Sentinel Lymph Node Biopsy in Breast Cancer

Manca, Gianpiero; Rubello, Domenico; Tardelli, Elisa; Giammarile, Francesco; Mazzarri, Sara; Boni, Giuseppe; Chondrogiannis, Sotirios; Marzola, Maria Cristina; Chiacchio, Serena; Ghilli, Matteo; Roncella, Manuela; Volterrani, Duccio; Colletti, Patrick M.

doi:10.1097/rlu.0000000000000985

Cited by 63 publications

(25 citation statements)

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“…In recent years, several transplant groups were able to demonstrate that 18 F-fludeoxyglucose ( 18 F-FDG) positron emission tomography (PET) provides useful information on metabolic tumor viability and posttransplant outcome 22 – 24 . PET-positivity was shown to correlate with presence of unfavourable histopathologic features, like MVI and poor grading 23 , 25 , 26 .…”

Section: Introductionmentioning

confidence: 92%

Combining 18F-FDG positron emission tomography with Up-to-seven criteria for selecting suitable liver transplant patients with advanced hepatocellular carcinoma

Kornberg

Witt

Schernhammer

et al. 2017

Sci Rep

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The Up-to-seven (UTS) criteria (sum of tumor size and number not exceeding 7) for indicating liver transplantation (LT) in hepatocellular carcinoma (HCC) were originally based on explant pathology features and absence of microvascular invasion (MVI). 18F-fludeoxyglucose (18F-FDG) positron emission tomography (PET) was shown to indicate the risk of MVI and tumor recurrence. The aim of this study was to analyze the prognostic significance of the clinical UTS criteria when being combined with PET-status of the tumor. Data of 116 liver transplant patients were subject to retrospective analysis. Five-year recurrence-free survival (RFS) rates in patients meeting (n = 85) and exceeding (n = 21) the radiographic UTS criteria were 81% and 55.1%, respectively (p = 0.014). In the UTS In subset, RFS was significantly better in PET-negative (94.9%) than in PET-positive patients (48.3%; p < 0.001). In the UTS Out subset, 5-year RFS rates were 87.1% and 19% in patients with non- 18F-FDG-avid and 18F-FDG-avid tumors (p < 0.001), respectively. Positive PET-status was identified as the only independent clinical predictor of tumor recurrence in beyond UTS patients (Hazard ratio [HR] 19.25; p < 0.001). Combining radiographic UTS criteria with FDG-PET may safely expand the HCC selection criteria for LT.

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Section: Introductionmentioning

confidence: 92%

Combining 18F-FDG positron emission tomography with Up-to-seven criteria for selecting suitable liver transplant patients with advanced hepatocellular carcinoma

Kornberg

Witt

Schernhammer

et al. 2017

Sci Rep

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“…SLNB has established its role as the standard surgical procedure for staging clinically negative nodes in patients with early-stage breast cancer. 2 The safety, clinical value, and feasibility of the SLNB have been validated in a robust body of randomized controlled trials. 13 , 14 However, more than 30 years after its introduction, 15 the application of SLNB in the real world in China is unclear.…”

Section: Discussionmentioning

confidence: 99%

“…However, axillary lymph node dissection (ALND) may result in lymphedema, nerve injury, shoulder dysfunction, and other short-term and long-term complications limiting functionality and reducing quality of life. 2 With the advent of sentinel lymph node biopsy (SLNB), surgical methods for accurately staging axilla in patients with early-stage breast cancer have become progressively less extensive. 3 SLNB has supplanted ALND as the gold standard for axillary lymph node staging in clinically and radiologically node-negative breast cancer.…”

Section: Introductionmentioning

confidence: 99%

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<p>Clinical Practice Status of Sentinel Lymph Node Biopsy for Early-Stage Breast Cancer Patients in China: A Multicenter Study</p>

Zhang

Wang

Yan

et al. 2020

CLEP

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Background: Sentinel lymph node biopsy (SLNB) was introduced over 30 years ago, but the application of SLNB in China is unclear. This study aimed to explore the real-world implementation of SLNB among early-stage breast cancer patients in China. Methods: A multi-center, retrospective study was conducted among primary breast cancer patients from 37 hospitals in China in 2018. Their clinical data were collected and analyzed, including the implementation status of SLNB in China, subsequent processing of sentinel lymph nodes (SLNs) containing metastases, and the effect of neoadjuvant chemotherapy (NAC) on SLNB. Results: SLNB surgery was performed on 43.5% of early-stage breast cancer patients in China and 11,942 patients who underwent SLNB were enrolled in this study. The majority of SLNBs were performed using a single mapping agent. A combination of blue dye and radiotracer or fluorescence imaging was used in only 14.9% of patients. The mean (SD) number of resected SLNs was 4.0 (2.1). For the patients with 1 or 2 positive SLNs, 83.0% of them continued to receive axillary lymph node dissection (ALND), while others did not. For the patients with three or more positive SLNs, 97.2% of them continued to receive ALND, among which 82.9% accepted radiotherapy simultaneously. Of the patients who underwent SLN surgery, 5.5% (654/11,942) were receiving NAC. Among them, 51.9% received SLNB before NAC, and the rest received SLNB after NAC. In biopsy-proven positive nodes, 64.7% positive SLNs turned negative after NAC. Conclusion: SLNB has been promoted in China, but it is not widely used compared to in developed countries. Furthermore, the usage of the dual tracer technique in SLNB is not high. Chinese breast surgeons are more conservative regarding the omission of ALND in 1 or 2 SLNs-positive patients.

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“… 3 As the breast cancer surgery becomes more conservative, SLN biopsy, a minimally invasive way, has gradually replaced the routine ALND for SLN staging. 7 - 9 As a revolution of the breast cancer surgery, SLN biopsy helps patients with the absence of non-SLNs metastases to avoid ALND. 1 , 8 However, complete ALND is still the gold standard treatment when metastases are found in SLNs.…”

Section: Discussionmentioning

confidence: 99%

Validation of Breast Cancer Models for Predicting the Nonsentinel Lymph Node Metastasis After a Positive Sentinel Lymph Node Biopsy in a Chinese Population

Zhao

Liang

et al. 2018

Technol Cancer Res Treat

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Objectives:Over the years, completion axillary lymph node dissection is recommended for the patients with breast cancer if sentinel lymph node metastasis is found. However, not all of these patients had nonsentinel lymph node metastasis on final histology. Some predicting models have been developed for calculating the risk of nonsentinel lymph node metastasis. The aim of our study was to validate some of the predicting models in a Chinese population.Method:Two hundred thirty-six patients with positive sentinel lymph node and complete axillary lymph node dissection were included. Patients were applied to 6 models for evaluation of the risk of nonsentinel lymph node involvement. The receiver–operating characteristic curves were shown in our study. The calculation of area under the curves and false negative rate was done for each model to assess the discriminative power of the models.Results:There are 105 (44.5%) patients who had metastatic nonsentinel lymph node(s) in our population. Primary tumor size, the number of metastatic sentinel lymph node, and the proportion of metastatic sentinel lymph nodes/total sentinel lymph nodes were identified as the independent predictors of nonsentinel lymph node metastasis. The Seoul National University Hospital and Louisville scoring system outperformed the others, with area under the curves of 0.706 and 0.702, respectively. The area under the curve values were 0.677, 0.673, 0.432, and 0.674 for the Memorial Sloan-Kettering Cancer Center, Tenon, Stanford, and Shanghai Cancer Hospital models, respectively. With adjusted cutoff points, the Louisville scoring system outperformed the others by classifying 26.51% of patients with breast cancer to the low-risk group.Conclusion:The Louisville and Seoul National University Hospital scoring system were found to be more predictive among the 6 models when applied to the Chinese patients with breast cancer in our database. Models developed at other institutions should be used cautiously for decision-making regarding complete axillary lymph node dissection after a positive biopsy in sentinel lymph node.

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Sentinel Lymph Node Biopsy in Breast Cancer

Cited by 63 publications

References 100 publications

Combining 18F-FDG positron emission tomography with Up-to-seven criteria for selecting suitable liver transplant patients with advanced hepatocellular carcinoma

Combining 18F-FDG positron emission tomography with Up-to-seven criteria for selecting suitable liver transplant patients with advanced hepatocellular carcinoma

<p>Clinical Practice Status of Sentinel Lymph Node Biopsy for Early-Stage Breast Cancer Patients in China: A Multicenter Study</p>

Validation of Breast Cancer Models for Predicting the Nonsentinel Lymph Node Metastasis After a Positive Sentinel Lymph Node Biopsy in a Chinese Population

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