scholarly journals Axillary Irradiation as an Imperative Alternative to Axillary Dissection in Clinically Lymph Node-Negative but Sentinel Node-Positive Breast Cancer Patients?

Breast Care ◽  
2011 ◽  
Vol 6 (5) ◽  
pp. 353-358
Author(s):  
Mirko Nitsche ◽  
Robert Hermann
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Node ◽  
Cancer Patients ◽  
Axillary Dissection ◽  
Breast Cancer Patients ◽  
Node Negative ◽  
Node Positive ◽  
Positive Breast Cancer

Sentinel node positive breast cancer patients who do not undergo axillary dissection: Are they different?

Surgery ◽  
2008 ◽  
Vol 143 (5) ◽  
pp. 641-647 ◽  
Author(s):  
Shaheen Zakaria ◽  
Gouri Pantvaidya ◽  
Carol A. Reynolds ◽  
Clive S. Grant ◽  
Sylvester Sterioff ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Sentinel Node ◽  
Cancer Patients ◽  
Axillary Dissection ◽  
Breast Cancer Patients ◽  
Node Positive ◽  
Positive Breast Cancer

scholarly journals Selective Extirpation of Tattooed Lymph Node in Combination with Sentinel Lymph Node Biopsy in the Management of Node-Positive Breast Cancer Patients after Neoadjuvant Systemic Therapy

Breast Care ◽  
2021 ◽  
pp. 1-7
Author(s):  
Lukas Dostalek ◽  
Andrej Cerny ◽  
Petra Saskova ◽  
David Pavlista
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Axillary Dissection ◽  
Breast Cancer Patients ◽  
Final Histology ◽  
Node Positive ◽  
Positive Breast Cancer

Introduction: Axillary dissection has little diagnostic and therapeutic benefit in node-positive breast cancer patients in whom axillary disease has been completely eradicated after neoadjuvant chemotherapy (ypN0). We sought to assess the efficacy of an algorithm used for the identification of the ypN0 patient consisting of intraoperative evaluation of sentinel and tattooed (initially positive) lymph nodes. Methods: Included were T1 and T2 breast cancer patients with 1–3 positive axillary lymph nodes marked with carbon who were referred for neoadjuvant chemotherapy followed by a surgery. Axillary dissection was performed only in the patients with residual axillary disease after neoadjuvant chemotherapy on ultrasound or with metastases described in the sentinel or tattooed lymph nodes either intraoperatively or in the final histology. Results: Out of 62 initially included node-positive patients, 15 (24%) were spared axillary dissection. The detection rate of tattooed lymph nodes after neoadjuvant chemotherapy was 81%. The ypN0 patients were identified with 91% sensitivity and 38% specificity using ultrasound and intraoperative assessment of both sentinel and tattooed lymph node according to the final histology. Discussion/Conclusion: Lymph node marking with carbon dye is a useful and cost-effective method, which can be successfully implemented in order to reduce the number of patients undergoing axillary dissection. Low specificity of the presented algorithm was caused mostly by the overestimation of residual axillary disease on ultrasound.

scholarly journals Minimize the extent and morbidity of axillary dissection for node-positive breast cancer patients: implementation of axillary lymph node dissection based on breast lymphatics level

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qianqian Yuan ◽  
Jinxuan Hou ◽  
Yukun He ◽  
Yiqian Liao ◽  
Lewei Zheng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Axillary Dissection ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Node Dissection ◽  
Node Positive ◽  
Surgical Extent ◽  
Positive Breast Cancer

Abstract Background Breast cancer-related lymphedema (BCRL) is associated with extensive axillary dissection. Axillary lymph node dissection (ALND) based on breast lymphatics level (BLL) was proposed to minimize the surgical extent for node-positive breast cancer patients. Methods A total of 156 consecutive sentinel lymph node-positive (SLN+) or clinically node-positive (cN+) patients underwent sentinel lymph node biopsy (SLNB) with indocyanine green and methylene blue (MB). The SLNs were injected with 0.1 ml MB before removal, and a standard ALND was subsequently performed. The nodes adjacent to the blue-stained axillary lymph nodes from the breast (bALNs) were sent for pathological examination separately by resecting serial tissue every 0.5 cm away from the marginal blue-stained bALNs. Then, a pilot study comparing ALND based on BLL and standard ALND was performed. Results BLL were successfully identified in 20 SLN+ (100%) and 134 cN+ (98.5%) patients. The median number of BLL was four, ranging from three to six. A horizontal line 1.0 cm away from the superior blue-stained bALN and a vertical line 1.0 cm away from the medial blue-stained bALN formed BLL II, III, and IV. All of the additional positive nodes were within 1.0 cm of the blue-stained bALNs. The minimized axillary dissection should resect upwards from the lowest BLL that contains the first confirmed negative blue-stained bALNs. In the pilot study, no patient developed axillary recurrence. Conclusion The ALND surgical procedure based on BLL could minimize the surgical extent for pathological node-positive breast cancer patients and potentially reduce the BCRL rate. Trial registration ChiCTR1800014247.

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