scholarly journals Sentinel Node Biopsy after Neoadjuvant Chemotherapy for Breast Cancer: Preliminary Experience with Clinically Node Negative Patients after Systemic Treatment

2021 ◽  
Vol 11 (3) ◽  
pp. 172
Author(s):  
Alejandro Martin Sanchez ◽  
Daniela Terribile ◽  
Antonio Franco ◽  
Annamaria Martullo ◽  
Armando Orlandi ◽  
...  
Keyword(s):  
Lymph Node ◽  
False Negative ◽  
Neoadjuvant Treatment ◽  
Disease Free Survival ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Free Survival ◽  
Oncological Outcomes ◽  
Node Biopsy ◽  
Disease Free

Sentinel lymph node biopsy (SLNB) following neoadjuvant treatment (NACT) has been questioned by many studies that reported heterogeneous identification (IR) and false negative rates (FNR). As a result, some patients receive axillary lymph node dissection (ALND) regardless of response to NACT, leading to a potential overtreatment. To better assess reliability and clinical significance of SLNB status on ycN0 patients, we retrospectively analyzed oncological outcomes of 399 patients treated between January 2016 and December 2019 that were either cN0-ycN0 (219 patients) or cN1/2-ycN0 (180 patients). The Endpoints of our study were to assess, furthermore than IR: oncological outcomes as Overall Survival (OS); Distant Disease Free Survival (DDFS); and Regional Disease Free Survival (RDFS) according to SLNB status. SLN identification rate was 96.8% (98.2% in patients cN0-ycN0 and 95.2% in patients cN+-ycN0). A median number of three lymph nodes were identified and removed. Among cN0-ycN0 patients, 149 (68%) were confirmed ypN0(sn), whereas regarding cN1/2-ycN0 cases 86 (47.8%) confirmed an effective downstaging to ypN0. Three year OS, DDFS and RDFS were significantly related to SLNB positivity. Our data seemed to confirm SLNB feasibility following NACT in ycN0 patients, furthermore reinforcing its predictive role in a short observation timing.

scholarly journals Influence of Sentinel Lymph Node Biopsy on Disease-Free Survival for Melanoma Patients

2014 ◽  
Vol 25 ◽  
pp. iv388
Author(s):  
M. Kukushkina ◽  
S. Korovin ◽  
O. Solodiannikova ◽  
G. Sukach ◽  
A. Palivets ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Disease Free Survival ◽  
Lymph Node Biopsy ◽  
Free Survival ◽  
Node Biopsy ◽  
Melanoma Patients ◽  
Disease Free

scholarly journals Lymphadenectomy after a positive sentinel node biopsy in patients with cutaneous melanoma. A systematic review

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Maribel L. Da Cunha Cosme ◽  
Juan F. Liuzzi Samaterra ◽  
Saul A. Siso Cardenas ◽  
José I. Chaviano Hernández
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
Disease Free Survival ◽  
Lymph Node Biopsy ◽  
Positive Sentinel Node ◽  
Free Survival ◽  
Node Biopsy ◽  
Disease Free

AbstractComplete lymph node dissection (CLND) following a positive sentinel lymph node biopsy (SLNB) has been the standard treatment for years. However, there is increasing evidence that CLND could be omitted. Approximately 80% of patients with a positive sentinel node biopsy do not have additional nodal involvement; in these contexts, the SLNB could be diagnostic and therapeutic. However, in this group of patients, the therapeutic effect of CLND is unclear.A systematic search was performed in EMBASE and MEDLINE (PubMed), for studies published between January 1, 2014 and December 31, 2019. Studies were included when they compared immediate CLND and observation after a positive sentinel node. The outcomes of interest were: Overall Survival (OS), melanoma-specific survival (MSS), and disease-free survival (DFS).Eleven studies met the inclusion criteria. Two randomized clinical trials reported no differences in OS or MSS when complete lymph dissection was compared with observation alone. An increase in regional relapse was observed in the CLND group, and in one randomized controlled trial (RCT) the rate of disease-free survival was superior in those patients.Most populations in both RCTs had low sentinel lymph node biopsy (SLNB) metastatic deposits, and head and neck melanomas were not included or underrepresented. When CNLD was omitted, an active surveillance protocol was carried out.The evidence supports that CLND in SLNB positive patients does not confer a survival benefit. Sentinel tumor burden, localization of primary tumor, and feasibility of active surveillance should be taken into account in treatment decisions.

scholarly journals Sentinel Node Mapping for Breast Cancer: Current Situation

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Sergi Vidal-Sicart ◽  
Renato Valdés Olmos
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
False Negative ◽  
False Negative Rate ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Node Biopsy

Axillary node status is a major prognostic factor in early-stage disease. Traditional staging needs levels I and II axillary lymph node dissection. Axillary involvement is found in 10%–30% of patients with T1 (<2 cm) tumours. Sentinel lymph node biopsy is a minimal invasive method of checking the potential nodal involvement. It is based on the assumption of an orderly progression of lymph node invasion by metastatic cells from tumour site. Thus, when sentinel node is free of metastases the remaining nodes are free, too (with a false negative rate lesser than 5%). Moreover, Randomized trials demonstrated a marked reduction of complications associated with the sentinel lymph node biopsy when compared with axillary lymph node dissection. Currently, the sentinel node biopsy procedure is recognized as the standard treatment for stages I and II. In these stages, this approach has a positive node rate similar to those observed after lymphadenectomy, a significant decrease in morbidity and similar nodal relapse rates at 5 years. In this review, the indications and contraindications of the sentinel node biopsy are summarized and the methodological aspects discussed. Finally, the new technologic and histologic developments allow to develop a more accurate and refinate technique that can achieve virtually the identification of 100% of sentinel nodes and reduce the false negative rate.

scholarly journals Sentinel lymph node biopsy for breast cancer using methylene blue: a new anatomical landmark involving intercostobrachial and medial pectoral nodes

2020 ◽  
Vol 29 (3) ◽  
pp. 298-304
Author(s):  
I Gusti Ngurah Gunawan Wibisana ◽  
Muliyadi
Keyword(s):  
Lymph Node ◽  
Axillary Lymph Node ◽  
False Negative ◽  
False Negative Rate ◽  
Lymph Node Biopsy ◽  
Anatomical Landmark ◽  
Lymph Node Status ◽  
Axillary Lymph ◽  
Axillary Lymph Node Status ◽  
Node Biopsy

BACKGROUND Sentinel lymph node biopsy (SLNB) using blue dye is becoming popular in Indonesia given that knowledge on new anatomical landmarks involving intercostobrachial and medial pectoral nodes have replaced the need for radioisotope tracers. This study aimed to evaluate the utility of the proposed landmark involving intercostobrachial and medial pectoral nodes to determine axillary lymph node status during SLNB. METHODS A prospective study was conducted involving 55 patients with early-stage breast cancer who had clinically negative lymph nodes (T1–T2, cN0) between 2018 and 2019 at Cipto Mangunkusumo Hospital. During SLNB, methylene blue 1% was injected at the subareolar area to identify intercostobrachial and medial pectoral nodes followed by axillary lymph node dissection (ALND). Histopathological results of sentinel nodes (SNs) were then compared to those of other axillary nodes. RESULTS SNs were identified in 54 patients (98%), 33 (61%) of whom had both intercostobrachial and medial pectoral SNs. Among patients with SNs, there were 1 patient without intercostobrachial SNs, 10 patients without medial pectoral SNs, and 1 patient with medial pectoral SNs but no intercostobrachial SNs. Accordingly, SNs had a negative predictive value (NPV) of 96.77% for axillary metastasis (95% confidence interval = 81.54–99.51), with a false negative rate of 4.7%. No serious adverse events was observed. CONCLUSIONS The high identification rate and NPV, as well as the low false negative rate of the new anatomical landmark involving intercostobrachial and medial pectoral nodes during SLNB, suggest its reliability in determining axillary lymph node status.

scholarly journals Axillary Lymph Node Nanometastases Are Prognostic Factors for Disease-Free Survival and Metastatic Relapse in Breast Cancer Patients

2006 ◽  
Vol 12 (22) ◽  
pp. 6696-6701 ◽  
Author(s):  
Patrizia Querzoli ◽  
Massimo Pedriali ◽  
Rosa Rinaldi ◽  
Anna Rita Lombardi ◽  
Elia Biganzoli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Metastatic Relapse ◽  
Disease Free
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