Can Axillary Lymph Node Dissection Be Safely Omitted for Early-Stage Breast Cancer Patients with Sentinel Lymph Node Micrometastasis?

Damle, Sameer; Teal, Christine B.

doi:10.1007/s13193-011-0058-6

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…The definitive answer will be provided by prospective studies with larger numbers of patients and longer follow-up. We agree with authors who argue that it is not yet possible to know if CALND can safely be omitted in positive SLN patients, but we hope so 22 .…”

Section: Roc Curvesupporting

confidence: 84%

Non-Sentinel Lymph Node Metastases in Breast Cancer Patients with a Positive Sentinel Lymph Node: Validation of Five Nomograms and Development of a New Predictive Model

Lombardi

Maggi

Russo

et al. 2011

Tumori

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Section: Roc Curvesupporting

confidence: 84%

Non-Sentinel Lymph Node Metastases in Breast Cancer Patients with a Positive Sentinel Lymph Node: Validation of Five Nomograms and Development of a New Predictive Model

Lombardi

Maggi

Russo

et al. 2011

Tumori

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“…Among patients with positive SLNs, ALN dissection (ALND) is the standard of care;5–7 however, it has been recently discussed whether ALND can be avoided in patients at low risk of metastasis in ALN 8 9. Many nomograms have been proposed in order to predict the likelihood of ALN positivity,10 11 but all of these are based on specific features concerning the primary tumour, such as size, histotype, grading, lymphovascular invasion, multifocality, oestrogen and progesterone receptors, Her2 neu overexpression, and molecular subtypes 11.…”

Section: Introductionmentioning

confidence: 99%

A new clinical cut-off of cytokeratin 19 mRNA copy number in sentinel lymph node better identifies patients eligible for axillary lymph node dissection in breast cancer

Deambrogio

Castellano

Paganotti³

et al. 2014

J Clin Pathol

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AimsCytokeratin 19 (CK19) mRNA copy number predicts the probability of tumour load in axillary lymph nodes (ALN) and can help in decision-making regarding the axillary dissection. The purpose of this study was to define a new cut-off of CK19 mRNA copy number using the one-step nucleic acid amplification (OSNA) assay on metastatic sentinel lymph nodes (SLN) in order to identify cases at risk of having one or more positive ALN. Methods1296 SLN from 1080 patients were analysed with the OSNA assay. 194 patients with positive SLN underwent ALN dissection and the mean value of CK19 copy number (320000) of their SLN was set as initial cut-off. Receiver operative characteristics curve identify a best cut-off of 7700 (sensitivity 78%, specificity 57%). A comparison between our and the traditional cut-off (5000) was performed. ResultsThe cut-off of 7700 successfully identifies patients with positive ALN (p=0.001, false-negative cases: 17%). In the range between 5000 and 7700, one patient with positive ALN would not undergo axillary dissection, whereas eight patients with negative ALN would be correctly identified. ConclusionsWe suggest that the level of CK19 mRNA copy number could be the only parameter to consider in the intraoperative management of the axilla.

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Can Axillary Lymph Node Dissection Be Safely Omitted for Early-Stage Breast Cancer Patients with Sentinel Lymph Node Micrometastasis?

Cited by 2 publications

References 9 publications

Non-Sentinel Lymph Node Metastases in Breast Cancer Patients with a Positive Sentinel Lymph Node: Validation of Five Nomograms and Development of a New Predictive Model

Non-Sentinel Lymph Node Metastases in Breast Cancer Patients with a Positive Sentinel Lymph Node: Validation of Five Nomograms and Development of a New Predictive Model

A new clinical cut-off of cytokeratin 19 mRNA copy number in sentinel lymph node better identifies patients eligible for axillary lymph node dissection in breast cancer

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