Evaluation of internal mammary lymph node biopsy during microsurgical breast reconstruction: An analysis of 230 consecutive patients

Karanetz, Irena; Jin, Michael X; Nguyen, Khang T.; DelMauro, Matthew A.; Lerman, Oren Z.; Smith, Mark L.; Tanna, Neil; Kasabian, Armen K.

doi:10.1111/tbj.14105

Cited by 5 publications

(3 citation statements)

References 34 publications

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“…Clinical studies have highlighted that lymph node metastasis in the internal mammary region is a poor prognostic indicator independent of ALN status ( Karanetz et al, 2021 ). However, local treatment of the IMLNs remains controversial.…”

Section: Discussionmentioning

confidence: 99%

Analysis of factors influencing the pathological complete remission (ipCR) in patients with internal mammary lymph node metastasis after neoadjuvant chemotherapy

Li,

Fei

2023

PeerJ

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Objective To investigate the factors impacting pathological complete remission (ipCR) of the internal mammary lymph nodes in patients with internal mammary lymph node metastasis (IMLN) after adjuvant chemotherapy. Methods Sixty-five cases of primary breast cancer (BC) with IMLN metastasis who had received neoadjuvant chemotherapy (NAC) were retrospectively analyzed. Postoperative pathology was used to divide the patients into ipCR and non-ipCR groups. Univariate and multivariate analyses were performed on ipCR after NAC. A receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the factors related to ipCR and a Kaplan-Meier curve was used to analyze prognosis. Results Twenty-nine (44.62%) of the 65 female patients received ipCR after NAC. Significant differences in hormone receptor (HR) negative and axillary pathological complete response (apCR) rates between the ipCR and non-ipCR group (P < 0.05). Multivariate logistic regression analysis showed that HR (OR = 2.698) and apCR (OR = 4.546) were the most significant factors that influenced ipCR (P < 0.05). The ROC curves showed that the area under the curves (AUC) for HR and apCR for the prediction of ipCR were 0.744 and 0.735 respectively. The AUC for the combined detection was 0.905. The average disease free survival (DFS) for patients in the ipCR group was 94.0 months which was significantly longer compared to patients in the non-ipCR group (64.2 months) (χ2 = 4.265, P = 0.039). No significant difference in OS was detected between the two groups (P > 0.05). Conclusions ipCR after NAC is correlated with HR and apCR. HR combined with apCR has value in predicting ipCR. ipCR has prognostic value in patients with IMLN metastasis and may have the potential to inform clinical decision-making. Further validation of these findings is required through larger-scale prospective studies.

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Section: Discussionmentioning

confidence: 99%

Analysis of factors influencing the pathological complete remission (ipCR) in patients with internal mammary lymph node metastasis after neoadjuvant chemotherapy

Li,

Fei

2023

PeerJ

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“…28 The surgeon should understand the stage, type, size, and laterality of cancer to inform decisions in the reconstructive process. 29 The following examples help to illustrate the importance of the initial consultation. Patients who have undergone certain types of abdominal surgery in the past, such as abdominoplasty, may not be candidates for abdominally based autologous breast reconstruction.…”

Section: Preoperative Assessment Medical and Surgical Historymentioning

confidence: 99%

Contemporary Microsurgical Breast Reconstruction: Abdominally Based Flaps

Tanna,

Sultan,

Minasian

et al. 2024

Plastic &Amp; Reconstructive Surgery

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Learning Objectives: After studying this article, the participant should be able to: 1. Understand the types of abdominally based flaps, their anatomy, and their drawbacks. 2. Understand important aspects of the history and physical examination of patients wishing to undergo these procedures. 3. Understand the benefits of preoperative planning and its role in avoiding complication. 4. Understand the operative steps of the procedures and tips to increase efficiency. 5. Understand the postoperative care of these patients and the role of enhanced recovery pathways. Summary: In this article, the authors review the history, current state, and future directions related to abdominally based microsurgical breast reconstruction. This article covers preoperative, intraoperative, and postoperative considerations intended to improve patient outcomes and prevent complications. Evidence-based findings are reported when available to comprehensively review important aspects of these procedures.

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“…The symptoms of early breast cancer are atypical and often overlooked. Breast cancer is mostly found during physical examination, and it is usually in the middle and late stages when it is discovered [4]. The metastasis of axillary lymph nodes is an important factor to evaluate the overall survival (OS) and disease-free survival (DFS) of breast cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Property of Axillary Lymph Nodes and Analysis of Lymph Node Metastasis Factors in Breast Cancer by Ultrasound Elastography

Zhou

Zhang

et al. 2022

Computational and Mathematical Methods in Medicine

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This research was aimed at investigating the role of ultrasound elastography (UE) in evaluating the properties of axillary lymph nodes in breast cancer and exploring the influencing factors of lymph node metastasis in breast cancer patients. Routine ultrasonography (US) and UE were performed for 160 breast cancer patients. 80 cases were in the group with lymph node metastasis, and the other 80 were in the nonlymph node metastasis group. The sensitivity, specificity, and accuracy of the two ultrasound examinations were compared, the receiver-operator characteristic (ROC) curves were drawn, and the influencing factors of lymph node metastasis were analyzed. The sensitivity, specificity, and accuracy of UE in diagnosing axillary lymph nodes of breast cancer were 97.22%, 95.45%, and 96.25%, respectively, which were markedly higher than those of routine US ( P < 0.05 ). Cortical thickness, blood flow grade, blood flow type, and elasticity score had a greater impact on axillary lymph node metastasis of breast cancer. When cortical thickness ≥ 3 cm , blood flow was of 2-3 grades, blood flow was the peripheral/mixed type, and elasticity score was 3-4 points, these became risk factors for lymph node metastasis in breast cancer patients. UE was effective in diagnosing the property of lymph nodes and could evaluate lymph node metastasis in breast cancer patients. It had a good clinical value and was worthy of popularization and application.

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Evaluation of internal mammary lymph node biopsy during microsurgical breast reconstruction: An analysis of 230 consecutive patients

Cited by 5 publications

References 34 publications

Analysis of factors influencing the pathological complete remission (ipCR) in patients with internal mammary lymph node metastasis after neoadjuvant chemotherapy

Analysis of factors influencing the pathological complete remission (ipCR) in patients with internal mammary lymph node metastasis after neoadjuvant chemotherapy

Contemporary Microsurgical Breast Reconstruction: Abdominally Based Flaps

Evaluation of the Property of Axillary Lymph Nodes and Analysis of Lymph Node Metastasis Factors in Breast Cancer by Ultrasound Elastography

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