which should be imageable by EPR. Lastly, after in vivo administration, liposomally encapsulated nitroxide signal also appears in the liver, spleen, and kidneys. Although these organs are spatially distinct and would not hinder tumor imaging in our model, understanding nitroxide signal retention in these organs is essential for further improvements in EPR imaging contrast between tumors and other tissues. These results lay the foundation to use liposomally delivered nitroxides and EPR imaging to visualize tumor cells in vivo.

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The prognostic impact of occult nodal metastasis in early breast carcinoma

Cited by 24 publications

References 32 publications

False-positive and false-negative sentinel node findings in 473 breast cancers

False-positive and false-negative sentinel node findings in 473 breast cancers

Sentinel Node and Bone Marrow Micrometastases and Nanometastases

Clearance and Biodistribution of Liposomally Encapsulated Nitroxides: A Model for Targeted Delivery of Electron Paramagnetic Resonance Imaging Probes to Tumors

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