scholarly journals Sentinel lymph node versus axillary lymph node dissection for early-stage breast carcinoma

Cancer ◽  
2003 ◽  
Vol 97 (2) ◽  
pp. 359-366 ◽  
Author(s):  
Ashesh B. Jani ◽  
Anirban Basu ◽  
Ruth Heimann ◽  
Samuel Hellman
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Breast Carcinoma ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Early Stage ◽  
Axillary Lymph ◽  
Node Dissection

scholarly journals Intraoperative Assessment of Sentinel Lymph Nodes in Breast Cancer Patients Post-Neoadjuvant Therapy

2019 ◽  
Vol 18 ◽  
pp. 153303381882110 ◽  
Author(s):  
Willard Wong ◽  
Illana Rubenchik ◽  
Sharon Nofech-Mozes ◽  
Elzbieta Slodkowska ◽  
Carlos Parra-Herran ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Neoadjuvant Therapy ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Frozen Section ◽  
Axillary Lymph ◽  
Node Dissection

Background: Shift toward minimizing axillary lymph node dissection in patients with breast cancer post neoadjuvant therapy has led to the assessment of sentinel lymph nodes by frozen section intraoperatively to determine the need for axillary lymph node dissection. However, few studies have examined the accuracy of sentinel lymph node frozen section after neoadjuvant therapy. Our objective is to compare the accuracy of sentinel lymph node frozen section in patients with breast cancer with and without neoadjuvant therapy and to identify features that may influence accuracy. Design: We identified 161 sentinel lymph node frozen section from 77 neoadjuvant therapy patients and 255 sentinel lymph node frozen section from 88 non-neoadjuvant therapy patients diagnosed between 2010 and 2016 in 2 institutions. The frozen section diagnoses were compared to the final diagnoses, and clinicopathologic data were analyzed. Results: The sensitivity, specificity, and accuracy of frozen section analysis were comparable between neoadjuvant therapy patients and non-neoadjuvant therapy patients (71.9% vs 50%, 100% vs 100%, and 88.3% vs 81.8%). Nine (11.7%) of 77 neoadjuvant therapy patients had discordant results, most often due to undersampling (tumor absent on frozen section slide). Four of these patients subsequently underwent axillary lymph node dissection. Discordant results (all false negatives) were significantly more likely in neoadjuvant therapy patients with Estrogen Receptor-positive/HER2-negative status, and in sentinel lymph node with pN1mic and pN0i+ deposits; age, preneoadjuvant therapy lymph node status, histotype, nuclear grade, tumor size, and response to neoadjuvant therapy showed no significant differences. For non-neoadjuvant therapy cases, large tumor size, lobular histotype, and sentinel lymph node with pN1mic and pN0i+ were associated with false-negative frozen section assessment. Conclusion: Sentinel lymph node frozen section diagnosis post-neoadjuvant therapy has comparable sensitivity, specificity, and accuracy to the sentinel lymph node frozen section diagnosis in the non-neoadjuvant therapy setting.

Is completion axillary lymph node dissection necessary in the presence of metastasis in the sentinel lymph node?

2013 ◽  
Vol 39 (5) ◽  
pp. 521
Author(s):  
Arnie Purushotham ◽  
Amalinda Suyoi ◽  
Salena Bains ◽  
Olorunsola Agbaje ◽  
Michael Douek ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Axillary Lymph ◽  
Node Dissection

scholarly journals Quality of Life After Sentinel Lymph Node Biopsy Versus Complete Axillary Lymph Node Dissection in Early Breast Cancer: A 3-Year Follow-up Study

Medicina ◽  
2018 ◽  
Vol 49 (3) ◽  
pp. 18
Author(s):  
Algirdas Boguševičius ◽  
Daiva Čepulienė
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Node Biopsy

Background and Objectives. The rating of life quality may belong to the method of surgical treatment: after the axillary lymph node dissection patients may suffer from arm symptoms; after sentinel lymph node biopsy women may highlight the anxiety about the success of radical treatment. The aim was to assess the influence of sentinel lymph node biopsy on the quality of life of the patients with early stage breast cancer compared with total axillary lymph node dissection. Material and Methods. In a prospective case-control study, 48 patients with early invasive breast cancer and no evidence of lymph nodes involvement underwent breast conserving surgery with sentinel lymph node biopsy. They were grouped as matched pairs with the patients who underwert axillary lymph node dissection, according to the age, TNM stage, localization, hormonal receptor status, and surgical characteristics. Quality of life was evaluated using the QLQ-C30 and QLQ-BR-23 questionnaires before surgery and after 1, 3, 6, 12, and 36 months. Results. The patients who underwent sentinel lymph node biopsy scored better on the emotional functioning, pain, sexual functioning, and future perspective scales in comparison with those who underwent axillary lymph node dissection. The score on the arm symptom scale remained significantly better in the sentinel lymph node biopsy group than the axillary lymph node dissection group within the overall follow-up period. Conclusions. The women who underwent sentinel lymph node biopsy experienced better quality of life than the patients who underwent axillary lymph node dissection.

Axillary Lymph Node Dissection for T1a Breast Carcinoma

1994 ◽  
Vol 49 (7) ◽  
pp. 476
Author(s):  
Melvin J. Silverstein ◽  
Eugene D. Gierson ◽  
James R. Waisman ◽  
Gregory M. Senofsky ◽  
William J. Colburn ◽  
...  
Keyword(s):  
Lymph Node ◽  
Breast Carcinoma ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Axillary Lymph ◽  
Node Dissection

scholarly journals Positive sentinel lymph nodes should be followed by axillary lymph node dissection

2007 ◽  
Vol 10 (5) ◽  
pp. 1-4
Author(s):  
F. Hoehne ◽  
H. Mabry ◽  
A. E. Giuliano
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Survival Advantage ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Term Survival ◽  
Survival Difference

The use of sentinel lymph node biopsy (SLNB) has revolutionized breast surgery for early stage breast cancer. SLNB accurately stages the axilla without the morbidity of axillary lymph node dissection (ALND). While allowing those patients with No disease to avoid a potentially morbid dissection, SLNB is a diagnostic procedure which identifies nodal disease and is not designed to replace ALND in patients with metastatic disease in the axilla. ALND provides regional disease control, assists physicians in making decisions for patients regarding systemic therapy, and may or may not have a survival advantage. The American College of Surgeons Oncology Group Z0011 study was constructed to determine whether there was a survival difference between completion ALND vs. observation in patients with a positive sentinel lymph node (SLN). Without strong data from randomized, controlled trials regarding the locoregional and long-term survival of patients who undergo observation after a positive SLN, patients should be offered completion ALND for a positive SLNB although ALND may offer no survival advantage.

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