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Sentinel Node Breast Biopsy

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181. Use of indocyanine green for detecting sentinel lymph nodes in breast cancer: letter to the editor (Full text)

Use of indocyanine green for detecting sentinel lymph nodes in breast cancer: letter to the editor In a previous issue of the journal, Oldřich Coufal and Vuk Fait reported a pilot study that specifically addressed the use of indocyanine green for detecting sentinel lymph nodes in breast cancer within a European population. They concluded that fluorescence method cannot currently be considered a method fully comparable with using radioisotopes in this setting. We consider that the absence (...) of a learning curve, the low mean of retrieved sentinel nodes, and the possibility that migration of indocyanine green occurred after the initial biopsy limit the strength of their conclusion.

2017 World journal of surgical oncology PubMed abstract

182. Phase-Transition Nanodroplets for Real-Time Photoacoustic/Ultrasound Dual-Modality Imaging and Photothermal Therapy of Sentinel Lymph Node in Breast Cancer (Full text)

Phase-Transition Nanodroplets for Real-Time Photoacoustic/Ultrasound Dual-Modality Imaging and Photothermal Therapy of Sentinel Lymph Node in Breast Cancer Pathological status of lymph nodes (LNs) plays a critical role in staging and treatment for the patients with breast cancer. Sentinel lymph node biopsy has become the standard method in determining pathological status of axillary LNs. Therefore, the determination of sentinel lymph nodes (SLNs) and therapy of metastatic LNs are highly (...) . Additionally, the CNPs are capable of staining lymph nodes, which can contribute significantly to the identification of LNs with naked eyes. With increased laser energy, the CNPs exhibit the high performance in killing the breast cancer cells both in vitro and in vivo, due to the photothermal effect induced from the CNs within CNPs. These results suggest that the developed multifunctional phase-transition nanodroplets have high potential to act as the theranostic agents in both SLNs detection and therapy

2017 Scientific reports PubMed abstract

183. The Pre-Treatment Neutrophil-Lymphocyte Ratio: a Useful Tool in Predicting Non-Sentinel Lymph Node Metastasis in Breast Cancer Cases (Full text)

The Pre-Treatment Neutrophil-Lymphocyte Ratio: a Useful Tool in Predicting Non-Sentinel Lymph Node Metastasis in Breast Cancer Cases Background: The sentinel lymph node (SLN) biopsy is a highly accurate predictor of overall axillary nodal status in early breast cancer patients. There is however, still a debate on which patients with a positive SLN can benefit from axillary lymph node dissection (ALND). Numerous studies have been designed to identify variables that are predictive of non-SLN (...) metastasis to avoid a complete ALND. The aim of this study was to determine whether the pre-treatment neutrophil-lymphocyte ratio (NLR) can be a predictive factor of non-SLN metastasis in early breast cancer patients. Materials and Methods: The records of 214 consecutive patients with cT1-3N0 invasive breast cancer who had undergone intraoperative SLN evaluation at Songklanagarind Hospital between the 1stof March 2011 and the 30thof May 2016 were examined. Data on patient demographics, tumor variables

2017 Asian Pacific journal of cancer prevention : APJCP PubMed abstract

184. Imprint cytology versus frozen section analysis for intraoperative assessment of sentinel lymph node in breast cancer (Full text)

Imprint cytology versus frozen section analysis for intraoperative assessment of sentinel lymph node in breast cancer Sentinel lymph node (SLN) biopsy is the gold standard for surgical staging of the axilla in breast cancer (BC). Frozen section (FS) remains the most popular means of intraoperative SLN diagnosis. Imprint cytology (IC) has also been suggested as a less expensive and equally accurate alternative to FS. The aim of our study was to perform a direct comparison between IC and FS (...) on the same SLNs of BC cases operated in a single center by the same surgical team.Into this prospective study we enrolled 60 consecutive patients with histologically proven T1-T3 BC and clinically negative axilla. Sentinel nodes were detected using a standard protocol. The SLN(s) was always assessed by IC as well as FS analysis and immunohistochemistry. Nevertheless, all intraoperative decisions were based on FS analysis.During the study period 60 patients with invasive BC were registered, with 80 SLNs

2017 Breast Cancer : Targets and Therapy PubMed abstract

185. Intramammary sentinel lymph node with capsular extravasation in breast cancer (Full text)

Intramammary sentinel lymph node with capsular extravasation in breast cancer Sentinel lymph node biopsy has been developed as the standard of treatment in breast cancer. Status of axillary sentinel lymph node is known to be a significant prognostic factor. Nevertheless, involvement of an intramammary lymph node with metastasis in breast cancer is a rare radiological and clinical presentation, and with extracapsular extravasation even more uncommon. Historically, reported series of patients (...) with intramammary lymph node diagnosed by final histological examination are small in number and clinical significance of metastasis is still unclear. Here, we report a case of conservative breast cancer surgery with 3 intramammary sentinel lymph nodes containing metastasis and extracapsular extravasation. After multidisciplinary consensus, the patient was surgically reapproached with mastectomy. Even though the 3 intramammary sentinel lymph nodes were positive for metastases, pathology examination did

2017 Annals of surgical treatment and research PubMed abstract

186. Identification of sentinel lymph nodes by contrast‐enhanced ultrasonography with Sonazoid in patients with breast cancer: a feasibility study in three hospitals (Full text)

Identification of sentinel lymph nodes by contrast‐enhanced ultrasonography with Sonazoid in patients with breast cancer: a feasibility study in three hospitals The aim of this prospective study was to evaluate the feasibility of periareolar injection of the contrast agent Sonazoid (SNZ) followed by ultrasonography (US) for the identification of sentinel lymph node (SLN) in breast cancer patients with clinically negative node. Patients (n = 100) with T1-2N0M0 breast cancer received (...) a periareolar injection of SNZ followed by US to identify contrast-enhanced SLN. Each contrast-enhanced SLN underwent fine needle aspiration cytology (FNAC) followed by SLN biopsy with a conventional method using blue dye and/or radiocolloid (B/R). In almost all cases, contrast-enhanced lymphatic vessels were clearly visualized by US soon after the periareolar injection of SNZ and the SLNs were easily identified with an identification rate of 98% (98/100) for SNZ and 100% (100/100) for B/R. The number

2017 Cancer medicine PubMed abstract

187. Predictive Value of Clinicopathological Characteristics for Sentinel Lymph Node Metastasis in Early Breast Cancer (Full text)

Predictive Value of Clinicopathological Characteristics for Sentinel Lymph Node Metastasis in Early Breast Cancer BACKGROUND Sentinel lymph node biopsy (SLNB) is one of the preferred treatments for breast cancer including clinically negative lymph node breast cancer. However, for 60-70% of patients this invasive axilla surgery is unnecessary. Our study aimed to identify the predictors for sentinel lymph node (SLN) metastasis in early breast cancer patients and provide evidence for rational (...) decision-making in specified clinical situations. MATERIAL AND METHODS Medical records of 417 breast cancer patients who were treated with a breast surgical procedure and SLNB in Ningbo Medical Center Lihuili Eastern Hospital were retrospectively reviewed. Univariate analysis and multivariate logistic regression analysis were used to analyze the correlation between SLN metastasis and clinicopathological characteristics, including patient age, menstrual status, body mass index (BMI), family history

2017 Medical science monitor : international medical journal of experimental and clinical research PubMed abstract

188. An Ultralow-Dose 1-Day Protocol With Activities Lower Than 20 MBq for the Detection of Sentinel Lymph Nodes in Breast Cancer—Experiences After 150 Cases (Full text)

An Ultralow-Dose 1-Day Protocol With Activities Lower Than 20 MBq for the Detection of Sentinel Lymph Nodes in Breast Cancer—Experiences After 150 Cases Common protocols for the detection of sentinel lymph nodes in early breast cancer often include the injection of the tracer 1 day before surgery. In order to detect enough activity on the day of surgery, the applied activity in many protocols is as high as several hundred MBq. So far, very few protocols with an activity below 20 MBq have been (...) reported. We developed an ultralow-dose 1-day protocol with a mean activity lower than 20 MBq in order to reduce radiation exposure for patients and staff. Here, we are presenting our experiences in 150 consecutive cases.A total of 150 patients with clinically and sonographically negative axilla and no multicentricity underwent a sentinel lymph node biopsy using an ultralow-dose protocol performed on the day of surgery. No patient received systemic therapy prior to sentinel node biopsy. After

2017 Technology in cancer research & treatment PubMed abstract

189. Analysis of Undesirable Sequelae of Sentinel Node Surgery in Breast Cancer Patients – a Prospective Cohort Study (Full text)

Analysis of Undesirable Sequelae of Sentinel Node Surgery in Breast Cancer Patients – a Prospective Cohort Study Use of sentinel lymph node biopsy limits the frequency and severity of sequelae of surgical treatment. However, the procedure itself may not be completely free of complications. The goal of this work was to analyze prospectively the occurrence of undesirable sequelae in patients undergoing sentinel lymph node biopsy as an isolated intervention in the axillary fossa (...) statistically significant differences, such as limited mobility in the shoulder joint (p ≤ 0.01), gradual increase in limb circumference on the operated side (p < 0.01) and pain (p ≤ 0.01). Despite relatively low invasiveness of the procedure, sentinel lymph node biopsy is not entirely devoid of the risk of undesirable sequelae.

2017 Pathology Oncology Research PubMed abstract

190. Frozen section evaluation of sentinel lymph nodes in breast carcinoma: a retrospective analysis (Full text)

Frozen section evaluation of sentinel lymph nodes in breast carcinoma: a retrospective analysis To determine the false-negative rate, sensitivity, and diagnostic accuracy of the frozen section analysis of the sentinel lymph node (SLN) biopsy in early-stage breast cancer compared to the definitive section and to identify the factors that could be associated with the appearance of false-negative cases. Secondarily, to evaluate the pathological results of cases submitted to completion axillary (...) lymph node dissection (ALND) for positive SLN.We performed a five-year review of cases (2011-2015), including patients with early-stage breast cancer undergoing SLN biopsy, with frozen section evaluation and subsequent definitive pathological analysis. These results were compared to calculate the false-negative rate and the factors associated with it. The histopathological findings were also evaluated in patients submitted to completion ALND.A total of 281 patients were evaluated, identifying 18

2017 Ecancermedicalscience PubMed abstract

191. Does Lymph Node Status Prior to Neoadjuvant Chemotherapy Influence the Number of Sentinel Nodes Removed? (Full text)

Does Lymph Node Status Prior to Neoadjuvant Chemotherapy Influence the Number of Sentinel Nodes Removed? Recent prospective trials support the use of sentinel lymph node biopsy (SLNB) in breast cancer patients after neoadjuvant chemotherapy (NAC) with a lower false-negative rate if three or more sentinel lymph nodes (SLNs) are identified. In this study, we investigated whether the pre-NAC axillary lymph node status influences the number of SLNs identified.Stage I-III breast cancer patients who (...) received NAC and underwent SLNB from May 2014 to April 2016 were identified from an institutional prospective database. Clinical and pathological factors among clinically node-negative (cN-) and clinically node-positive (cN+) patients who converted to cN- post-NAC were compared. Generalized linear mixed models analyzed factors associated with the number of SLNs removed.Among 343 patients who underwent SLNB during the study period, 335 (98%) had at least one SLN identified, and subsequently comprised

2018 Annals of Surgical Oncology PubMed abstract

192. Sentinel lymph node biopsy using indocyanine green fluorescence in early-stage breast cancer: a meta-analysis. (Abstract)

Sentinel lymph node biopsy using indocyanine green fluorescence in early-stage breast cancer: a meta-analysis. Sentinel lymph node (SLN) biopsy using indocyanine green (ICG) fluorescence is safe and has a high detection rate for SLNs. However, the results of this novel technique are heterogeneous. The objective of this meta-analysis was to evaluate the diagnostic performance of the ICG fluorescence method compared with the standard radioisotope (RI) method. All eligible studies were identified (...) detection and shows a trend toward better axilla staging compared with the RI method. ICG fluorescence is a useful alternative to RI for SLN biopsy.

2016 International journal of clinical oncology

193. Troubleshooting Sentinel Lymph Node Biopsy in Breast Cancer Surgery. (Full text)

Troubleshooting Sentinel Lymph Node Biopsy in Breast Cancer Surgery. Performing a sentinel lymph node biopsy (SLNB) is the standard of care for axillary nodal staging in patients with invasive breast cancer and clinically negative nodes. The procedure provides valuable staging information with few complications when performed by experienced surgeons. However, variation in proficiency exists for this procedure, and a great amount of experience is required to master the technique, especially when (...) faced with challenging cases. The purpose of this paper was to provide a troubleshooting guide for commonly encountered technical difficulties in SLNB, and offer potential solutions so that surgeons can improve their own technical performance from the collective knowledge of experienced specialists in the field.Information was obtained from a convenience sample of six experienced breast cancer specialists, each actively involved in training surgeons and residents/fellows in SLNB. Each surgeon

2016 Annals of Surgical Oncology PubMed abstract

194. Meta-analysis of sentinel lymph node biopsy in breast cancer using the magnetic technique. (Abstract)

Meta-analysis of sentinel lymph node biopsy in breast cancer using the magnetic technique. The standard for sentinel lymph node biopsy (SLNB), the dual technique (radiolabelled tracer and blue dye), has several drawbacks. A novel magnetic technique without these drawbacks has been evaluated in a number of clinical trials. It uses a magnetic tracer and a handheld magnetometer to identify and excise sentinel lymph nodes. A systematic review and meta-analysis was performed to assess (...) the performance and utility of the magnetic in comparison to the standard technique.MEDLINE, PubMed, Embase and the Cochrane online literature databases were used to identify all original articles evaluating the magnetic technique for SLNB published up to April 2016. Studies were included if they were prospectively conducted clinical trials comparing the magnetic with the standard technique for SLNB in patients with breast cancer.Seven studies were included. The magnetic technique was non-inferior

2016 The British journal of surgery

195. The interplay between hospital and surgeon factors and the use of sentinel lymph node biopsy for breast cancer. (Full text)

The interplay between hospital and surgeon factors and the use of sentinel lymph node biopsy for breast cancer. Several surgeon characteristics are associated with the use of sentinel lymph node biopsy (SLNB) for breast cancer. No studies have systematically examined the relative contribution of both surgeon and hospital factors on receipt of SLNB.To evaluate the relationship between surgeon and hospital characteristics, including a novel claims-based classification of hospital commitment (...) to cancer care (HC), and receipt of SLNB for breast cancer, a marker of quality care.Observational prospective survey study was performed in a population-based cohort of Medicare beneficiaries who underwent incident invasive breast cancer surgery, linked to Medicare claims, state tumor registries, American Hospital Association Annual Survey Database, and American Medical Association Physician Masterfile. Multiple logistic regression models determined surgeon and hospital characteristics that were

2016 Medicine PubMed abstract

196. Preliminary results for treatment of early stage breast cancer with endoscopic subcutaneous mastectomy combined with endoscopic sentinel lymph node biopsy in China. (Abstract)

Preliminary results for treatment of early stage breast cancer with endoscopic subcutaneous mastectomy combined with endoscopic sentinel lymph node biopsy in China. To evaluate efficacy and aesthetic outcome for combined endoscopic subcutaneous mastectomy (E-SM) and endoscopic sentinel lymph node biopsy (E-SLNB) in early stage breast cancer patients.Combined E-SM+E-SLNB was compared to modified radical resection in a cohort of Chinese patients (n = 49) with stages I and II breast cancer (...) patients rated satisfaction with their appearance as excellent or good (23/24; 95.8% vs. 19/25; 76.0%; P < 0.001), and exhibited less disturbance of sensory (P < 0.001) and motor function (P = 0.014) relative to modified radical resection.E-SM+E-SLNB provides significant aesthetic and functional advantages for patients with early stage breast cancer without compromising medical efficacy as assessed at 16 months postsurgery. J. Surg. Oncol. 2016;113:616-620. © 2016 Wiley Periodicals, Inc.© 2016 Wiley

2016 Journal of Surgical Oncology

197. Successful Completion of the Pilot Phase of a Randomized Controlled Trial Comparing Sentinel Lymph Node Biopsy to No Further Axillary Staging in Patients with Clinical T1-T2 N0 Breast Cancer and Normal Axillary Ultrasound. (Full text)

Successful Completion of the Pilot Phase of a Randomized Controlled Trial Comparing Sentinel Lymph Node Biopsy to No Further Axillary Staging in Patients with Clinical T1-T2 N0 Breast Cancer and Normal Axillary Ultrasound. Axillary surgery is not considered therapeutic in patients with clinical T1-T2 N0 breast cancer. The importance of axillary staging is eroding in an era in which tumor biology, as defined by biomarker and gene expression profile, is increasingly important in medical decision (...) making. We hypothesized that axillary ultrasound (AUS) is a noninvasive alternative to sentinel lymph node biopsy (SLNB), and AUS could replace SLNB without compromising patient care.Patients with clinical T1-T2 N0 breast cancer and normal AUS were eligible for enrollment. Subjects were randomized to no further axillary staging (arm 1) vs SLNB (arm 2). Descriptive statistics were used to describe the results of the pilot phase of the randomized controlled trial.Sixty-eight subjects were enrolled

2016 Journal of the American College of Surgeons Controlled trial quality: uncertain PubMed abstract

198. Diagnostic Performance of Indocyanine Green-Guided Sentinel Lymph Node Biopsy in Breast Cancer: A Meta-Analysis. (Full text)

Diagnostic Performance of Indocyanine Green-Guided Sentinel Lymph Node Biopsy in Breast Cancer: A Meta-Analysis. The diagnostic performance of indocyanine green (ICG) fluorescence-guided sentinel lymph node biopsy (SLNB) for the presence of metastases in breast cancer remains unclear.We performed a meta-analysis to investigate the diagnostic performance of ICG-guided SLNB.Eligible studies were identified from searches of the databases PubMed and EMBASE up to September 2015. Studies (...) (95% confidence interval [CI], 0.96-0.99). Six studies finally met the criteria for meta-analysis, which yielded a pooled sensitivity of 0.92 (95% CI, 0.85-0.96), specificity 1 (95% CI, 0.97-1), and DOR 311.47 (95% CI, 84.11-1153.39). The area under the SROC was 0.9758. No publication bias was found.ICG fluorescence-guided SLNB is viable for detection of lymph node metastases in breast cancer. Large-scale randomized multi-center trials are necessary to confirm our results.

2016 PloS one PubMed abstract

199. Sentinel lymph node biopsy and aberrant lymphatic drainage in recurrent breast cancer: Findings likely to change treatment decisions. (Abstract)

Sentinel lymph node biopsy and aberrant lymphatic drainage in recurrent breast cancer: Findings likely to change treatment decisions. It is not clear whether sentinel lymph node biopsy (SLNB) can be applied to patients with a second breast cancer or recurrence occurring at previously treated breast. The purpose of this study was to assess the feasibility of SLNB procedure in patients with recurrent breast cancer.Patients with non-metastatic recurrent N0 breast cancer at ipsilateral breast were (...) underwent axillary lymph node dissection (ALND) (44.2%; P = 0,002). Aberrant lymphatic drainage was detected in 64.3% of drainage positive patients. Success rate of reoperative SLNB was 92.9%. Adjuvant treatment plan was altered in 12 (16%) patients. In 15 patients, negative SLNB prevented axillary dissection.Reoperative SLNB seems to be technically feasible in N0 recurrent breast cancer patients. It may further avoid unnecessary ALND and lead changes in adjuvant treatment plans. J. Surg. Oncol

2016 Journal of Surgical Oncology

200. Percutaneous Sentinel Node Biopsy in Breast Cancer: Results of a Phase 1 Study. (Abstract)

Percutaneous Sentinel Node Biopsy in Breast Cancer: Results of a Phase 1 Study. While sentinel lymph node dissection (SLND) provides axillary staging, recent trials question the necessity of removing positive nonsentinel axillary lymph nodes (LN) in breast cancer. We sought to determine the technical feasibility of percutaneous core needle biopsy (PNB) of axillary sentinel lymph nodes (SLNs).After dual tracer injection, 25 patients underwent intraoperative axillary ultrasound and ultrasound (...) of PNB at the SLN was found in 76 % (19 of 25) of cases. Blue staining, radioisotope, and pathology matched in core and SLN specimens in 36 % (9 of 25), 64 % (16 of 25), and 72 % (18 of 25) of cases, respectively. Overall, successful correlation of core biopsy with SLN occurred in 72 % (18 of 25) of cases.Results of this phase I study demonstrate that PNB of the SLN is technically feasible, but further refinement of technique is warranted to improve correlation of core biopsy to SLND.

2016 Annals of Surgical Oncology

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