Update on Sentinel Lymph Node Methods and Pathology in Breast Cancer

Zhang-Yin, Jules; Mauel, Etienne; Talpe, Stéphanie

doi:10.3390/diagnostics14030252

Cited by 2 publications

(1 citation statement)

References 96 publications

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“…ALN metastases occur in fewer than 20% of early-stage breast tumors that are <1.5 cm in diameter, which has ramifications for the staging and prognosis of patients with BC ( 2 , 3 ). Moreover, the SLN technique is highly valuable for improving the quality of life of patients, as it can help prevent unnecessary ALN dissection, thereby reducing the length of hospitalization, the risk of infection in the axillary fossa, and the risk of lymphedema ( 4 ). Hence, determination of preoperative SLN status is crucial for accurate clinical staging and individualized treatment in patients with BC ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Evaluating the added value of synthetic magnetic resonance imaging in predicting sentinel lymph node status in breast cancer

Yang,

Lu,

Tan

et al. 2024

Quant Imaging Med Surg

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Background The noninvasive prediction of sentinel lymph node (SLN) metastasis using quantitative magnetic resonance imaging (MRI), particularly with synthetic MRI (syMRI), is an emerging field. This study aimed to explore the potential added benefits of syMRI over conventional MRI and diffusion-weighted imaging (DWI) in predicting metastases in SLNs. Methods This retrospective study consecutively enrolled 101 patients who were diagnosed with breast cancer (BC) and underwent SLN biopsy from December 2022 to October 2023 at the Affiliated Hospital of Jiangnan University. These patients underwent preoperative MRI including conventional MRI, DWI, and syMRI and were categorized into two groups according to the postoperative pathological results: those with and without metastatic SLNs. MRI morphological features, DWI, and syMRI-derived quantitative parameters of breast tumors were statistically compared between these two groups. Binary logistic regression was used to separately develop predictive models for determining the presence of SLN involvement, with variables that exhibited significant differences being incorporated. The performance of each model was evaluated through receiver operating characteristic (ROC) curve analysis, including the area under the curve (AUC), sensitivity, and specificity. Results Compared to the group of 54 patients with BC but no metastatic SLNs, the group of 47 patients with BC and metastatic SLNs had a significantly larger maximum axis diameter [metastatic SLNs: median 2.40 cm, interquartile range (IQR) 1.50–3.00 cm; no metastatic SLNs: median 1.80 cm, IQR 1.37–2.50 cm; P=0.03], a higher proton density (PD) (78.44±11.92 vs. 69.20±10.63 pu; P<0.001), and a lower apparent diffusion coefficient (ADC) (metastatic SLNs: median 0.91×10 −3 mm 2 /s, IQR 0.79–1.01 mm 2 /s; no metastatic SLNs: median 1.02×10 −3 mm 2 /s, IQR 0.92–1.12 mm 2 /s; P=0.001). Moreover, the prediction model with maximum axis diameter and ADC yielded an AUC of 0.71 [95% confidence interval (CI): 0.618–0.802], with a sensitivity of 78.72% and a specificity of 51.85%; After addition of syMRI-derived PD to the prediction model, the AUC increased significantly to 0.86 (AUC: 0.86 vs. 0.71; 95% CI: 0.778–0.922; P=0.002), with a sensitivity of 80.85% and a specificity of 81.50%. Conclusions Combined with conventional MRI and DWI, syMRI can offer additional value in enhancing the predictive performance of determining SLN status before surgery in patients with BC.

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Section: Introductionmentioning

confidence: 99%

Evaluating the added value of synthetic magnetic resonance imaging in predicting sentinel lymph node status in breast cancer

Yang,

Lu,

Tan

et al. 2024

Quant Imaging Med Surg

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Melanin-Based Nanoparticles for Lymph Node Tattooing: Experimental, Histopathological and Ultrastructural Study

Baselga,

Güemes,

Yus

et al. 2024

Nanomaterials

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In breast cancer, Targeted Axillary Dissection (TAD) allows for the selective excision of the sentinel lymph node (SLN) during primary tumor surgery. TAD consists of the resection of labelled SLNs prior to neoadjuvant chemotherapy (NACT). Numerous clinical and preclinical studies have explored the use of carbon-based colloids for SLN tattooing prior to NACT. However, carbon vectors show varying degrees of inflammatory reactions and, in about one fifth of cases, carbon particles migrate via the lymphatic pathway to other nodes, causing the SLN to mismatch the tattooed node. To overcome these limitations, in this study, we explored the use of melanin as a staining endogenous pigment. We synthesized and characterized melanin-loaded polymeric nanoparticles (Mel-NPs) and used them to tattoo lymph nodes in pig animal models given the similarity in the size of the human and pig nodes. Mel-NPs tattooed lymph nodes showed high identification rates, reaching 83.3% positive identification 16 weeks after tattooing. We did not observe any reduction in the identification as time increased, implying that the colloid is stable in the lymph node tissue. In addition, we performed histological and ultrastructural studies to characterize the biological behavior of the tag. We observed foreign-body-like granulomatous inflammatory responses associated with Mel-NPs, characterized by the formation of multinucleated giant cells. In addition, electron microscopy studies showed that uptake is mainly performed by macrophages, and that macrophages undergo cellular damage associated with particle uptake.

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Update on Sentinel Lymph Node Methods and Pathology in Breast Cancer

Cited by 2 publications

References 96 publications

Evaluating the added value of synthetic magnetic resonance imaging in predicting sentinel lymph node status in breast cancer

Evaluating the added value of synthetic magnetic resonance imaging in predicting sentinel lymph node status in breast cancer

Melanin-Based Nanoparticles for Lymph Node Tattooing: Experimental, Histopathological and Ultrastructural Study

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