Factors predicting non-sentinel lymph node involvement in sentinel node positive breast carcinoma

Durak, Merih Güray; Akansu, Bülent; Akın, Mehmet; Sevinç, Ali İbrahim; Koçdor, Mehmet Ali; Saydam, Serdar; Omer, Hammad; Ellıdokuz, Hülya; Bekiş, Recep; Canda, Tülay

doi:10.5146/tjpath.2011.01074

Cited by 7 publications

(6 citation statements)

References 24 publications

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“…Luminal A-like patients with a high ratio (1/1 or 2/2) had a higher risk of having 4 LNMs. These results are in line with findings from previous studies [26,28,29]. A low SN ratio among patients with one to two positive SNs seems to reliably predict a low axillary tumor burden.…”

Section: Discussionsupporting

confidence: 92%

“…SNB results in a false negative SN in 10% of the cases [22][23][24] and in most cases with a solitary positive SN there are no additional LNMs [25]. Factors that predict tumor engagement of NSNs are the number of positive SNs, 3 SNs removed, macrometastases in SNs, a larger percentage of the SN occupied by metastases, lymphovascular invasion, tumor size, extracapsular growth, higher histologic grade and estrogen receptor negativity [25][26][27]. The SN macrometastasis ratio was predictive of axillary tumor burden in our study.…”

Section: Discussionmentioning

confidence: 99%

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Positive sentinel node in luminal A-like breast cancer patients - implications for adjuvant chemotherapy?

et al. 2018

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Background: In luminal Alike breast cancer, the indication for adjuvant chemotherapy still is largely based on lymph nodestatus. Sentinel node (SN) positive patients who are no longer recommended an axillary lymph node dissection (ALND) risk undertreatment, especially if they have 4 lymph node metastases (LNMs). Aim: To quantify the group of SN positive luminal Alike patients with 4 LNMs and to investigate if the ratio between positive SNs and examined SNs (SN ratio) can provide information of the axillary tumor burden. Material and methods: Nearly 370 patients between 2014-2016 in Western Sweden with a clinically node-negative invasive breast cancer treated with both SNB and subsequent ALND were included. SNB findings were compared to ALND findings and the ability of the SN ratio to describe the axillary tumor burden was evaluated using multivariable analysis. Results: In total,17.6% of patients with luminal Alike tumors had 4 LNMs. The SN ratio was statistically significant for predicting 4 LNMs among luminal Alike patients (p ¼ .013, OR 1.89 (95% CI 1.14-3.12) per 0.1 increment in SN ratio). Conclusions: One sixth of patients with SN positive luminal Alike tumors risk undertreatment. The SN ratio may aid in identifying many of these patients.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Positive sentinel node in luminal A-like breast cancer patients - implications for adjuvant chemotherapy?

et al. 2018

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“…The results from our study clearly confirm that size of primary tumor (T) presents strong independent predictive factor od SLN positivity in breast cancer patients, which correlates with the results of other similar studies ( 20 ). Some authors investigated the size of metastatic deposits within SLNs and found that both the number of positive SLNs as well as the size of metastatic deposits within SLNs independently serve as predictive factors of other non-SLNs involvement ( 21 ). There are also other studies that further analyze the predictive value of SLN.…”

Section: Discussionmentioning

confidence: 99%

Methylene Blue as Inexpensive and Reliable Sole Sentinel Lymph Node Mapping Agent for Patients with Invasive Ductal Carcinoma

Halilbasic¹,

Iljazović²,

Mehmedović³

et al. 2021

Mater Sociomed

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Background: Invasive ductal cancer (IDC) represents about 75% of all breast malignancies. There are many breast cancer prognostic factors, but the ones that have the most impact on the survival rates in advanced breast cancer are tumor size and regional lymph node involvement. Axillary lymph node dissection (ALND) has particularly important and undoubtful role in current surgical options for breast cancer treatment. With the introduction of sentinel lymph node biopsy (SLNB) for breast cancer patients it was possible to identify those to whom regional spread of the disease did not occur at the time of surgery, and thus spare them an unnecessary ALND procedure. Objective: To determine the rate of sentinel lymph node (SLN) detection using only methylene blue dye as a mapping agent, as well as to correlate the number of positive SLNs with the number of positive non-sentinel lymph nodes (non-SLNs). Methods: The study represents a prospective study that included 50 female patients with histologically confirmed invasive ductal carcinoma (IDC) who underwent SLNB using only methylene blue dye as the mapping agent, while the detection and harvest of SNL was done by visual control only. All patients also underwent an obligatory complete ALND, which was as that time the institutional oncological protocol for surgical treatment of histologically confirmed IDC. The final data such as tumor size, SLN and non-SLN status were obtained by further analysis of pathohistological reports from tumor biopsy and other surgical specimens. Results: The accuracy rate of SLN detection was 98%. The number of detected SLN was in the range of 1 to 6, with an average of 2 for each patient. The number of positive SLN was in significant correlation with the number of tumor-affected non-SNL (p<0,001). Further analysis showed that for each increase in the number of positive SLN by 1, the risk of positive non-SLN increased 6-fold, OR=6,22 (p<0,001). Conclusion: Use of methylene blue dye as a sole mapping agent when performing SLNB in patients with IDC is a reliable and effective method that can be safely implemented in medical institutions that lack availability of nuclear medicine services or significant monetary funds.

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“…SLD pozitif olgularda, NSLD durumunun, metastazların öngörülmesi: Erken evre invaziv meme kanseri hastalarının %40-70'inde SLD de tek metastaz saptanmakta ve bu nedenle gereksiz aksiller diseksiyonu önleyip morbiditeyi azaltmak için aksiller NSLD durumunu, tutulumunu öngören faktörlerin belirlenmesine yönelik çalışmalar yapılmaktadır (52).…”

Section: Sld'nin Pn0-pn1mi Evrelemesinde Ve Raporlandırılmasındakigüçunclassified

“…Meme kanseri ve pozitif SLD olan hastalarda, primer tümör boyutu, peritümöral lenfovasküler invazyon yanısıra SLD'deki metastazın boyutu, metastazların anatomik yerleşimi (subkapsüler, parankimal ya da ikisi birlikte), metastatik SLD sayısı, perikapsüler invazyon, çıkarılan SLD'nin sayısının, NSLD tutulumu açısından önemli bulgular içinde yer aldığı belirtilmektedir (52 (13,32,33,45,52). Bunlar da NSLD'nin durumunu %100 doğrulukla belirlememektedir (33).…”

Section: Sld'nin Pn0-pn1mi Evrelemesinde Ve Raporlandırılmasındakigüçunclassified

Pathological Examination of Sentinel Lymph Node Biopsy

Canda¹

2017

Nts

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Öz Abstract GirişMeme kanserleri kadınlarda görülme sıklığı ve kanserden ölüm nedenleri içinde ilk sıralarda yer almaktadır.Meme kanserlerinde hastalığın evresini belirlemede aksiller lenf düğümlerinin (ALD) durumu, uygun tedavi protokollerinin seçiminde, sağkalım sürecinin belirlenmesinde en önemli prognostik faktörlerdendir (1).Sentinel lymph node biopsy SLNB is a standardized method with a high accuracy rate, which is currently applied in many centers at the stage of axillary lymph node involvement of early stage, clinically node-negative breast cancers. Detailed pathological examination methods are applied to obtain reliable results in terms of metastasis in SLNB. Currently there is no standard protocol for histopathological examination methods. In this article, pathological examination methods are presented with the light of the relevant literature and about 20 years' of our own experience. Pathological examination of the SLNB is performed during the operation and after the operation. Frequently frozen, imprint methods are applied in intraoperative examinations. For the detection of micrometastases and isolated cell metastases in postoperative examination, detailed interval sections and immunohistochemistry are applied. It is the responsibility of the experienced pathologist in every stage, from the arrival of SLNB until the outcome is reported. The pathology report should be clear, understandable, and pathologic staging of metastases should be done correctly. Keywords: Sentinel lymph node biopsy, intraoperative examination, postoperative examination, frozen, imprint, immunohistochemistry, micrometastasis, isolated cell metastasis, pathological N stage Sentinel lenf düğümü biyopsisi (SLDB), günümüzde daha çok erken evre, klinik olarak nod negatif meme kanserlerinin aksiller lenf düğümü evrelemesinde, birçok merkezde uygulanan doğruluk oranı yüksek, standart bir yöntemdir. SLDB'sinde metastaz yönünden güvenilir sonuçların elde edilmesi için ayrıntılı patolojik inceleme yöntemleri uygulanmaktadır. Günümüzde histopatolojik inceleme yöntemlerine ait standart protokol bulunmamaktadır. Bu yazıda, ilgili kaynakların ışığında, ayrıca yaklaşık 20 yıllık kendi deneyimiz ile birlikte patolojik inceleme yöntemleri sunulmuştur. SLDB'sinin patolojik incelenmesi operasyon sırasında ve operasyon sonrasında olmak üzere iki aşamada yapılmaktadır. İntraoperatif incelemede sıklıkla frozen, imprint yöntemleri uygulanmaktadır. Postoperatif incelemede mikrometastazların, izole hücre metastazlarının saptanması için ayrıntılı kesitlerden aralıklı kesit ve immünhistokimya uygulanmaktadır. SLDB'nin patoloji laboratuvarına ulaştığı andan, sonuç rapor edilinceye dek her aşaması, bu konuda deneyimli patoloji uzmanının sorumluluğundadır. Patoloji raporu net, açık, anlaşılır olmalı, metastazların patolojik evrelendirmesi doğru olarak yapılmalıdır. Anahtar Kelimeler: Sentinel lenf düğümü biyopsisi, operasyon sırasında inceleme, operasyon sonrası inceleme, frozen, imprint, immünhistokimya, mikrometastaz, izole hücre metastazı, patolojik N e...

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Factors predicting non-sentinel lymph node involvement in sentinel node positive breast carcinoma

Abstract: In patients with invasive breast cancer and positive sentinel node, area percent of sentinel node occupied by tumor, and the number of sentinel nodes removed are independently predictive of non-sentinel node involvement.

Cited by 7 publications

References 24 publications

Positive sentinel node in luminal A-like breast cancer patients - implications for adjuvant chemotherapy?

Positive sentinel node in luminal A-like breast cancer patients - implications for adjuvant chemotherapy?

Methylene Blue as Inexpensive and Reliable Sole Sentinel Lymph Node Mapping Agent for Patients with Invasive Ductal Carcinoma

Pathological Examination of Sentinel Lymph Node Biopsy

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