How many sentinel lymph nodes in addition to the clipped node are needed to accurately stage the axilla after neoadjuvant treatment in breast cancer?
Background: Identifying residual disease in the axilla after neoadjuvant treatment (NAT) is important to select patient for sparing an axillary node dissection (ALND). Controversy exists on the optimal number of sentinel nodes (SLNs) needed to excise along with the axillary clipped node. The aim of the study is to assess the false negative rates (FNR) in the SLN after NAT and to refine the axillary surgery using intraoperative ultrasound (IOUS) for excising axillary clipped nodes as a part of axillary staging after NAT.
CONCLUSION: The probability of nodal positivity after neoadjuvant chemotherapy was less than 3 per cent in patients with TNBC or HER2-positive disease who achieved a breast rCR on MRI. These patients could be included in trials investigating the omission of sentinel node biopsy after neoadjuvant chemotherapy. PMID: 33031572 [PubMed - as supplied by publisher]
Authors: Linhares S, Alrammah T, Alghamdi HA, Möller MG Abstract Inflammatory breast cancer (IBC) represents only 1% to 5% of all breast malignancies and is an extremely aggressive subtype. At time of diagnosis, up to 85% of patients will present with regional nodal metastases and up to 30 % will have metastasis to distant organs. There is limited medical literature describing treatment guidelines for IBC during gestation. The best diagnostic tools are core needle and full-thickness skin punch biopsies to assess presence of dermal lymphatic invasion. Breast Ultrasound is preferred to mammogram, but mammography...
A 64-year-old woman complaining of left arm and breast edema was referred to our hospital. Mammography and ultrasound could not initially show any masses, but magnetic resonance imaging (MRI) showed ill-defined small masses in her left breast. Histological examination showed the tumor to be triple-negative breast cancer. After neoadjuvant chemotherapy, the patient underwent operation. Postoperative histological examination showed massive cancer remnants in the lymph nodes and lymphatics. Enhanced CT taken at the onset of abdominal pain showed multiple liver masses with ring enhancement 17 months after the operation. Gadoxe...
Abstract Sentinel lymph node biopsy (SLNB) has emerged as an alternative to axillary lymph node dissection during breast cancer surgery during the last 2 decades. However, there are several controversies regarding the indication of the sentinel node biopsy after neoadjuvant chemotherapy which can convert positive lymph nodes to negative. The false negative rate after neoadjuvant chemotherapy is unacceptably high. This high false negative rate can be decreased by marking of the positive lymph nodes and removal during sentinel lymph node biopsy procedure in addition to the sentinel lymph nodes. The aim of this study...
Publication date: Available online 10 July 2020Source: European Journal of RadiologyAuthor(s): Rosalind P. Candelaria, Beatriz E. Adrada, Kenneth Hess, Lumarie Santiago, Deanna L. Lane, Alastair M. Thompson, Stacy L. Moulder, Monica L. Huang, Elsa M. Arribas, Gaiane M. Rauch, Jessica W.T. Leung, W. Fraser Symmans, Vicente Valero, Elizabeth E. Ravenberg, Jason B. White, Wei Tse Yang
Publication date: Available online 3 July 2020Source: European Journal of RadiologyAuthor(s): Dorothy Ibifuro Makanjuola, Abdulmohsen Alkushi, Khalid Al Anazi
Conclusions: When histologic examination from the base of the nipple is negative (either by FS or permanent pathology), NSM can be considered oncologically safe. Lack of nipple involvement by preoperative clinical and imaging assessment and intraoperative FS is sufficient to classify patients as suitable for NSM.
ConclusionQUS ‚Äźbased radiomics can predict response to NAC based on pretreatment features with acceptable accuracy.
CONCLUSION: Removal of sonographically abnormal metastatic clipped nodes using SMART, without sentinel lymph node biopsy, could accurately predict axillary status. This finding needs validation in larger studies. PMID: 32537791 [PubMed - as supplied by publisher]
A targeted surgical approach which accurately determines axillary status after neoadjuvant chemotherapy (NAC) may allow appropriate de-escalation of surgical treatment. It is postulated that the combined use of a particular marker clip, ULTRACOR ®TWIRL™ (Bard, Inc.), and specific ultrasound settings for its identification, may overcome the challenges of pre-operative localisation with size diminution of nodes following NAC. Hence, this feasibility study was performed.