More tumor-affected lymph nodes because of the sentinel lymph node procedure but no stage migration, because the 2002 TNM classifies small tumor deposits as pathologic N0 breast cancer

Cancer ◽  
2009 ◽  
Vol 115 (23) ◽  
pp. 5589-5595 ◽  
Author(s):  
Marieke J. Bolster ◽  
Peter Bult ◽  
Carla A. P. Wauters ◽  
Luc J. A. Strobbe ◽  
Petronella G. M. Peer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Stage Migration ◽  
Sentinel Lymph Node Procedure ◽  
Small Tumor

scholarly journals Do axillary sentinel lymph node micrometastases predict involvement of the non-sentinel lymph nodes in breast cancer?

2013 ◽  
Vol 11 (8) ◽  
pp. 610
Author(s):  
Ashley Topps ◽  
Emma de Sousa ◽  
Katherine McNamara ◽  
Katherine Miller ◽  
Mohammed Absar
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Sentinel Lymph Nodes ◽  
Lymph Node Micrometastases

scholarly journals Identification of the sentinel lymph node using hemosiderin in locally advanced breast cancer

2017 ◽  
Vol 44 (6) ◽  
pp. 612-618
Author(s):  
PAULO HENRIQUE WALTER DE AGUIAR ◽  
RANNIERE GURGEL FURTADO DE AQUINO ◽  
MAYARA MAIA ALVES ◽  
JULIO MARCUS SOUSA CORREIA ◽  
AYANE LAYNE DE SOUSA OLIVEIRA ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Sentinel Lymph Nodes ◽  
Advanced Breast ◽  
Identification Rate

ABSTRACT Objective: to verify the agreement rate in the identification of sentinel lymph node using an autologous marker rich in hemosiderin and 99 Technetium (Tc99) in patients with locally advanced breast cancer. Methods: clinical trial phase 1, prospective, non-randomized, of 18 patients with breast cancer and clinically negative axilla stages T2=4cm, T3 and T4. Patients were submitted to sub-areolar injection of hemosiderin 48 hours prior to sentinel biopsy surgery, and the identification rate was compared at intraoperative period to the gold standard marker Tc99. Agreement between methods was determined by Kappa index. Results: identification rate of sentinel lymph node was 88.9%, with a medium of two sentinel lymph nodes per patients. The study identified sentinel lymph nodes stained by hemosiderin in 83.3% patients (n=15), and, compared to Tc99 identification, the agreement rate was 94.4%. Conclusion: autologous marker rich in hemosiderin was effective to identify sentinel lymph nodes in locally advanced breast cancer patients.

scholarly journals Real-world data: evaluation of sentinel lymph node biopsy after complete pathological response of breast cancer to neoadjuvant chemotherapy in patients with triple-negative and her2 positive breast cancer in a cohort from rio grande do sul, brazil

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Alessandra Borba Anton de Souza ◽  
Nathalia da Cunha Rossato ◽  
Felipe Pereira Zerwes ◽  
Tomas Reinert ◽  
Antonio Luiz Frasson
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Triple Negative ◽  
Pathological Response ◽  
Complete Pathological Response ◽  
Her2 Positive ◽  
Node Disease ◽  
Positive Lymph Nodes

Introduction: International publications show a high correlation of axillary response and complete pathological response (CPR) of breast cancer to neoadjuvant chemotherapy (NACT) in patients with triple-negative (TN) and HER2 positive (HER2+) tumors. The need for surgery is being questioned when percutaneous breast biopsy after NACT indicates CPR, despite recent presentations demonstrating high rates of false-negative (FN), ranging from 17–39%. The proper axillary management in patients with CPR of breast cancer is still discussed: is it possible to avoid the axillary evaluation? What is the axillary downstaging rate? Identifying any residual disease to adjust the adjuvant treatment is also a concern. Retrospective studies reveal a rate of positive lymph nodes lower than 2% in this population when CPR of breast cancer is reached. Objective: To identify the rate of complete axillary response in patients with CPR of breast cancer to NACT in TN and HER2+ tumors. Methods: This is a retrospective cohort study conducted in two health facilities in Southern Brazil. The sample consists of 130 patients who underwent NACT, followed by surgery between January 2016 and December 2018. The patients included were treated in the public health system (Sistema Único de Saúde – SUS) and private health system. Results: Among the 130 patients submitted to NACT, 76 (58%) had HER2+ and TN immunohistochemical subtypes – luminal HER2+: 23 patients, HER2+ pure: 15, TN: 38. Among these patients, 33 (43%) reached CPR of breast cancer, of which 9 corresponded to luminal HER2+, 10 to HER2+, and 14 to TN. In patients with CPR of breast cancer, 29 (87.8%) had no lymph node disease. Out of the 10 HER2+ pure with CPR of breast cancer, 100% had no lymph node disease, and 8 were positive pre-NACT. Among the 14 TN, only 1 patient had 2 positive lymph nodes (2+/10), and she was cN0 prior to NACT (with negative axillary ultrasound). Among the 5 pre-NACT clinically positive lymph nodes in TN patients (including 1 patient with cN2), all had CPR to NACT (3 axillary dissections and 2 sentinel lymph node biopsies – SLNB). Out of the 9 patients with luminal HER and CPR of breast cancer, 4 had clinically positive lymph nodes before NACT, and 3 remained positive (15% of conversion). Conclusion: In this study, CPR of breast cancer was highly correlated with negative axillary evaluation after NACT (87.8%), mainly in the TN and HER2+ pure subtypes (98%), even if the lymph node was clinically positive before NACT, with 100% of conversion of HER 2+ pure cases. SUS patients used trastuzumab as the single drug targeting anti HER2. These data agree with those found in the literature, despite the small sample. Larger studies are necessary, as around 70% of our population depend on SUS. With more published data, considering the performance of SLNB in HER2+ pure and TN patients submitted to NACT could become a common practice, reducing morbidity. The safety of this practice in the luminal HER+ subtype remains unclear.

scholarly journals Factors that affect the false negative rate of sentinel lymph node mapping with methylene blue dye alone in breast cancer

2019 ◽  
Vol 47 (10) ◽  
pp. 4841-4853 ◽  
Author(s):  
Huang Li ◽  
Zhang Jun ◽  
Ge Zhi-Cheng ◽  
Qu Xiang
Keyword(s):  
Breast Cancer ◽  
Methylene Blue ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
False Negative ◽  
False Negative Rate ◽  
Blue Dye ◽  
Methylene Blue Dye ◽  
Clinicopathological Factors

Objective This study aimed to investigate the clinicopathological factors of the false negative rate (FNR) and accuracy of sentinel lymph node biopsy (SLNB) mapping with 1% methylene blue dye (MBD) alone, and to examine how to reduce the FNR in patients with breast cancer. Methods A total of 365 patients with invasive breast carcinoma who received axillary lymph node dissection after SLNB were retrospectively analyzed. SLNB was performed with 2 to 5 mL of 1% MBD. We studied the clinicopathological factors that could affect the FNR of SLNB. Results The identification rate of sentinel lymph nodes (SLNs) was 98.3% (359/365) and the FNR of SLNB was 10.4% (16/154). Multivariate analysis showed that the number of dissected SLNs and metastatic lymph nodes were independent predictive factors for the FNR of SLNB. The FNR in patients with 1, 2, 3, and ≥4 SLNs was 23.53%, 15.79%, 3.85%, and 1.79%, respectively. Conclusions SLNB mapping with MBD alone in patients with breast cancer can produce favorable identification rates. The FNR of SLNB decreases as the number of SLNs rises. Because of side effects of searching for additional SLNs and the FNR, removal of three or four SLNs may be appropriate.

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