Management of the Axilla in Early Breast Cancer

Valero, M.; Golshan, Mehra

doi:10.1007/978-3-319-70197-4_4

Cited by 8 publications

(4 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1,2 The status of ALN has been well assessed with the axillary sentinel lymph node biopsy (A-SLNB) procedure in patients with early breast cancer. 3 For the patients receiving neoadjuvant systemic therapy (NST), the nodal pathologic complete response (pCR) was identified as no existence of metastatic carcinoma in ALN and has been shown to be associated with improved survival outcomes. 4 However, accurate regional staging and nodal pCR definition could not be achieved by depending on the status of the ALN alone, which might lead to understage and under-/overtreatment.…”

mentioning

confidence: 99%

Internal Mammary Sentinel Lymph Node Biopsy in Clinically Axillary Lymph Node-Positive Breast Cancer: Diagnosis and Implications for Patient Management

et al. 2019

View full text Add to dashboard Cite

Background. Routine performance of internal mammary sentinel lymph node biopsy (IM-SLNB) remains a subject of debate due to no clinical relevance in breast cancer, because it was performed only in clinically axillary lymph node (ALN)-negative patients. In this study, IM-SLNB was performed in clinically ALN-positive patients, and its impact on nodal staging and therapeutic strategy were subsequently analyzed. Methods. Clinically ALN-positive patients who underwent IM-SLNB were enrolled in this prospective study. Statistical analysis was performed using Chi square test, Mann-Whitney U and logistic regression models with a significance level of 0.05. Results. Among the 352 recruited patients, the internal mammary sentinel lymph node (IMSLN) visualization rate of patients who received initial surgery and neoadjuvant systemic therapy (NST) was 71.9% (123/171) and 33.1%

show abstract

mentioning

confidence: 99%

Internal Mammary Sentinel Lymph Node Biopsy in Clinically Axillary Lymph Node-Positive Breast Cancer: Diagnosis and Implications for Patient Management

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The flowchart of searching strategy and study selection is shown in Table 1. Forty‐seven articles were strongly in favour of performing SLNB in PrBC, 2,4,6,13–56 4 articles were partially in favour, 57–60 2 articles were partially against 61,62 and 10 articles were strongly against SLNB in PrBC patients 3,5,10,63–69 . Sub‐analysis based on type of study showed that out of 47 articles which were strongly in favour of SLNB, 11 were prospective cohorts or RCTs, 5 were retrospective case series or case reports, 25 were review articles and 6 articles were guidelines.…”

Section: Resultsmentioning

confidence: 99%

Sentinel lymph node biopsy for breast cancer during pregnancy: A comprehensive update

Bothou,

Margioula‐Siarkou,

Petousis

et al. 2023

Eur J Clin Investigation

View full text Add to dashboard Cite

BackgroundPregnant patients diagnosed with breast cancer (PrBC) may receive substantially different treatments compared to general population, considering that certain treatment options cannot be applied during pregnancy due to their potential harmful effects to the foetus. Regarding the use of sentinel lymph node biopsy (SLNB) in pregnant patients, potential concerns include foetal harm from radiation exposure, possible teratogenic effects of blue dyes and maternal anaphylaxis to isosulfan.ObjectiveThe main objective of the present systematic review is to summarize and present current knowledge and up‐to‐date evidence about the safety and efficacy of SLNB in PABC.MethodsMEDLINE, Google Scholar and UpToDate databases were searched up to 22 January 2023. Articles studying the safety and effectiveness of SLNB in patients for PrBC were eligible for inclusion in the present review.ResultsIn total, 63 articles that met the inclusion criteria were included in this study. Forty‐seven articles were strongly in favour of performing SLNB in PABC, 4 articles were partially in favour, 10 articles were strongly against and 2 articles were partially against performing SLNB in PABC. Sub‐categorization based on type of study showed that the majority of studies in favour were of higher level of evidence than those against. Furthermore, there were overall 12 studies reporting on outcomes. There were overall 382 women with PrBC that underwent SLNB. Full data were reported for 237 cases. Overall live birth rate was 95.8%, while overall neonatal complication rate was 3.4%.No case of maternal side effects or anaphylactic reaction, maternal death, stillbirth and neonatal death was reported (0%).ConclusionsSentinel lymph node biopsy seems to be safe and effective technique for breast cancer during pregnancy.

show abstract

“…Over the past two decades, evidence from randomized clinical trials has enabled the de-escalation of axillary surgery in the management of early breast cancer 1 , with the major change has begun the replacement of axillary lymph node dissection (ALND) by sentinel lymph node biopsy (SLNB). Three randomized trials, The American College of Surgeons Oncology Group (ACOSOG)-Z0011 trial, the After Mapping of the Axilla: Radiotherapy Or Surgery (AMAROS) trial, and the International Breast Cancer Study Group (IBCSG) 23–01 trial found that complete ALND could be safely omitted 2 – 4 .…”

Section: Introductionmentioning

confidence: 99%

A nomogram for predicting three or more axillary lymph node involvement before breast cancer surgery

Kang

Park

et al. 2022

Sci Rep

View full text Add to dashboard Cite

Based on the American College of Surgeons Oncology Group (ACOSOG)-Z0011, a useful nomogram has been constructed to identify patients who do not require intraoperative frozen sections to evaluate sentinel lymph nodes in the previous study. This study investigated the developed nomogram by ultrasonography (US) and positron emission tomography (PET)/computed tomography (CT) as a modality. In the training set, 89/1030 (8.6%) patients had three or more positive nodes. Larger tumor size, higher grade ultrasonographic ALN classification, and findings suspicious of positive ALN on PET/CT were associated in multivariate analysis. The areas under the receiver operating characteristic curve (AUC) of the nomogram were 0.856 [95% CI 0.815–0.897] in the training set. The AUC in the validation set was 0.866 [95% CI 0.799–0.934]. Application of the nomogram to 1067 patients who met the inclusion criteria of ACOSOG-Z0011 showed that 90 (8.4%) patients had scores above the cut-off and a false-negative result was 37 (3.8%) patients. And the specificity was 93.8%, and the negative predictive value was 96.4%. The upgraded nomogram improved the predictive accuracy, using only US and PET/CT. This nomogram is useful for identifying patients who do not require intraoperative analysis of sentinel lymph nodes and considering candidates for identifying neoadjuvant chemotherapy. The patients consisted of clinical T1-2 and node-negative invasive breast cancer. The training and validation set consisted of 1030 and 781 patients, respectively. A nomogram was constructed by analyzing factors related to three or more axillary lymph node metastases. The patients who matched the ACOSOG-Z0011 criteria were selected and applied to the new nomogram.

show abstract

Management of the Axilla in Early Breast Cancer

Cited by 8 publications

References 57 publications

Internal Mammary Sentinel Lymph Node Biopsy in Clinically Axillary Lymph Node-Positive Breast Cancer: Diagnosis and Implications for Patient Management

Internal Mammary Sentinel Lymph Node Biopsy in Clinically Axillary Lymph Node-Positive Breast Cancer: Diagnosis and Implications for Patient Management

Sentinel lymph node biopsy for breast cancer during pregnancy: A comprehensive update

A nomogram for predicting three or more axillary lymph node involvement before breast cancer surgery

Contact Info

Product

Resources

About