Excision of both pretreatment marked positive nodes and sentinel nodes improves axillary staging after neoadjuvant systemic therapy in breast cancer.
Published: 8th October 2019
Authors: J. M. Simons, M. L. M. A. van Pelt, A. W. K. S. Marinelli, M. E. Straver, A. M. Zeillemaker, L. M. Pereira Arias‐Bouda et al.
Marking the axilla with radioactive iodine seed and sentinel lymph node (SLN) biopsy have been proposed for axillary staging after neoadjuvant systemic therapy in clinically node‐positive breast cancer. This study evaluated the identification rate and detection of residual disease with combined excision of pretreatment‐positive marked lymph nodes (MLNs) together with SLNs.
This was a multicentre retrospective analysis of patients with clinically node‐positive breast cancer undergoing neoadjuvant systemic therapy and the combination procedure (with or without axillary lymph node dissection). The identification rate and detection of axillary residual disease were calculated for the combination procedure, and for MLNs and SLNs separately.
At least one MLN and/or SLN(s) were identified by the combination procedure in 138 of 139 patients (identification rate 99·3 per cent). The identification rate was 92·8 per cent for MLNs alone and 87·8 per cent for SLNs alone. In 88 of 139 patients (63·3 per cent) residual axillary disease was detected by the combination procedure. Residual disease was shown only in the MLN in 20 of 88 patients (23 per cent) and only in the SLN in ten of 88 (11 per cent), whereas both the MLN and SLN contained residual disease in the remainder (58 of 88, 66 per cent).
Excision of the pretreatment‐positive MLN together with SLNs after neoadjuvant systemic therapy in patients with clinically node‐positive disease resulted in a higher identification rate and improved detection of residual axillary disease.Full text
You may also be interested in
Population‐based study of the effect of preoperative breast MRI on the surgical management of ductal carcinoma in situ. BJS 2019; 106: 1488-1494.
Authors: K. B. I. M. Keymeulen, S. M. E. Geurts, M. B. I. Lobbes, E. M. Heuts, L. E. M. Duijm, L. F. S. Kooreman et al.
Nationwide population‐based study of the impact of immediate breast reconstruction after mastectomy on the timing of adjuvant chemotherapy.
Authors: E. Heeg, J. X. Harmeling, B. E. Becherer, P. J. Marang‐van de Mheen, M. T. F. D. Vrancken Peeters, M. A. M. Mureau et al.
International multidisciplinary expert panel consensus on breast reconstruction and radiotherapy. BJS 2019; 106: 1327-1340.
Authors: M. B. Nava, J. R. Benson, W. Audretsch, P. Blondeel, G. Catanuto, M. W. Clemens et al.
Prognostic impact of repeat sentinel lymph node biopsy in patients with ipsilateral breast tumour recurrence. BJS 2019; 106: 574-585.
Authors: I. G. M. Poodt, G. Vugts, R. J. Schipper, R. M. H. Roumen, H. J. T. Rutten, A. J. G. Maaskant‐Braat et al.
Notes: No impact
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). BJS 2019; 106: 720-728.
Authors: A. Karakatsanis, A.‐F. Hersi, L. Pistiolis, R. Olofsson Bagge, P. M. Lykoudis, S. Eriksson et al.
Short‐term cost‐effectiveness of one‐stage implant‐based breast reconstruction with an acellular dermal matrix versus two‐stage expander‐implant reconstruction from a multicentre randomized clinical trial. BJS 2019; 106: 586-595.
Authors: V. L. Negenborn, J. M. Smit, R. E. G. Dikmans, H. A. H. Winters, J. W. R. Twisk, P. Q. Ruhé et al.
Autologous fat transplantation alters gene expression patterns related to inflammation and hypoxia in the irradiated human breast. BJS 2019; 106: 563-573.
Authors: A. Lindegren, I. Schultz, I. Sinha, L. Cheung, A. A. Khan, M. Tekle et al.
Notes: Effects on fibrosis after radiotherapy
Authors: F. Magnoni, G. Massari, G. Santomauro, V. Bagnardi, E. Pagan, G. Peruzzotti et al.
Authors: Y. Grant, R. Al‐Khudairi, E. St John, M. Barschkett, D. Cunningham, R. Al‐Mufti et al.
Notes: Reoperations expensive
Meta‐analysis of sentinel lymph node biopsy after neoadjuvant chemotherapy in patients with initial biopsy‐proven node‐positive breast cancer. BJS 2018; 105: 1541-1552.
Authors: S. R. Tee, L. A. Devane, D. Evoy, J. Rothwell, J. Geraghty, R. S. Prichard et al.
Notes: In selected patients using dual tracer
Feasibility study of combined dynamic imaging and lymphaticovenous anastomosis surgery for breast cancer‐related lymphoedema. BJS 2019; 106: 100-110.
Authors: A. A. Khan, I. Hernan, J. A. Adamthwaite, K. W. D. Ramsey
Notes: Effective in selected patients
Randomized clinical trial
INTEND II randomized clinical trial of intraoperative duct endoscopy in pathological nipple discharge. BJS 2018; 105: 1583-1590.
Authors: G. Gui, A. Agusti, D. Twelves, S. Tang, M. Kabir, C. Montgomery et al.
Notes: Identifies causative lesion