The morbidity after SLN biopsy alone is not negligible but significantly lower compared with level I and II ALND. SLN biopsy can be performed with similar short- and intermediate-term morbidity in academic and nonacademic centers.
BMI is an independent prognostic factor for OS in patients with breast cancer, especially among pre-/perimenopausal patients treated with chemotherapy without endocrine therapy.
Sentinel lymph node biopsy (SLNB) is the standard surgical procedure for the axilla in early node-negative breast cancer. To date, the "gold standard" to localize the sentinel lymph node (SLN) is the radiotracer (99m)Tc with or without blue dye. The aim of this study was to evaluate potential equivalency of the new SentiMag(®) technique in comparison to the "gold standard". Within this prospective, multicentric and multinational non-inferiority study including 150 patients (99m)Tc was compared with the magnetic technique, using superparamagnetic iron oxide particles (SPIOs, Sienna+(®)) for localization of SLNs. The results showed a detection rate per patient of 97.3% (146/150) for (99m)Tc vs. 98.0% (147/150) for Sienna+(®) with a similar average number of removed SLNs per patient and a higher per patient malignancy detection rate for the SPIO tracer. We obtained convincing results that magnetic SLNB can be performed easily, safely and equivalently well in comparison to the radiotracer method.
Intratumoral hypoxia has been shown to be a prognostic parameter in diverse studies [1]. Electrode measurements of oxygen tension have thus far served as the gold standard for its determination. The disadvantage of this method is its inability to discriminate between different cell types and areas of different cell viability [2].Hypoxia-inducible factor 1 is a heterodimeric DNA-binding complex, of which the β subunit is responsible for its translocation into the nucleus and the α subunit for its oxygen sensitivity. Under normoxic conditions the hypoxia-inducible factor 1 alpha (hif-1α) protein is degraded within minutes, whereas under hypoxic conditions it is stabilized and upregulated [3]. hif-1α is a transcription factor for target genes, involved in cell adaptation to stress parameters such as hypoxia. These genes are involved mainly in the modulation of erythropoesis, angiogenesis and metabolism.A spatial coexpression of hif-1α and the nitroimidazole EF5, the levels of which are selectively lowered only in viable hypoxic cells, was recently reported [4]. Further-DFS = disease-free survival; DMFS = distant metastasis-free survival; 5-FU = 5-fluorouracil; hif-1α = hypoxia-inducible factor 1 alpha; OS = overall survival.
AbstractBackground: Hypoxia-inducible factor 1 alpha (hif-1α) furnishes tumor cells with the means of adapting to stress parameters like tumor hypoxia and promotes critical steps in tumor progression and aggressiveness. We investigated the role of hif-1α expression in patients with node-positive breast cancer.
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