Analysis of predictive tools for further axillary involvement in patients with sentinel lymph node positive small (≤15 mm) invasive breast cancer

2009 ◽  
Vol 150 (48) ◽  
pp. 2182-2188 ◽  
Author(s):  
Gábor Cserni ◽  
Rita Bori ◽  
István Sejben ◽  
Gábor Boross ◽  
Róbert Maráz ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Node ◽  
Axillary Dissection ◽  
Axillary Lymph ◽  
Breast Cancers ◽  
Predictive Tools ◽  
Sentinel Node Metastasis ◽  
Node Metastasis ◽  
Small Breast

Small breast cancers often require different treatment than larger ones. The frequency and predictability of further nodal involvement was evaluated in patients with positive sentinel lymph nodes and breast cancers ≤15 mm by means of 8 different predictive tools. Of 506 patients with such small tumors 138 with positive sentinel nodes underwent axillary dissection and 39 of these had non-sentinel node involvement too. The Stanford nomogram and the micrometastatic nomogram were the predictive tools identifying a small group of patients with low probability of further axillary involvement that might not require completion axillary lymph node dissection. Our data also suggest that the Tenon score can separate subsets of patients with a low and a higher risk of non-sentinel node metastasis. Predictive tools based on multivariate models can help in omitting completion axillary dissection in patients with low risk of non-sentinel lymph node metastasis based on their small tumor size.

scholarly journals Survival and recurrence with or without axillary dissection in patients with invasive breast cancer and sentinel node metastasis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Vanessa Monteiro Sanvido ◽  
Simone Elias ◽  
Gil Facina ◽  
Silvio Eduardo Bromberg ◽  
Afonso Celso Pinto Nazário
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Node ◽  
Lymph Node Dissection ◽  
Locoregional Recurrence ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Sentinel Node Metastasis ◽  
Node Metastasis

AbstractTo evaluate overall survival and locoregional recurrence between patients with invasive breast tumours and sentinel node metastasis undergoing sentinel lymph node dissection (SLND) alone and those undergoing complete axillary lymph node dissection (ALND). In this retrospective cohort study, we reviewed the medical records of patients with invasive breast carcinoma who underwent lumpectomy at a public university hospital in Brazil between 2008 and 2018. We evaluated the overall survival and the locoregional recurrence using Kaplan–Meier and Cox regression analyses, respectively. Overall, 97 participants who underwent lumpectomy were enroled; 41 in the ALND group, and 56 in the SLND group, according to Z0011 criteria. Only 17% of the patients in the ALND group had an additional biopsy-proven axillary disease, and 83% were treated with complete dissection unnecessarily. The 5-year survival rates were 80.1% and 87.5% for SLND and ALND, respectively (p = 0.376). Locoregional recurrence was rare (1.7% and 7.3% in the SLND and ALND, respectively; p = 0.3075). Overall survival and locoregional recurrence were similar between the two groups. The de-escalation of ALND to SLND in women with metastasis in the sentinel lymph node treated with conservative surgery and radiotherapy that meet the Z0011 criteria is feasible even in developing countries.

scholarly journals Targeted axillary dissection in breast cancer by marking lymph node metastasis with a magnetic seed before starting neoadjuvant treatment

2019 ◽  
Vol 2019 (11) ◽  
Author(s):  
Joaquín Luis García-Moreno ◽  
Ana María Benjumeda-Gonzalez ◽  
Marta Amerigo-Góngora ◽  
Piero José Landra-Dulanto ◽  
Yisela Gonzalez-Corena ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Node Metastasis ◽  
Axillary Dissection ◽  
Neoadjuvant Treatment ◽  
Axillary Lymph Node Metastasis ◽  
Axillary Lymph ◽  
Node Metastasis ◽  
Magnetic Seeds

Abstract We report the first documented clinical case of the use of magnetic seeds to mark axillary lymph node metastasis in breast cancer before neoadjuvant chemotherapy. After chemotherapy, the patient showed a complete radiological response. One single sentinel lymph node was detected using a radiotracer, while the marked node was intraoperative magnetometer-guided identified. The analysis of the nodes showed negative sentinel lymph node and positive marked node, and the subsequent targeted axillary dissection was performed. Marking axillary positive lymph nodes with a magnetic seed is a simple and effective procedure for the intraoperative localisation of the node after neoadjuvant treatment.

A breast cancer nomogram for prediction of non–sentinel-node metastasis in patients with sentinel node metastasis and validations of the 14 models.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 93-93
Author(s):  
Bekir Kuru ◽  
Bulent Koca ◽  
Necati Ozen ◽  
Savas Yuruker ◽  
Yuksel Bek
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Node ◽  
Predictive Factors ◽  
Invasive Breast Cancer ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Operating Characteristics ◽  
Sentinel Node Metastasis ◽  
Node Metastasis

93 Background: To avoid performing axillary lymph node dissection (ALND) for non-sentinel lymph node (SLN)-negative patients with SLN-positive axilla, nomograms for predicting the status of the axillary non-SLNs have been developed in many centers. We created a new nomogram predicting non-SLN metastasis in SLN positive patients with invasive breast cancer and evaluated 14 existing breast cancer models in our patient group. Methods: Two hundred and thirty seven invasive breast cancer patients with SLN metastases who underwent ALND were included in the present study. Based on the independent predictive factors for non-SLN metastasis identified by logistic regression analysis, we developed a new nomogram. Receiver operating characteristics (ROC) curves for the models were created, and the areas under the curves (AUC) were computed. Results: In a multivariate analysis, tumor size, presence of lymphovascular invasion, extranodal extension of SLN, large size of metastatic SLN in mm, the number of negative SLNs, and the multifocality were found to be independent predictive factors for non-SLN metastasis. The AUC was found to be 0.87 which is the highest value reported to date for previous models, and calibration was good for the present Ondokuz Mayis nomogram. Among the 14 validated models, the MSKCC, Stanford, Turkish, MD Anderson, MOU (Masaryk), Ljubljana, and 9 Eylul models yielded excellent AUC values of > 0.80. Conclusions: We present a new model (the Ondokuz Mayis nomogram) to predict the likelihood of non-SLN metastasis. Each clinic should determine and use the most suitable nomogram or should create their own nomograms for the prediction of non-SLN metastasis. [Table: see text]

Sentinel Node Biopsy: Interpretation and Management of Patients With Immunohistochemistry-Positive Sentinel Nodes and Those With Micrometastases

2008 ◽  
Vol 26 (5) ◽  
pp. 698-702 ◽  
Author(s):  
Emiel J.T. Rutgers
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Sentinel Node ◽  
Tumor Cells ◽  
Clinical Decision Making ◽  
Prognostic Significance ◽  
Axillary Lymph ◽  
Isolated Tumor Cells ◽  
Sentinel Nodes ◽  
Node Metastasis

The sentinel node procedure is an adequate tool to identify lymph node metastasis in breast cancer. Sentinel nodes are generally examined with greater attention mainly to exclude, as reliably as possible, lymph node metastasis. To achieve this, many protocols are used, resulting in different rates of micrometastasis or isolated tumor cells encountered. Since the prognostic significance of isolated tumor cells or micrometastasis in the sentinel nodes, and the risk of further axillary lymph node involvement in patients with isolated tumor cells, is uncertain and at most limited, these findings may pose difficulties for clinicians in clinical decision making. Protocols that identify lymph node metastasis, from which the clinical relevance is known, are warranted. Unnecessary lymph node dissections should be avoided.

Completion Lymph Node Dissection or Radiation Therapy for Sentinel Node Metastasis in Merkel Cell Carcinoma

2018 ◽  
Vol 26 (2) ◽  
pp. 386-394 ◽  
Author(s):  
Jay S. Lee ◽  
Alison B. Durham ◽  
Christopher K. Bichakjian ◽  
Paul W. Harms ◽  
James A. Hayman ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Lymph Node ◽  
Sentinel Node ◽  
Cell Carcinoma ◽  
Lymph Node Dissection ◽  
Completion Lymph Node Dissection ◽  
Merkel Cell ◽  
Node Dissection ◽  
Sentinel Node Metastasis ◽  
Node Metastasis
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