Evaluation of sentinel lymph node biopsy after previous breast surgery for breast cancer: GATA study

Renaudeau, Céline; Lefebvre-Lacœuille, C.; Campion, Loı̈c; Dravet, F.; Descamps, Philippe; Ferron, Gwénaël; Houvenaeghel, Gilles; Giard, S.; Lara, C. Tunon de; Dupré, Pierre‐François; Fritel, Xavier; Ngô, Charlotte; Verhaeghe, Jean-Luc; Faure, C.; Mezzadri, M.; Damey, C.; Classe, Jean‐Marc

doi:10.1016/j.breast.2016.04.006

Cited by 20 publications

(15 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This may hamper visualization of the lymphatics and, consequently, LNs by lymphography. However, it has been shown that previous breast cancer surgery does not affect visualization of lymphatic drainage, and sentinel LN biopsy remains feasible. Likewise, in gastric cancer, SNNS studies in patients who underwent ESD successfully visualized the lymphatic anatomy after ESD.…”

Section: Discussionmentioning

confidence: 99%

Indocyanine green fluorescence lymphography during gastrectomy after initial endoscopic submucosal dissection for early gastric cancer

Roh

Choi

Seo

et al. 2020

British Journal of Surgery

View full text Add to dashboard Cite

Background: Indocyanine green (ICG) fluorescence lymphography can be used to visualize the lymphatic drainage of gastric cancer. Few studies have been performed to identify lymphatic drainage patterns after endoscopic submucosal dissection (ESD). ESD results in changes to lymphatics owing to fibrosis of the submucosal layer. This study aimed to evaluate the efficacy of ICG fluorescence lymphography for visualization of lymphatic drainage after ESD, and to assess its clinical application in additional gastrectomy after ESD for early gastric cancer. Methods: All patients who underwent gastrectomy after ESD between 2014 and 2017 in a single centre were reviewed. ICG was injected endoscopically into the submucosal layer around the ESD scar the day before surgery. At the time of surgery, lymph nodes (LNs) were visualized and lymphadenectomy was performed with near-infrared imaging. Ex vivo, all LNs were examined for the presence of fluorescence. Number of LNs resected and number of tumour-positive LNs were compared between patients who underwent near-infrared imaging and those who had conventional lymphadenectomy without intraoperative imaging. Results: Some 290 patients underwent gastrectomy after ESD, 98 with fluorescence lymphographyguided lymphadenectomy and 192 with conventional lymphadenectomy. Fluorescence lymphography visualized lymphatic drainage in all patients, without complications related to ICG injection or near-infrared imaging. Fluorescence lymphography visualized all stations containing metastatic LNs. The sensitivity for detecting LN metastasis in fluorescent stations was 100 per cent (9 of 9 stations), and the negative predictive value was 100 per cent (209 of 209). One patient with LN metastasis had one non-fluorescent metastatic LN within a fluorescent station. Conclusion: Fluorescence lymphography successfully visualized all draining LNs after ESD, with high sensitivity and negative predictive value for detecting LN metastasis. Fluorescence lymphography-guided lymphadenectomy could be an alternative to systematic lymphadenectomy during additional surgery after ESD. Resection specimensLN-containing soft tissues were dissected from the specimen and LN stations were classified according to the Japanese classification of gastric carcinoma (3rd English edition) 20 . After fluorescence lymphography-guided

show abstract

Section: Discussionmentioning

confidence: 99%

Indocyanine green fluorescence lymphography during gastrectomy after initial endoscopic submucosal dissection for early gastric cancer

Roh

Choi

Seo

et al. 2020

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…This strategy may be challenged, as a detection rate of near 90 per cent after previous BCS has been reported, and may be considered suboptimal. The GATA study reported a detection rate of 85·5 per cent for SLND after diagnostic excision. The same study also showed that an interval shorter than 36 days between primary breast operation and secondary SLND increased the risk of detection failure, which is worrying as the usual time frame for reoperation is no longer than 30 days.…”

Section: Discussionmentioning

confidence: 99%

Effect of preoperative injection of superparamagnetic iron oxide particles on rates of sentinel lymph node dissection in women undergoing surgery for ductal carcinoma in situ (SentiNot study)

Karakatsanis

Hersi

Pistioli

et al. 2019

British Journal of Surgery

View full text Add to dashboard Cite

Background: One-fifth of patients with a preoperative diagnosis of ductal carcinoma in situ (DCIS) have invasive breast cancer (IBC) on definitive histology. Sentinel lymph node dissection (SLND) is performed in almost half of women having surgery for DCIS in Sweden. The aim of the present study was to try to minimize unnecessary SLND by injecting superparamagnetic iron oxide (SPIO) nanoparticles at the time of primary breast surgery, enabling SLND to be performed later, if IBC is found in the primary specimen.Methods: Women with DCIS at high risk for the presence of invasion undergoing breast conservation, and patients with DCIS undergoing mastectomy were included. The primary outcome was whether this technique could reduce SLND. Secondary outcomes were number of SLNDs avoided, detection rate and procedure-related costs.Results: This was a preplanned interim analysis of 189 procedures. IBC was found in 47 and a secondary SLND was performed in 41 women. Thus, 78⋅3 per cent of patients avoided SLND (P < 0⋅001). At reoperation, SPIO plus blue dye outperformed isotope and blue dye in detection of the sentinel node (40 of 40 versus 26 of 40 women; P < 0⋅001). Costs were reduced by a mean of 24⋅5 per cent in women without IBC (€3990 versus 5286; P < 0⋅001).Conclusion: Marking the sentinel node with SPIO in women having surgery for DCIS was effective at avoiding unnecessary SLND in this study. Registration number: ISRCTN18430240

show abstract

“…SLNB alone, in advance of the breast procedure, would mean that a second operation was always needed, which may not be acceptable to patients, but is necessary in centres without frozen section facilities [21]. On the other hand, some studies have supported SLNB following diagnostic lumpectomy [27]. Over 7% of our patients finally had pN2 disease, which is lower than the 13% reported elsewhere [2] and this could be a QI for the diagnostic pathway.…”

Section: Discussionmentioning

confidence: 72%

“…Only 19% of patients in this study presented with T1 disease, and 20% of them opted for mastectomy. Assessing our program against this QI would have meant that > 75% of our patients would have been excluded, although we offered SLNB to all patients with T1, T2 or T3 disease having either BCS or mastectomy [27].…”

Section: Discussionmentioning

confidence: 99%

Quality Indicators for Sentinel Lymph Node Biopsy in Breast Cancer: Applicability and Clinical Relevance in a Non-screened Population

Agrawal

Shenoy

Nalawade

et al. 2017

Indian J Surg Oncol

View full text Add to dashboard Cite

Quality Indicators for Sentinel Lymph Node Biopsy in Breast Cancer: Applicability and Clinical Relevance in a Non-screened Population: sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) as standard of care for management of early breast cancer. This study assessed our SLNB program against 11 published quality indicators (QIs). All breast cancer patients who underwent SLNB in our centre from June 2013-Dec 2015 were included. Clinical, pathological and follow-up data were extracted from the institutional REDCap data system. Analysis was done with SPSS 23. Following validation, 234 patients had SLNB, always performed along with primary surgery. Identification rate was 95.3% and > 1 SLN was identified in 72% of patients. SLNB positivity was 33%, of these, 100% underwent ALND. Overall 91% of QI eligible patients underwent SLNB. No ineligible patients (T4) underwent SLNB. For the patients who had radio colloid, injection criteria were met for 100%. Pathological evaluation and reporting criteria were met for 100% of patients. There were no axillary recurrences in a median follow-up of 2 years. 7.6% patients had SLN negative on frozen section but positive on final histology. 7.2% of patients with clinical negative nodes had pN2 disease in final histopathology report after surgery. Sixty percent of patients who had completion ALND had only positive SLN. This study supports the applicability of published QI of SLNB in a non-screened cohort of early breast cancer patients. Although QI were useful, modification based on patient characteristics and resource availability may be needed. These indicators can be used as audit tools to improve the overall accuracy of the procedure.

show abstract

Evaluation of sentinel lymph node biopsy after previous breast surgery for breast cancer: GATA study

Cited by 20 publications

References 34 publications

Indocyanine green fluorescence lymphography during gastrectomy after initial endoscopic submucosal dissection for early gastric cancer

Indocyanine green fluorescence lymphography during gastrectomy after initial endoscopic submucosal dissection for early gastric cancer

Effect of preoperative injection of superparamagnetic iron oxide particles on rates of sentinel lymph node dissection in women undergoing surgery for ductal carcinoma in situ (SentiNot study)

Quality Indicators for Sentinel Lymph Node Biopsy in Breast Cancer: Applicability and Clinical Relevance in a Non-screened Population

Contact Info

Product

Resources

About