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6. Lemos S, Dias M, Gonçalo M, Pinto E, Fernandes G, Oliveira C: Detection of axillary metastases in breast cancer patients using ultrasound and colour Doppler combined with fine needle aspiration cytology. Eur J Gynaecol Oncol; 2005;26(2):165-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Detection of axillary metastases in breast cancer patients using ultrasound and colour Doppler combined with fine needle aspiration cytology.
  • The aims of this study were to evaluate the diagnostic value of ultrasonography and colour Doppler combined with fine needle aspiration (FNA) cytology for the detection of non-palpable axillary lymph node metastases in breast cancer patients.
  • Forty patients with operable breast cancer (T1/T2), invasive carcinoma, not submitted to neo-adjuvant therapy, underwent axillary ultrasonography and colour Doppler preoperatively.
  • FNA cytology was performed on axillary lymph nodes presenting ultrasonographic and/or Doppler suspicious features.
  • A total of 542 lymph nodes were surgically removed from the 40 patients; 19 were metastatic lymph nodes.
  • Ultrasound-guided FNA detected metastases in six out of 11 histologically node-positive patients.
  • [MeSH-major] Breast Neoplasms / diagnosis. Carcinoma, Ductal, Breast / diagnosis. Carcinoma, Lobular / diagnosis. Lymph Nodes / ultrasonography. Lymphatic Diseases / ultrasonography
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Axilla. Biopsy, Fine-Needle / methods. Female. Humans. Lymphatic Metastasis. Mastectomy. Middle Aged. Prospective Studies. Sensitivity and Specificity. Treatment Outcome. Ultrasonography, Doppler, Color

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  • (PMID = 15857022.001).
  • [ISSN] 0392-2936
  • [Journal-full-title] European journal of gynaecological oncology
  • [ISO-abbreviation] Eur. J. Gynaecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
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7. van Rijk MC, Peterse JL, Nieweg OE, Oldenburg HS, Rutgers EJ, Kroon BB: Additional axillary metastases and stage migration in breast cancer patients with micrometastases or submicrometastases in sentinel lymph nodes. Cancer; 2006 Aug 1;107(3):467-71
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Additional axillary metastases and stage migration in breast cancer patients with micrometastases or submicrometastases in sentinel lymph nodes.
  • The aims of the current study were to investigate the incidence of micro- and submicrometastases in the sentinel node, to estimate the risk of additional metastases in the remaining axillary lymph nodes, and to consider implications for staging and treatment.
  • METHODS: A total of 2150 breast cancer patients who had undergone axillary sentinel node biopsy between 1999 and 2004 were retrospectively evaluated.
  • RESULTS: In all, 649 patients (30%) had a tumor-positive axillary sentinel node.
  • Of the 148 patients with micrometastases, 106 underwent axillary lymph node dissection (ALND) and additional metastases were found in 20 patients (19%).
  • Seven of the 106 patients (7%) received additional systemic treatment based on the findings in the axillary lymph nodes.
  • Based on these findings, offering additional treatment of the axilla is suggested in patients with micrometastases, but refraining from ALND in patients with submicrometastases in their sentinel node.
  • [MeSH-major] Breast Neoplasms / diagnosis. Lymph Nodes / pathology. Neoplasm Staging. Sentinel Lymph Node Biopsy
  • [MeSH-minor] Female. Humans. Lymphatic Metastasis. Retrospective Studies

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  • [Copyright] Copyright 2006 American Cancer Society.
  • (PMID = 16804924.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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8. Wang X, Zhao Y, Cao X: Clinical benefits of mastectomy on treatment of occult breast carcinoma presenting axillary metastases. Breast J; 2010 Jan-Feb;16(1):32-7
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  • [Title] Clinical benefits of mastectomy on treatment of occult breast carcinoma presenting axillary metastases.
  • Occult breast carcinoma presenting axillary metastases is uncommon and accounts for less than 1% of newly diagnosed breast carcinoma.
  • All these patients had a palpable axillary nodule, no dominant breast mass, and no abnormal mammograms and breast ultrasonograph.
  • Histological examination of axillary mass revealed metastasis from breast.
  • Seventy-seven percent of patients who had no local treatment of the breast had a tumor recurrence, compared with 26% who had a mastectomy.
  • Once the diagnosis of occult breast carcinoma is clarified, an axillary dissection and the local treatment of breast should be carried out.
  • [MeSH-major] Adenocarcinoma / secondary. Adenocarcinoma / surgery. Breast Neoplasms / surgery. Lymph Nodes / pathology. Lymphatic Diseases / diagnosis
  • [MeSH-minor] Adult. Age Factors. Aged. Axilla. Cohort Studies. Diagnosis, Differential. Female. Humans. Lymph Node Excision / methods. Lymphatic Metastasis. Mammography / methods. Mastectomy / methods. Mastectomy / mortality. Middle Aged. Neoplasm Recurrence, Local / mortality. Neoplasm Recurrence, Local / pathology. Prognosis. Retrospective Studies. Risk Assessment. Survival Analysis. Treatment Outcome. Ultrasonography, Mammary / methods

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  • (PMID = 20465598.001).
  • [ISSN] 1524-4741
  • [Journal-full-title] The breast journal
  • [ISO-abbreviation] Breast J
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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9. Veronesi U, Galimberti V, Paganelli G, Maisonneuve P, Viale G, Orecchia R, Luini A, Intra M, Veronesi P, Caldarella P, Renne G, Rotmensz N, Sangalli C, De Brito Lima L, Tullii M, Zurrida S: Axillary metastases in breast cancer patients with negative sentinel nodes: a follow-up of 3548 cases. Eur J Cancer; 2009 May;45(8):1381-8
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  • [Title] Axillary metastases in breast cancer patients with negative sentinel nodes: a follow-up of 3548 cases.
  • PREMISES: Sentinel node biopsy (SNB) in patients with breast carcinoma accurately predicts the axillary node status.
  • However, in some 4-7% of patients with negative sentinel nodes, the remaining axillary nodes harbour cancer cells.
  • OBJECTIVE: Our purpose was the long-term observation of a large number of patients who did not receive axillary dissection after a negative sentinel node biopsy, in order to evaluate the incidence of overt axillary metastases.
  • METHODS: Patients (3548) treated from 1996 to 2004, with negative sentinel nodes not submitted to axillary dissection, were followed up to 11 years with a median follow-up of 48 months.
  • Thirty one cases of overt axillary metastases were found (0.9%): they received total axillary dissection and 27 of them are at present alive and well.
  • CONCLUSIONS: Patients with negative sentinel node biopsy not submitted to axillary dissection show, at follow-up, a rate of overt axillary metastases lower than expected.
  • [MeSH-major] Breast Neoplasms / pathology. Carcinoma, Ductal, Breast / secondary
  • [MeSH-minor] Adult. Aged. Axilla. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Kaplan-Meier Estimate. Lymphatic Metastasis. Middle Aged. Proportional Hazards Models. Receptors, Estrogen / analysis. Reoperation. Risk. Sentinel Lymph Node Biopsy. Survival Rate. Treatment Outcome

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  • (PMID = 19128957.001).
  • [ISSN] 1879-0852
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Receptors, Estrogen
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10. Moore A, Hester M, Nam MW, Brill YM, McGrath P, Wright H, Weisinger K, Romond E, Samayoa LM: Distinct lymph nodal sonographic characteristics in breast cancer patients at high risk for axillary metastases correlate with the final axillary stage. Br J Radiol; 2008 Aug;81(968):630-6
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  • [Title] Distinct lymph nodal sonographic characteristics in breast cancer patients at high risk for axillary metastases correlate with the final axillary stage.
  • The purpose of this study was to assess the clinical relevance, limitations and most common findings of axillary ultrasound and subsequent image-guided aspiration cytology in clinically node-negative breast cancer patients who are at high risk for axillary metastasis.
  • Following institutional review board approval and Health Insurance Portability and Accountability Act (HIPAA) compliance, sonographic axillary surveys from 112 patients considered at high risk for axillary metastases were reviewed retrospectively for the following abnormal features: asymmetric cortical thickening/lobulations; loss or compression of the hyperechoic medullary region; absence of fatty hilum; abnormal lymph node shape; hypoechoic cortex; admixture of normal and abnormal appearing nodes; and increased peripheral blood flow.
  • Patients with abnormal ultrasound and positive cytology proceeded to complete axillary dissection.
  • The number of positive nodes, the size of tumour deposits and the histological pattern of metastatic disease on the positive nodes were then correlated and compared with their corresponding sonographic abnormalities.
  • In conclusion, nodal sonographic characteristics of patients at high risk for metastases are useful predictors of tumour burden in the axilla.
  • When combined with the results from aspiration cytology, these findings could modify the surgical approach to the axilla, eliminating the need for sentinel node mapping in a significant proportion of patients.
  • [MeSH-minor] Axilla. Female. Humans. Lymphatic Metastasis / pathology. Lymphatic Metastasis / ultrasonography. Neoplasm Invasiveness. Neoplasm Staging. Retrospective Studies. Risk Assessment. Sensitivity and Specificity. Sentinel Lymph Node Biopsy / methods. Ultrasonography, Interventional

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  • (PMID = 18628332.001).
  • [ISSN] 1748-880X
  • [Journal-full-title] The British journal of radiology
  • [ISO-abbreviation] Br J Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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11. Yamaguchi H, Ishikawa M, Hatanaka K, Uekusa T, Ishimaru M, Nagawa H: Occult breast cancer presenting as axillary metastases. Breast; 2006 Apr;15(2):259-62
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  • [Title] Occult breast cancer presenting as axillary metastases.
  • We report the case of a 52-year-old woman with occult breast cancer who presented with a hard metastatic nodule in the left axilla.
  • Although histology identified a metastatic adenocarcinoma in the lymph nodes, numerous tests failed to detect the primary tumor.
  • Immunohistochemistry showed that the resected lymph node was positive for both estrogen and progesterone receptors, suggesting the breast as the site of the primary tumor.
  • [MeSH-major] Breast Neoplasms / diagnosis. Carcinoma, Ductal, Breast / diagnosis. Neoplasms, Unknown Primary / diagnosis
  • [MeSH-minor] Axilla. Diagnosis, Differential. Female. Humans. Lymph Nodes / pathology. Lymphatic Metastasis. Middle Aged. Neoplasm Metastasis

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  • (PMID = 15996865.001).
  • [ISSN] 0960-9776
  • [Journal-full-title] Breast (Edinburgh, Scotland)
  • [ISO-abbreviation] Breast
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Scotland
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12. Veronesi U, De Cicco C, Galimberti VE, Fernandez JR, Rotmensz N, Viale G, Spano G, Luini A, Intra M, Veronesi P, Berrettini A, Paganelli G: A comparative study on the value of FDG-PET and sentinel node biopsy to identify occult axillary metastases. Ann Oncol; 2007 Mar;18(3):473-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A comparative study on the value of FDG-PET and sentinel node biopsy to identify occult axillary metastases.
  • BACKGROUND: Sentinel node biopsy (SNB) has become a standard treatment in staging axillary lymph nodes in early breast cancer.
  • Breast cancer is frequently characterised by increased 2-fluoro-2-deoxy-D-glucose uptake and many studies have shown encouraging results in detecting axillary lymph node metastases.
  • The aim of this study was to compare SNB and -positron emission tomography (-PET) imaging, to assess their values in detecting occult axillary metastases.
  • PATIENTS AND METHODS: In all, 236 patients with breast cancer and clinically negative axilla were enrolled in the study.
  • Patients underwent axillary lymph nodes dissection (ALND) in cases of positive FDG-PET or positive SNB.
  • RESULTS: In all, 103 out of the 236 patients (44%) had metastases in axillary nodes.
  • Sensitivity of FDG-PET scan for detection of axillary lymph node metastases in this series was low (37%); however, specificity and positive predictive values were acceptable (96% and 88%, respectively).
  • CONCLUSIONS: The high specificity of PET imaging indicates that patients who have a PET-positive axilla should have an ALND rather than an SNB for axillary staging.
  • In contrast, FDG-PET showed poor sensitivity in the detection of axillary metastases, confirming the need for SNB in cases where PET is negative in the axilla.

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  • (PMID = 17164229.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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13. Esen G, Gurses B, Yilmaz MH, Ilvan S, Ulus S, Celik V, Farahmand M, Calay OO: Gray scale and power Doppler US in the preoperative evaluation of axillary metastases in breast cancer patients with no palpable lymph nodes. Eur Radiol; 2005 Jun;15(6):1215-23
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  • [Title] Gray scale and power Doppler US in the preoperative evaluation of axillary metastases in breast cancer patients with no palpable lymph nodes.
  • The purpose of this study is to evaluate the accuracy of gray scale and Doppler US findings in the detection of axillary metastases in breast cancer patients with no palpable lymph nodes.
  • Histopathologically, there were 93 malignant and 105 benign nodes.
  • In conclusion, US is successful and reliable in the determination of axillary metastatic involvement in nonpalpable and small lymph nodes.
  • Inclusion of axillary US in the preoperative diagnostic evaluation would be complimentary to sentinel node biopsy, and also could eliminate the need for it in patients with positive US results, after confirmation with biopsy.
  • [MeSH-major] Breast Neoplasms / pathology. Lymphatic Metastasis / diagnostic imaging. Ultrasonography, Doppler
  • [MeSH-minor] Adult. Aged. Axilla. Chi-Square Distribution. Female. Humans. Middle Aged. Predictive Value of Tests. Prospective Studies. Sensitivity and Specificity

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  • (PMID = 15690206.001).
  • [ISSN] 0938-7994
  • [Journal-full-title] European radiology
  • [ISO-abbreviation] Eur Radiol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
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1
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4. Apsey H, Roy V, Pockaj B, Northfelt D, Sticca R, Nikcevich DA, Mattar B, Fitch T, Perez EA: Surgical practice patterns following NCCTG N0338 "Phase II trial of docetaxel and darboplatin administered every two weeks as induction therapy for stage II and stage III breast cancer.". J Clin Oncol; 2009 May 20;27(15_suppl):623

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Residual tumor size did not always impact primary surgical therapy.
  • Axillary lymph node (ALN) staging varied tremendously.
  • Three (6%) patients presented with palpable lymphadenopathy and proceeded to complete axillary lymph node dissection (ALND) after chemotherapy (CT).
  • Fine needle aspiration (8) or core needle biopsy (7) of the axilla was performed in 15 (30%) patients before CT; 1 was negative and went on to have sentinel lymph node biopsy (SLNB) after CT; 14 (94%) were positive with 13 (86%) going on to ALND and 1 SLNB after CT.
  • Ten (20%) underwent ALND with no pre-operative staging with 8 being positive for ALN metastases.
  • CONCLUSIONS: Review of study data from multiple institutions revealed no consistent criteria in selection of surgical intervention for the breast tumor or ALN staging.

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  • (PMID = 27961428.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. Park Y, Kim S, Ok O, Baek H, Lee J, Nam S, Yang J, Cho E, Ahn J, Im Y: Risk stratification by hormonal receptor (ER, PgR) and HER2 status in small (≤1cm) invasive breast cancer: Who might be a possible candidate for adjuvant treatment? J Clin Oncol; 2009 May 20;27(15_suppl):564

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • 1) to identify the risk factors of systemic metastases in patients with ≤ 1 cm invasive breast cancer and 2) to investigate the patients group at greatest risk of such failure even in these small tumors.
  • Ipsilateral axillary lymph node involvement was found in 13% (57/427) at the time of surgery.
  • Axillary lymph node involvement was much more common in HER-2 positive group (33% vs 11%, p < 0.0001) and triple negative (TN) group (24% vs 11%, p = 0.002) than in hormone receptor positive group.
  • CONCLUSIONS: Even though T1aN0 and T1bN0 tumors have been known to have a relative low risk of systemic failure, anti-HER-2 directed therapy for HER-2 positive group and new innovative adjuvant systemic treatment for TN group in patients with T1bN0 tumor should be considered.

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  • (PMID = 27960726.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Pugliese MS, Stempel MM, Patil SM, Hsu M, Cody HS 3rd, Morrow M, Gemignani ML: The clinical impact and outcomes of immunohistochemistry-only metastases in breast cancer. J Clin Oncol; 2009 May 20;27(15_suppl):613

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The clinical impact and outcomes of immunohistochemistry-only metastases in breast cancer.
  • : 613 Background: Modern surgical and pathologic techniques can detect small volume axillary metastases in breast cancer.
  • The clinical significance of these metastases was evaluated in comparison to patients with negative sentinel lymph nodes (Neg-SN).
  • METHODS: Retrospective database review from 1997 through 2003 for eligible patients with unilateral breast cancer and no history of significant non-breast malignancy identified 232 patients with sentinel lymph node (SLN) metastases identified only by immunohistochemical stains (IHC-SN).
  • In 123 IHC-SN patients treated with axillary dissection (ALND), 16% had macrometastases in the non-SLNs.
  • Only one axillary recurrence occurred in the group of IHC-SN patients without ANLD (n=109).
  • There were no differences between cases and controls for recurrence-free survival (RFS) or overall survival (OS) both by univariate and multivariate models that included variables such as age, tumor size, chemotherapy and hormone therapy [HR 0.99 (95%CI 0.43-2.28, p=0.99) for RFS, HR 2.06 (95%CI 0.79-5.35) p=0.14 for OS].
  • In patients not undergoing dissection, axillary recurrence was a rare event.
  • However, failure to identify additional metastases by omitting ALND may result in understaging and inadequate systemic treatment in some patients.

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  • (PMID = 27961483.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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17. Haid A, Knauer M, Köberle-Wührer R, Wenzl E: Sentinel node biopsy in breast cancer: technique and indication. Wien Klin Wochenschr; 2005 Feb;117(4):121-128

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Accepted indications are uni- and multifocal tumors smaller than 3 cm without suspicious findings in the axilla, furthermore SNB is indicated in patients with large ductal carcinoma in situ (>2 cm) and/or with assumed microinvasion.
  • SNB allows the pathologist to focus on a small number of nodes most likely to contain metastases.
  • Broad application and refurbishment led to scientific discussion of prognostic importance of micrometastases and its relevance regarding axillary dissection and adjuvant systemic treatment.
  • Although many unicentric and multicentric observational studies validated by complete axillary dissection could demonstrate that SNB is accurate and suitable for all operable clinically node-negative breast cancers, long-term results and especially the incidence of axillary recurrence and its sequelae are outstanding.
  • Sentinel node biopsy is a team approach, requirements are good cooperation and well-defined structures of quality indicators and documentation.

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  • (PMID = 28108807.001).
  • [ISSN] 1613-7671
  • [Journal-full-title] Wiener klinische Wochenschrift
  • [ISO-abbreviation] Wien. Klin. Wochenschr.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Austria
  • [Keywords] NOTNLM ; Breast cancer / Indications / Sentinel node biopsy / Technique
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18. Bastiaannet E, De Jong JR, Brouwers AH, Suurmeijer AJ, Hoekstra HJ: The prognostic value of FDG-PET measured by standardized uptake value in patients with melanoma stage III evaluated in a prospective study. J Clin Oncol; 2009 May 20;27(15_suppl):e20000

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • : e20000 Background: FDG-PET is a sensitive modality to detect melanoma metastases; melanomas are typically FDG-avid and melanoma shows an unpredictable pattern of spread.
  • Therefore, aim of this study was to perform a prospective analysis to determine whether SUV is of prognostic value in the DFS and DSS of melanoma patients with palpable lymph node metastases.
  • METHODS: From July 2002 until December 2007, all consecutive patients with palpable, histology or cytology proven lymph node metastases of melanoma referred to the University Medical Centre Groningen for examination with FDG-PET were prospectively included.
  • The SUVmean (70% isocontour) and SUVmax in the lymph node metastasis were calculated for patients who showed no distant metastases on chest X-Ray, FDG-PET and CT.
  • High SUV values were present in axillary metastases (p=0.118), in patients who had more than 15 nodes removed (p=0.061) and in patients with a large tumor size in the lymph node (p=0.0001).
  • CONCLUSIONS: The SUV in the lymph node metastasis seems to be associated with disease-free survival for melanoma patients clinically stage III.

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  • (PMID = 27962608.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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19. Yamashita K, Haga S, Shimizu K: Sentinel and axillary nodes of the breast distinguished from those of the arm by 3D-CT lymphography and selectively dissected by endoscopic surgery. J Clin Oncol; 2009 May 20;27(15_suppl):616

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Sentinel and axillary nodes of the breast distinguished from those of the arm by 3D-CT lymphography and selectively dissected by endoscopic surgery.
  • : 616 Background: In early breast cancer, the presence of metastasis in axillary lymph nodes (AN) is an important factor in prognosis and further treatment.
  • 3D-CT lymphography (LG) can show the precise individual lymphatic flow not only from the breast tumor to SN but also from SN to venous angle, which means breast lymphatic channel.
  • Above the tumor and near the areola and the arm pit, 2 ml of Iopamidol 300 was injected subcutaneously.
  • 3D-CT LG clearly showed the precise lymphatic flow from the tumor to SN.

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  • (PMID = 27961492.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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20. Vigo SA, Sansano M, Marmissolle F, Mainella A, Lujan L, Price P, Antonelli M, Mohamed F, Giacomi N: Characteristics and behavior of HER-2/neu positive tumors in patients under 35 years of age with breast cancer. J Clin Oncol; 2009 May 20;27(15_suppl):e11634

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • It is believed that tumor is more aggressive in biologic nature in this group of pts.
  • OBJECTIVE: to describe Her2/neu status, tumor behavior and prognosis in women aged 35 and under with BC.
  • METHODS: We reviewed the records of 45 women aged 35 years or less, with diagnosis of BC between 1999 and 2007.
  • Stage at diagnosis was I 2 pts and II 6 pts.
  • 5 out of the 8 pts with Her2/neu tumors had axillary node involvement (11.1% out of the total of population), and tumor size was more than 2cm at diagnosis.
  • Disease free survival of 24 month was achieved in 5pts, 1pt died with bone, lung and liver metastases.
  • 2pts had progressive disease (bone and lung metastases one of them, and local recurrence the other one).
  • In this small group of pts lymph node involvement was frequent and tumor size was more than 2cm.
  • Progressive disease with distant metastases in bone, lung and liver was observed.

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  • (PMID = 27961197.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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21. Moghimi M, Ghoddosi I, Rahimabadi AE, Sheikhvatan M: Accuracy of sentinel node biopsy in breast cancer patients with a high prevalence of axillary metastases. Scand J Surg; 2009;98(1):30-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Accuracy of sentinel node biopsy in breast cancer patients with a high prevalence of axillary metastases.
  • BACKGROUND: Sentinel lymph node biopsy (SLNB) has become a standard diagnostic tool for axillary staging of breast cancer and has many advantages in comparison with axillary dissection.
  • The goal of our study was to determine accuracy and predictive value of SLNB for assessing the axillary lymph nodes involvement in breast cancer.
  • Statistical analyses were performed by evaluating of sensitivity, specificity, accuracy, and positive and negative predictive values of SLNB in comparison to axillary lymph node dissection (ALND).
  • CONCLUSION: Our experience shows SLNB to be reliable and accurate for axillary staging in breast cancer patients with a high prevalence of axillary metastases and can be replaced diagnostic ALND in our breast cancer centers.
  • [MeSH-minor] Axilla / pathology. Axilla / surgery. Cross-Sectional Studies. Female. Humans. Lymph Node Excision. Lymphatic Metastasis. Middle Aged. Neoplasm Staging / methods. Sensitivity and Specificity

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  • (PMID = 19447739.001).
  • [ISSN] 1457-4969
  • [Journal-full-title] Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society
  • [ISO-abbreviation] Scand J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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22. Craft PS, Buckingham J, Dahlstrom JE, Beckmann K, Zhang Y, Stuart-Harris R, Jacob G, Roder D, Tait N: Variations in care for operable breast cancer and outcomes between rural and metropolitan centers in Australia. J Clin Oncol; 2009 May 20;27(15_suppl):e11517

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The overall recurrence rate, including distant metastases, for all women was 11.6%.
  • Breast cancer mortality was increased in women with large tumors, high grade disease, and positive axillary lymph nodes.

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  • (PMID = 27964652.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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23. Revillion F, Lhotellier V, Hornez L, Leroy A, Baranzelli MC, Giard S, Bonneterre J, Peyrat JP: Real-time reverse-transcription PCR to quantify a panel of 19 genes in breast cancer: relationships with sentinel lymph node invasion. Int J Biol Markers; 2008 Jan - Mar;23(1):10-17
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • : At the Centre Oscar Lambret, the anticancer centre of the North of France, sentinel lymph node (SLN) procedures are routinely performed for localized (T0-T1, N0, M0) breast carcinoma without any previous treatment, in order to prevent the deleterious effects of axillary lymph node dissection.
  • The present study was undertaken to assess if the expression in the tumor of a panel of 19 genes would allow to predict histological SLN involvement.
  • Their expression was quantified by real-time RT-PCR in 134 breast cancer samples and the relationships with SLN metastases were analyzed.
  • A slight increase (35-40%) in CK19 and HER3 expression was observed in the tumors of patients with SLN metastases compared to those of patients without metastases, even if neither CK19 expression nor HER3 expression allowed to distinguish patients with micrometastases from patients with macrometastases.
  • We conclude that the tumoral expression of biological parameters involved in cell proliferation or playing a critical role in the metastatic process, including tumor invasion and angiogenesis, is not strongly associated with SLN metastases.


24. Durbecq V, Majjaj S, Nogaret J, Sirtaine N, Schobbens J, Noterman D, Hertens D, Filipov V, Larsimont D, Veys I: Use of quantitative RT-PCR assay to predict metastases size of sentinel node from breast cancer patients. J Clin Oncol; 2009 May 20;27(15_suppl):621

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Use of quantitative RT-PCR assay to predict metastases size of sentinel node from breast cancer patients.
  • : 621 Background: A RT-PCR Assay (GeneSearch, Veridex, LLC), FDA approved and CE marked to detect metastases > 0.2 mm in sentinel lymph nodes (SLNs) of breast cancer patients, has been in clinical use in our institute for 25 months.
  • This study evaluates if quantitative Ct values can be used to estimate the probable size of nodal metastases.
  • During clinical use, same-surgery complete axillary dissection was performed when the assay was positive (n=59).
  • The marker Ct values are correlated with metastases size as determined by H&E on adjacent node pieces (r = -0.74 for MG and -0.77 for CK19, p < 0.001).
  • Additionally, Assay Ct values in the SLN were predictive of metastases in non-SLN nodes.
  • CONCLUSIONS: The BLN Assay's high intra- operative qualitative performance minimizes the need for second surgeries for complete axillary dissections.
  • Results from this investigational study examining the marker Ct values suggest that the assay may provide valuable individual tumor volume data intra- operatively or post-operatively.

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  • (PMID = 27961419.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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25. Han W, Kim H, Lee J, Lee K, Moon H, Ko E, Kim E, Yu J, Noh D: Value of preoperative staging of breast cancer patients using computed tomography to detect asymptomatic lung and liver metastasis. J Clin Oncol; 2009 May 20;27(15_suppl):1105

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Value of preoperative staging of breast cancer patients using computed tomography to detect asymptomatic lung and liver metastasis.
  • Identifying unexpected distant metastases in newly diagnosed breast cancer patients frequently alters initial treatment plans.
  • Routine imaging studies to detect lung or liver metastasis is not indicated in patients with early and operable breast cancer.
  • METHODS: We aimed to investigate the value of preoperative computed tomography to detect asymptomatic liver and lung metastasis in breast cancer patients.
  • We performed preoperative CT for 667 breast cancer patients to detect lung and liver metastasis among 1,636 primary breast cancer patients who had been diagnosed and treated between January 2006 and December 2007 at Seoul National University Hospital.
  • RESULTS: CT showed abnormal findings (suspicious of metastasis or indeterminate nodules) in 78 patients (10.5%).
  • Among these, abnormal finding in 13 patients (1.7%) turned out to be true metastatic lesions.
  • There was no CT-detected lung or liver metastasis in patients with T1 tumor and 4 metastases in patients with T2 tumor.
  • There was no CT-detected lung or liver metastasis in patients with negative axillary lymph node metastasis.
  • When patients were classified according to the AJCC staging, CT-detected true metastatic lesions were only present in stage III patients (13 out of 173 patients, 7.5%).
  • The true metastatic lesions in lung or liver were all small sized nodules, ranging from 0.3cm to 1.2cm in largest diameters.
  • In seven patients, the CT-detected metastatic lesions were less than 1cm which is in contrast with the previous studies.
  • CONCLUSIONS: Our results demonstrated the lack of usefulness in performing routine CT exams to detect asymptomatic liver and lung metastasis in early breast cancer patients.

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  • (PMID = 27962171.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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26. Di Filippo F, Mottolese M, Botti C, Marandino F, Psaila A, Perri P, Di Filippo S, Pasqualoni R, Ferranti F, Buglioni S: A prospective clinical study for molecular intra-operative detection of lymph node metastasis in breast cancer patients by one step nucleic acid amplification (OSNA) in comparison to intensive histological investigation. J Clin Oncol; 2009 May 20;27(15_suppl):609

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A prospective clinical study for molecular intra-operative detection of lymph node metastasis in breast cancer patients by one step nucleic acid amplification (OSNA) in comparison to intensive histological investigation.
  • : 609 Background: The aims of the study were 1) to assess the accuracy of a new intra-operative molecular diagnostic tool named OSNA, based on the measurement of cytokeratin 19 (CK19) mRNA, in the detection of axillary sentinel lymph node (SLN) metastases in patients with breast carcinoma 2) to determine the concordance of OSNA analysis with multilevel haematoxylin and eosin (H&E) and immunohistochemical (IHC) examination.

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  • (PMID = 27961472.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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27. Keskek M, Balas S, Gokoz A, Sayek I: Re-evaluation of axillary skip metastases in the era of sentinel lymph node biopsy in breast cancer. Surg Today; 2006;36(12):1047-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Re-evaluation of axillary skip metastases in the era of sentinel lymph node biopsy in breast cancer.
  • PURPOSE: To investigate whether skip axillary metastases are really skip metastases or a continuation of level I micrometastases in invasive breast cancer, and to determine whether there are any factors predisposing to skip metastases.
  • METHODS: We reviewed 568 consecutive patients with breast cancer who underwent complete axillary lymph node dissections (ALND) between January 1998 and December 2004.
  • For patients with skip axillary lymph node metastases, resectioning and immunohistochemical staining of the remaining part of paraffin blocks from level I lymph nodes were done to determine whether there were any micrometastases in this group of lymph nodes.
  • RESULTS: Skip axillary metastases were found in 27 (10%) of 268 patients with axillary lymph node metastases.
  • Re-evaluation of the level I lymph nodes, both with thin sectioning and immunohistochemical staining, in the patients with axillary skip metastases revealed no micrometastases.
  • No significant correlation was found between the demographic and histopathological variables of the patients with skip metastases and those with regular axillary metastases.
  • CONCLUSIONS: These results suggest that skip axillary metastases are actual skip metastases, not a continuation of undetected level I micrometastases.
  • Moreover, none of the clinical and histopathological measures of primary tumors are predictors of the presence of skip metastases.
  • [MeSH-major] Breast Neoplasms / secondary. Lymph Node Excision / methods. Lymph Nodes / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Axilla. Breast Neoplasms, Male / pathology. Breast Neoplasms, Male / secondary. Breast Neoplasms, Male / surgery. Female. Humans. Immunohistochemistry. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Prognosis. Sentinel Lymph Node Biopsy

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  • (PMID = 17123131.001).
  • [ISSN] 0941-1291
  • [Journal-full-title] Surgery today
  • [ISO-abbreviation] Surg. Today
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
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28. Sakakibara M, Nagashima T, Kadowaki M, Onai Y, Fujimori T, Yokomizo J, Suzuki H, Fushimi K, Nakatani Y, Miyazaki M: Clinical significance of axillary microresiduals after neoadjuvant chemotherapy in breast cancer patients with cytologically proven metastases. Ann Surg Oncol; 2009 Sep;16(9):2470-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical significance of axillary microresiduals after neoadjuvant chemotherapy in breast cancer patients with cytologically proven metastases.
  • The pCR status of cytologically proven axillary metastases (ALN-pCR) offers a more powerful prognostic predictor than pCR of the main tumor.
  • This study evaluated the clinical significance of residual micrometastases and discusses screening methods after NAC in patients with cytologically proven axillary metastases.
  • METHODS: Eighty patients with a diagnosis of cytologically proven axillary metastases received NAC.
  • All dissected lymph nodes were evaluated using multislice sectioning and cytokeratin immunohistochemistry, and categorized into four groups: no metastases (ALN-pCR), and with metastases <or=0.2 mm (ALN-itc), >0.2 mm but <or=2 mm (ALN-mic), and >2 mm (ALN-mac).
  • Disease-free survival (DFS) and overall survival (OS) were calculated by Kaplan-Meier method based on the status of residual metastases.
  • These data showed the clinical significance of microresidual metastases >0.2 mm after NAC in patients with cytologically proven axillary metastases.
  • [MeSH-minor] Adult. Aged. Axilla. Chemotherapy, Adjuvant. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Female. Humans. Keratins / metabolism. Lymphatic Metastasis. Middle Aged. Neoplasm Staging. Paclitaxel / administration & dosage. Prognosis. Prospective Studies. Survival Rate. Treatment Outcome

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  • [CommentIn] Ann Surg Oncol. 2010 Mar;17(3):933-4; author reply 935 [19830493.001]
  • (PMID = 19588201.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 68238-35-7 / Keratins; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; P88XT4IS4D / Paclitaxel
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29. Veronesi U, Galimberti V, Mariani L, Gatti G, Paganelli G, Viale G, Zurrida S, Veronesi P, Intra M, Gennari R, Rita Vento A, Luini A, Tullii M, Bassani G, Rotmensz N: Sentinel node biopsy in breast cancer: early results in 953 patients with negative sentinel node biopsy and no axillary dissection. Eur J Cancer; 2005 Jan;41(2):231-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Sentinel node biopsy in breast cancer: early results in 953 patients with negative sentinel node biopsy and no axillary dissection.
  • Sentinel node biopsy in patients with breast carcinoma accurately predicts the axillary nodal status.
  • However, in some 6% of patients with negative sentinel nodes the remaining axillary nodes harbour metastases.
  • Our purpose was to observe a large number of patients who did not undergo an axillary dissection after a negative sentinel node biopsy for the appearance of overt axillary metastases.
  • 953 patients treated from 1996 to 2000, with negative sentinel nodes not submitted to axillary dissection, were followed-up to 7 years, with a median follow-up of 38 months.
  • Three cases of overt axillary metastases were found: they received total axillary dissection and are presently alive and well.
  • Patients with negative sentinel node biopsies not submitted to axillary dissection show during follow-up a rate of overt axillary metastases that is lower than that expected.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Disease-Free Survival. Follow-Up Studies. Humans. Lymphatic Metastasis / pathology. Mastectomy / methods. Middle Aged. Neoplasm Recurrence, Local / etiology. Sentinel Lymph Node Biopsy / methods

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  • [CommentIn] Eur J Cancer. 2005 Jan;41(2):197-8 [15661542.001]
  • (PMID = 15661547.001).
  • [ISSN] 0959-8049
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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30. Guth AA, Mercado C, Roses DF, Darvishian F, Singh B, Cangiarella JF: Microinvasive breast cancer and the role of sentinel node biopsy: an institutional experience and review of the literature. Breast J; 2008 Jul-Aug;14(4):335-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Its true metastatic potential has been unclear, due in part to historical differences in the definition of microinvasion.
  • The role of routine axillary staging for DCISM is controversial, given the reportedly low incidence of axillary metastases.
  • We describe our institutional experience with DCISM, and define the role of axillary staging.
  • Forty-four patients underwent axillary staging (24 axillary lymph node dissection [ALND], 22 sentinel node biopsy [SNB]).
  • Macrometastatic disease was present in three patients (7%), and two patients had isolated tumor cells (itc) in the sentinel node.
  • Patients with axillary metastases tended to be younger.
  • Comedonecrosis, nuclear grade, multifocal microinvasion or presentation as a clinical mass was not associated with a higher rate of axillary metastases.
  • Axillary staging is indicated, and SNB is appropriate for the identification of axillary metastatic disease.
  • [MeSH-minor] Adenocarcinoma / pathology. Age Factors. Axilla. Female. Humans. Lymph Node Excision. Lymphatic Metastasis. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Retrospective Studies

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  • (PMID = 18537917.001).
  • [ISSN] 1524-4741
  • [Journal-full-title] The breast journal
  • [ISO-abbreviation] Breast J
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 27
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31. Davis JT, Brill YM, Simmons S, Sachleben BC, Cibull ML, McGrath P, Wright H, Romond E, Hester M, Moore A, Samayoa LM: Ultrasound-guided fine-needle aspiration of clinically negative lymph nodes versus sentinel node mapping in patients at high risk for axillary metastasis. Ann Surg Oncol; 2006 Dec;13(12):1545-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Ultrasound-guided fine-needle aspiration of clinically negative lymph nodes versus sentinel node mapping in patients at high risk for axillary metastasis.
  • BACKGROUND: Sonographically directed fine-needle aspiration is a less invasive and less costly alternative to sentinel node (SN) mapping in breast cancer patients at high risk for metastatic disease but with clinically negative axillae.
  • METHODS: Radiographic, cytological, and histological diagnostic data on breast primary tumors from 114 consecutive SN candidates were prospectively assessed for clinicopathologic variables associated with an increased incidence of axillary metastases.
  • SN mapping was performed in patients with normal axillary sonogram results or negative cytological results.
  • Patients with positive cytological results proceeded to complete axillary dissection.
  • Final axillary histological outcomes from patients not meeting the high-risk criteria were recorded.
  • Additionally, a cost analysis was performed in which the costs of ultrasonography and ultrasound-guided fine-needle aspiration of the axilla were compared with those of SN mapping.
  • RESULTS: According to our selection criteria, a third of the patients with clinically negative axillae (37 of 114; 32%) were considered at high risk for axillary metastases.
  • Fifty-nine percent of these patients (22 of 37) had metastatic disease on final histological analysis.
  • CONCLUSIONS: This study suggests that in patients at increased risk for axillary metastases, the use of sonographic evaluation of the axilla in combination with fine-needle aspiration is not only clinically justified, but also cost-effective.
  • [MeSH-minor] Axilla. Cost-Benefit Analysis. Female. Humans. Lymphatic Metastasis. Risk Factors

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  • (PMID = 17009156.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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32. Veronesi U, Orecchia R, Zurrida S, Galimberti V, Luini A, Veronesi P, Gatti G, D'Aiuto G, Cataliotti L, Paolucci R, Piccolo P, Massaioli N, Sismondi P, Rulli A, Lo Sardo F, Recalcati A, Terribile D, Acerbi A, Rotmensz N, Maisonneuve P: Avoiding axillary dissection in breast cancer surgery: a randomized trial to assess the role of axillary radiotherapy. Ann Oncol; 2005 Mar;16(3):383-8
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  • [Title] Avoiding axillary dissection in breast cancer surgery: a randomized trial to assess the role of axillary radiotherapy.
  • BACKGROUND: The need to dissect axillary nodes in patients with early breast cancer and clinically negative axilla remains controversial.
  • The aim of the study was to assess the role of axillary radiotherapy (RT) in reducing axillary metastases in patients with early breast cancer who did not receive axillary dissection.
  • PATIENTS AND METHODS: From 1995 to 1998, 435 patients over 45 years old with breast cancer up to 1.2 cm and no palpable axillary nodes were randomized 214 to breast conservation without axillary treatment and 221 to breast conservation plus axillary RT.
  • RESULTS: After a median follow-up of 63 months, overt axillary metastases were fewer than expected: three cases in the no axillary treatment group (1.5%) and one in the RT group (0.5%).
  • Expected cases were 43 in the no axillary treatment group and 10 in the RT group.
  • Rates of distant metastases and local failures were low, and 5-year disease free survival was 96.0% (95% confidence interval, 94.1%-97.9%) without significant differences between the two arms.
  • CONCLUSIONS: This study suggests that occult axillary metastases might never become clinically overt and axillary dissection might be avoided in patients with small carcinomas and a clinically negative axilla.
  • Axillary RT seems to protect the patients from axillary recurrence almost completely.

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  • (PMID = 15668261.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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33. Trocciola SM, Hoda S, Osborne MP, Christos PJ, Levin H, Martins D, Carson J, Daly J, Simmons RM: Do bone marrow micrometastases correlate with sentinel lymph node metastases in breast cancer patients? J Am Coll Surg; 2005 May;200(5):720-5; discussion 725-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Do bone marrow micrometastases correlate with sentinel lymph node metastases in breast cancer patients?
  • BACKGROUND: Sentinel lymph node biopsies (SLNB) are used to detect axillary metastases as an important prognostic indicator for breast cancer patients.
  • SLNB were examined for the presence of metastases by hematoxylin and eosin (H&E) stains and also by immunohistochemistry (IHC) for lymph nodes negative by H&E.
  • CONCLUSIONS: There was poor agreement between axillary metastases and micrometastases detected in the bone marrow.
  • This study suggests that BMM and axillary metastases are not concordant findings in most patients.
  • [MeSH-major] Bone Marrow Neoplasms / secondary. Breast Neoplasms / pathology. Lymphatic Metastasis / pathology

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  • (PMID = 15848362.001).
  • [ISSN] 1072-7515
  • [Journal-full-title] Journal of the American College of Surgeons
  • [ISO-abbreviation] J. Am. Coll. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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34. Newman EA, Newman LA: Lymphatic mapping techniques and sentinel lymph node biopsy in breast cancer. Surg Clin North Am; 2007 Apr;87(2):353-64, viii
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  • The axillary nodal status is accepted universally as the most powerful prognostic tool available for early stage breast cancer.
  • The removal of level I and level II lymph nodes at axillary node dissection (ALND) is the most accurate method to assess nodal status, and it is the universal standard; however, it is associated with several adverse long-term sequelae.
  • Lymphatic mapping with sentinel lymph node biopsy has emerged as an effective and safe alternative to the ALND for detecting axillary metastases.
  • [MeSH-minor] Coloring Agents. Female. Humans. Lymphatic Metastasis / pathology. Neoplasm Staging. Prognosis. Radiopharmaceuticals. Rosaniline Dyes. Technetium Tc 99m Sulfur Colloid

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  • (PMID = 17498531.001).
  • [ISSN] 0039-6109
  • [Journal-full-title] The Surgical clinics of North America
  • [ISO-abbreviation] Surg. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Coloring Agents; 0 / Radiopharmaceuticals; 0 / Rosaniline Dyes; 39N9K8S2A4 / iso-sulfan blue; 556Q0P6PB1 / Technetium Tc 99m Sulfur Colloid
  • [Number-of-references] 47
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35. Chung A, Liou D, Karlan S, Waxman A, Fujimoto K, Hagiike M, Phillips EH: Preoperative FDG-PET for axillary metastases in patients with breast cancer. Arch Surg; 2006 Aug;141(8):783-8; discussion 788-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Preoperative FDG-PET for axillary metastases in patients with breast cancer.
  • HYPOTHESIS: Fludeoxyglucose F 18 (FDG) positron emission tomography (PET) can be used to predict axillary node metastases.
  • INTERVENTION: Whole-body FDG-PET performed before axillary surgery and interpreted blindly.
  • MAIN OUTCOME MEASURES: Axillary FDG activity, quantified by standardized uptake value (SUV); axillary metastases, quantified histologically; and tumor characteristics.
  • There were no significant differences between these 2 groups except in axillary metastasis size (SUV </=2.2 vs SUV >/=2.3): mean age, 53 vs 58 years (P = .90); mean modified Bloom-Richardson score, 7.7 vs 7.6 (P = .20); lymphovascular invasion present, 25% vs 36% (P = .40); mean Ki-67 level, 25% vs 32% (P = .20); mean tumor size, 2.9 vs 3.2 cm (P = .05); and axillary metastasis size, 0.9 vs 1.7 (P = .001).
  • CONCLUSIONS: Patients with an SUV greater than 2.3 had axillary metastases.
  • This finding obviates the need for sentinel lymph node biopsy or needle biopsy to diagnose axillary involvement.
  • Surgeons can proceed to axillary node dissection to assess the number of nodes involved, eliminate axillary disease, or perhaps provide a survival benefit if preoperative FDG-PET has an SUV greater than 2.3.
  • [MeSH-minor] Axilla. Biopsy, Fine-Needle. Female. Follow-Up Studies. Humans. Lymphatic Metastasis. Mastectomy. Middle Aged. Preoperative Care / methods. Prognosis. ROC Curve. Retrospective Studies

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  • (PMID = 16924086.001).
  • [ISSN] 0004-0010
  • [Journal-full-title] Archives of surgery (Chicago, Ill. : 1960)
  • [ISO-abbreviation] Arch Surg
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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36. Gilissen F, Oostenbroek R, Storm R, Westenend P, Plaisier P: Prevention of futile sentinel node procedures in breast cancer: ultrasonography of the axilla and fine-needle aspiration cytology are obligatory. Eur J Surg Oncol; 2008 May;34(5):497-500
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prevention of futile sentinel node procedures in breast cancer: ultrasonography of the axilla and fine-needle aspiration cytology are obligatory.
  • AIMS: To determine the value of ultrasonography (US) and fine-needle aspiration (FNA) of the axilla in preventing futile sentinel node procedures (SNP) in breast cancer.
  • We analysed the results of axillary staging by US and FNA retrospectively.
  • Furthermore, we correlated the histopathologic outcome of operative procedures with the preoperative findings during examination of the axilla.
  • RESULTS: Of the 209 patients, 195 underwent US of the axilla.
  • In 67 patients, US was followed by FNA because of suspect lymph nodes in the axilla.
  • Ninety-three of these 195 patients had axillary metastases.
  • In 52 of these 93 patients, the metastases were detected prior to surgery, so that these 52 patients could be scheduled immediately for axillary lymph node dissection (ALND) and a futile SNP could be prevented.
  • CONCLUSIONS: By preoperative US and FNA of the axilla in patients with breast cancer, half of the axillary metastases can be detected prior to surgery.
  • Therefore, preoperative US of the axilla plus FNA are obligatory in patients with breast carcinoma.
  • [MeSH-minor] Axilla. Biopsy, Fine-Needle. Female. Humans. Lymphatic Metastasis. Neoplasm Staging. Retrospective Studies

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  • (PMID = 17845836.001).
  • [ISSN] 1532-2157
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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37. Susini T, Nori J, Olivieri S, Molino C, Marini G, Bianchi S, Vezzosi V, Livi L, Mascalchi M, Scarselli G: Predicting the status of axillary lymph nodes in breast cancer: a multiparameter approach including axillary ultrasound scanning. Breast; 2009 Apr;18(2):103-8
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  • [Title] Predicting the status of axillary lymph nodes in breast cancer: a multiparameter approach including axillary ultrasound scanning.
  • In a prospective study, we attempted to predict axillary metastases in 135 breast cancer patients by a preoperative multiparameter evaluation including axillary ultrasound scanning (US).
  • After surgery, factors associated with lymph node metastases by univariate analysis were included in a multivariate model.
  • By multivariate analysis, the stronger independent predictors of lymph node metastases were suspicious axillary US (p<0.001), tumor location in the outer quadrants (p=0.001) and high Ki-67 index (>10%) (p=0.002).
  • A predictive model based on these variables, identified a high-risk group (20.0%) represented by women with suspicious axillary US, tumor in the outer quadrants and high Ki-67 index, with axillary metastases in 100%, whereas all patients with opposite features (8.1%) had uninvolved axillary lymph nodes.
  • This multiparameter evaluation including axillary US may be used to optimize the selection of breast cancer patients candidate to sentinel lymph node biopsy or axillary lymph node dissection.
  • [MeSH-minor] Adult. Aged. Female. Humans. Lymphatic Metastasis. Middle Aged. Neoplasm Invasiveness. Predictive Value of Tests. Prospective Studies. Risk Factors

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  • (PMID = 19285396.001).
  • [ISSN] 1532-3080
  • [Journal-full-title] Breast (Edinburgh, Scotland)
  • [ISO-abbreviation] Breast
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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38. Cervinka V, St'astný K, Havlícek K, Nechvátal L: [An axillary metastasis as the first sign of the breast carcinoma--a case review]. Rozhl Chir; 2006 Feb;85(2):71-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [An axillary metastasis as the first sign of the breast carcinoma--a case review].
  • Less than 1% of the patients diagnosed with breast cancer initially present with axillary metastases as their only clinical manifestation.
  • CASUISTIC: We report case of 58 years old woman with occult breast carcinoma in which extensive axillary node metastasis was the first manifestation.
  • DISCUSSION: Breast cancer presenting with axillary metastases and no clinical apparent primary tumour in the breast is an uncommon form of stage II or IV of this disease.
  • The appropriate treatment of the breast after an axillary presentation of occult breast carcinoma continues to be a controversial issue.
  • Complete axillary lymph node dissection is indicated in all patients.
  • CONCLUSION: Axillary metastasis is rare first sign of breast cancer.
  • [MeSH-major] Breast Neoplasms / diagnosis. Carcinoma, Ductal, Breast / diagnosis
  • [MeSH-minor] Axilla. Female. Humans. Lymph Node Excision. Lymphatic Metastasis. Mastectomy, Segmental. Middle Aged

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  • (PMID = 16626014.001).
  • [ISSN] 0035-9351
  • [Journal-full-title] Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
  • [ISO-abbreviation] Rozhl Chir
  • [Language] cze
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Czech Republic
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39. Heuts EM, van der Ent FW, Hulsewé KW, von Meyenfeldt MF, Voogd AC: Results of tailored treatment for breast cancer patients with internal mammary lymph node metastases. Breast; 2009 Aug;18(4):254-8
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  • [Title] Results of tailored treatment for breast cancer patients with internal mammary lymph node metastases.
  • A total of 406 patients had no lymph node metastases (group 1), 330 patients had axillary metastases (group 2), 7 patients had IM metastases only (group 3) and 21 patients had both axillary and IM metastases (group 4).
  • Prognosis did not appear to be worse for patients with IM metastases compared to those with axillary metastases only, which might indicate that they benefit from improved staging and tailored adjuvant treatment algorithms.
  • [MeSH-minor] Adult. Algorithms. Axilla / pathology. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Lymph Nodes / pathology. Lymph Nodes / radionuclide imaging. Lymphatic Metastasis. Multivariate Analysis. Neoplasm Staging. Prognosis. Retrospective Studies. Treatment Outcome

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  • (PMID = 19515565.001).
  • [ISSN] 1532-3080
  • [Journal-full-title] Breast (Edinburgh, Scotland)
  • [ISO-abbreviation] Breast
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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40. Mills P, Sever A, Weeks J, Fish D, Jones S, Jones P: Axillary ultrasound assessment in primary breast cancer: an audit of 653 cases. Breast J; 2010 Sep-Oct;16(5):460-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Axillary ultrasound assessment in primary breast cancer: an audit of 653 cases.
  • Axillary lymph node status is an important factor in determining the prognosis and treatment in patients with invasive breast cancer.
  • The introduction of the sentinel lymph node biopsy technique in the axilla has significantly reduced the number of patients requiring an axillary clearance procedure.
  • However, a proportion of patients will be found to have axillary metastases after a sentinel node biopsy and will then require a second axillary surgical procedure.
  • A retrospective audit of 653 consecutive patients presenting with invasive breast cancer showed a preoperative diagnosis rate of axillary disease of 23% using axillary ultrasound and fine-needle aspiration (FNA) together.
  • We performed 232 axillary FNAs to diagnose 150 positive axillae.
  • The negative predictive value for axillary metastases using this technique was 79%.
  • [MeSH-major] Axilla / ultrasonography. Breast Neoplasms / ultrasonography. Lymphatic Metastasis / ultrasonography
  • [MeSH-minor] Adult. Female. Humans. Neoplasm Invasiveness. Retrospective Studies. Sensitivity and Specificity. Sentinel Lymph Node Biopsy

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  • [Copyright] © 2010 Wiley Periodicals, Inc.
  • [CommentIn] Breast J. 2010 Sep-Oct;16(5):457-9 [21054643.001]
  • (PMID = 20626394.001).
  • [ISSN] 1524-4741
  • [Journal-full-title] The breast journal
  • [ISO-abbreviation] Breast J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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41. Cianga C, Cianga P, Cozma L, Chifu C, Diaconu C, Carasevici E: [Different phenotypes generated by changes in bcl-2 and p53 expression in breast cancer]. Rev Med Chir Soc Med Nat Iasi; 2005 Oct-Dec;109(4):831-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • We have identified by immunohistochemistry/ immunocytochemistry the expression of bcl-2 molecule in 55 primary breast carcinomas and in 30 corresponding axillary lymph nodes metastases, together with a set of molecules known as prognostic factors: estrogen receptors, progesterone receptors, and p53 protein.
  • Our results demonstrated a significant correlation (p < 0.05) between bcl-2 and hormonal receptors expression in tumors, but not in axillary metastases (p < 0.1), a significant inverse correlation between bcl-2 and p53 expression in primary tumors (p < 0.02), but a significant direct correlation in axillary metastases (p < 0.02).
  • The bcl-2+/p53- phenotype, associated with normal breast epithelium, is present in 79.17% primary tumors, but only in 15.38% axillary lymph nodes metastases.
  • A larger number of lymph nodes metastases expressed a bcl-2+/ p53+ more aggressive phenotype compared with primary tumors (58.82% versus 48.39%).
  • [MeSH-major] Apoptosis. Biomarkers, Tumor / metabolism. Breast Neoplasms / metabolism. Lymph Nodes / metabolism. Proto-Oncogene Proteins c-bcl-2 / metabolism. Tumor Suppressor Protein p53 / metabolism
  • [MeSH-minor] Axilla. Female. Humans. Immunohistochemistry. Neoplasm Staging. Phenotype. Receptors, Estrogen / metabolism. Receptors, Progesterone / metabolism

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  • (PMID = 16610184.001).
  • [ISSN] 0048-7848
  • [Journal-full-title] Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
  • [ISO-abbreviation] Rev Med Chir Soc Med Nat Iasi
  • [Language] rum
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] Romania
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Proto-Oncogene Proteins c-bcl-2; 0 / Receptors, Estrogen; 0 / Receptors, Progesterone; 0 / Tumor Suppressor Protein p53
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42. Leikola J, Heikkilä P, von Smitten K, Leidenius M: The prevalence of axillary lymph-node metastases in patients with pure tubular carcinoma of the breast and sentinel node biopsy. Eur J Surg Oncol; 2006 Jun;32(5):488-91
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The prevalence of axillary lymph-node metastases in patients with pure tubular carcinoma of the breast and sentinel node biopsy.
  • AIMS: We aimed to evaluate the prevalence of and the risk factors for axillary lymph-node metastases in pure tubular carcinoma (PTC) of the breast.
  • The role of axillary staging and treatment in PTC was also evaluated.
  • Level I/II axillary clearance was carried out in case of tumour positive SN findings.
  • To confirm the correct histological diagnosis (PTC, >90% tubular component), the breast tumours were reviewed by an expert breast pathologist.
  • The median number of SN harvested in the axilla was 3 (range 1-10).
  • Nine (27%) of the 33 patients had axillary nodal metastases.
  • The median number of metastatic nodes was 1 (range 1-3).
  • The median size of the SN metastases was 0.5 mm (mean 1.7 mm, range 0.4-5 mm).
  • The median histological tumour size was similar, 9 vs 10mm, in patients with or without axillary metastases.
  • After the histopathological review, six of the 27 patients with true PTC had axillary metastases.
  • The review did not significantly change the risk factors for axillary metastases.
  • CONCLUSIONS: Every fourth PTC patient has axillary lymph-node metastases, most often micrometastases.
  • SN biopsy appears as a feasible method for axillary staging in PTC patients.
  • [MeSH-major] Adenocarcinoma / secondary. Breast Neoplasms / pathology. Lymphatic Metastasis / pathology. Sentinel Lymph Node Biopsy
  • [MeSH-minor] Adult. Age Factors. Aged. Aged, 80 and over. Axilla. Feasibility Studies. Female. Humans. Lymph Node Excision. Lymph Nodes / pathology. Lymph Nodes / radionuclide imaging. Middle Aged. Neoplasm Staging. Radiopharmaceuticals. Risk Factors. Technetium Tc 99m Aggregated Albumin

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  • (PMID = 16569494.001).
  • [ISSN] 0748-7983
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0 / Technetium Tc 99m Aggregated Albumin; 0 / technetium Tc 99m nanocolloid
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43. Neri A, Marrelli D, Roviello F, De Stefano A, Guarnieri A, Pallucca E, Pinto E: Prognostic value of extracapsular extension of axillary lymph node metastases in T1 to T3 breast cancer. Ann Surg Oncol; 2005 Mar;12(3):246-53
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  • [Title] Prognostic value of extracapsular extension of axillary lymph node metastases in T1 to T3 breast cancer.
  • BACKGROUND: The importance of extracapsular extension (ECE) of axillary metastases as a risk factor for either local or distant recurrence and poorer survival in breast cancer has been suggested, but its prognostic value has not been uniformly confirmed.
  • The prognostic significance of ECE of axillary metastases was evaluated with respect to disease-free survival, overall survival, and the patterns of disease recurrence.
  • We suggest that the decision on adjuvant therapy should consider the presence of ECE of axillary metastases and peritumoral LVI as indicators of high biological aggressiveness.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Axilla. Disease-Free Survival. Female. Humans. Lymphatic Metastasis. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Predictive Value of Tests. Prognosis. Prospective Studies. Risk Factors. Survival Analysis

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  • (PMID = 15827817.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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44. Seenu V, Pavan Kumar MN, Sharma U, Gupta SD, Mehta SN, Jagannathan NR: Potential of magnetic resonance spectroscopy to detect metastasis in axillary lymph nodes in breast cancer. Magn Reson Imaging; 2005 Dec;23(10):1005-10
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Potential of magnetic resonance spectroscopy to detect metastasis in axillary lymph nodes in breast cancer.
  • Focused pathological evaluation of axillary lymph nodes in breast cancer is gaining importance.
  • The biochemical changes associated with breast cancer metastases in axillary nodes by in vitro NMR and its use in the detection of axillary metastases in a clinical setting in comparison with conventional histopathology is presented in this study.
  • Histopathology revealed metastases in 20 nodes from 11 patients, while in vitro NMR spectroscopy revealed metastases in 22 nodes.
  • Out of these 22 nodes, 16 were the same, which showed metastases on histopathology, while 6 nodes have shown metastases only on in vitro magnetic resonance spectroscopy (MRS).
  • These 6 nodes with suspicion of metastases on MRS were subjected to reevaluation with serial sectioning and immunohistochemistry, but no additional metastases were revealed.
  • The levels of the glycerophosphocholine-phosphocholine (GPC-PC), choline, lactate, alanine and uridine diphosphoglucose were elevated significantly in nodes with metastases.
  • In addition, the intensity ratio of GPC-PC/threonine (Thr) was higher in nodes with metastases, and using this as marker, MRS detected the axillary metastases with a sensitivity, specificity and accuracy of 80%, 91% and 88%, respectively.
  • The accuracy of MRS in detecting metastases was 75% in patients who received NACT (n=9) as compared to 96% in those who did not (n=21).
  • Our results demonstrate the potential of in vitro MRS in characterizing the metabolite profile of the axillary nodes with breast cancer metastases.
  • It detected axillary metastases with reasonable accuracy and can be complementary to histopathological evaluation and immunohistochemistry.
  • [MeSH-major] Breast Neoplasms / pathology. Lymphatic Metastasis / pathology. Magnetic Resonance Spectroscopy / methods
  • [MeSH-minor] Axilla. Biomarkers, Tumor / analysis. Female. Humans. Lymph Nodes / chemistry. ROC Curve. Sensitivity and Specificity. Sentinel Lymph Node Biopsy

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  • (PMID = 16376185.001).
  • [ISSN] 0730-725X
  • [Journal-full-title] Magnetic resonance imaging
  • [ISO-abbreviation] Magn Reson Imaging
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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45. Beadle BM, Guadagnolo BA, Ballo MT, Lee JE, Gershenwald JE, Cormier JN, Mansfield PF, Ross MI, Zagars GK: Radiation therapy field extent for adjuvant treatment of axillary metastases from malignant melanoma. Int J Radiat Oncol Biol Phys; 2009 Apr 1;73(5):1376-82
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  • [Title] Radiation therapy field extent for adjuvant treatment of axillary metastases from malignant melanoma.
  • PURPOSE: To compare treatment-related outcomes and toxicity for patients with axillary lymph node metastases from malignant melanoma treated with postoperative radiation therapy (RT) to either the axilla only or both the axilla and supraclavicular fossa (extended field [EF]).
  • METHODS AND MATERIALS: The medical records of 200 consecutive patients treated with postoperative RT for axillary lymph node metastases from malignant melanoma were retrospectively reviewed.
  • All patients received postoperative hypofractionated RT for high-risk features; 95 patients (48%) received RT to the axilla only and 105 patients (52%) to the EF.
  • The 5-year overall survival, disease-free survival, and distant metastasis-free survival rates were 51%, 43%, and 46%, respectively.
  • The 5-year axillary control rate was 88%.
  • There was no difference in axillary control rates on the basis of the treated field (89% for axilla only vs. 86% for EF; p = 0.4).
  • CONCLUSIONS: Adjuvant hypofractionated RT to the axilla only for metastatic malignant melanoma with high-risk features is an effective method to control axillary disease.
  • Limiting the radiation field to the axilla only produced equivalent axillary control rates to EF and resulted in lower treatment-related complication rates.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Analysis of Variance. Axilla. Disease-Free Survival. Dose Fractionation. Female. Humans. Lymphatic Metastasis / pathology. Lymphatic Metastasis / radiography. Lymphatic Metastasis / radiotherapy. Male. Middle Aged. Neoplasm Recurrence, Local / mortality. Radiotherapy, Adjuvant / adverse effects. Treatment Outcome. Young Adult

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  • (PMID = 18774657.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P30 CA016672
  • [Publication-type] Journal Article
  • [Publication-country] United States
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46. Steunebrink M, Schnater JM, Storm RK, van Ingen G, Vegt PA, Plaisier PW: Bilateral axillary metastases of occult breast carcinoma: report of a case with a review of the literature. Breast; 2005 Apr;14(2):165-8
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  • [Title] Bilateral axillary metastases of occult breast carcinoma: report of a case with a review of the literature.
  • The case of a 47-year-old premenopausal woman is presented in whom axillary lymph node metastases occurred on both sides 3 years apart although no primary tumor was detectable in either breast is presented.
  • Patients with occult breast carcinoma with axillary lymph node metastases should have a complete physical examination, radiologic analysis (mammography, ultrasonography, and MRI of both breasts) and screening for disseminated disease.
  • If there is no evidence of a primary tumor and metastases other than in the axilla, an axillary dissection should be carried out.
  • [MeSH-major] Breast Neoplasms / pathology. Carcinoma / pathology. Lymphatic Metastasis. Neoplasms, Multiple Primary / pathology. Neoplasms, Unknown Primary
  • [MeSH-minor] Axilla. Female. Functional Laterality. Humans. Middle Aged. Premenopause

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  • (PMID = 15767189.001).
  • [ISSN] 0960-9776
  • [Journal-full-title] Breast (Edinburgh, Scotland)
  • [ISO-abbreviation] Breast
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Scotland
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47. Cowher MS, Erb KM, Poller W, Julian TB: Correlation of the use of axillary ultrasound and lymph node needle biopsy with surgical lymph node pathology in patients with invasive breast cancer. Am J Surg; 2008 Nov;196(5):756-9
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  • [Title] Correlation of the use of axillary ultrasound and lymph node needle biopsy with surgical lymph node pathology in patients with invasive breast cancer.
  • BACKGROUND: Results vary regarding the utility of perioperative axillary ultrasound (AUS) and biopsy for detecting axillary metastases.
  • [MeSH-major] Axilla / ultrasonography. Breast Neoplasms / pathology. Lymphatic Metastasis / ultrasonography
  • [MeSH-minor] Biopsy, Needle. Female. Humans. Lymph Node Excision. Middle Aged. Neoplasm Invasiveness. Predictive Value of Tests. Registries. Sensitivity and Specificity. Ultrasonography, Mammary

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  • (PMID = 18513695.001).
  • [ISSN] 1879-1883
  • [Journal-full-title] American journal of surgery
  • [ISO-abbreviation] Am. J. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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48. Rivers A, Hansen N: Axillary management after sentinel lymph node biopsy in breast cancer patients. Surg Clin North Am; 2007 Apr;87(2):365-77, ix
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  • [Title] Axillary management after sentinel lymph node biopsy in breast cancer patients.
  • According to the available data, sentinel lymph node (SLN) biopsy is proving to be an accurate staging technique with less post-surgical morbidity than standard axillary lymph node dissection (ALND).
  • Despite this, ALND remains the standard of care in breast cancer patients with clinically palpable axillary lymph nodes that are suspicious for metastatic disease.
  • Although controversial, many clinicians believe that axillary metastases will precede systemic spread of disease.
  • Therefore, axillary clearance of clinically palpable nodes could potentially quell the progression of metastases.
  • [MeSH-minor] Axilla. Female. Forecasting. Humans. Lymphatic Metastasis / pathology. Neoadjuvant Therapy. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Survival Rate

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  • (PMID = 17498532.001).
  • [ISSN] 0039-6109
  • [Journal-full-title] The Surgical clinics of North America
  • [ISO-abbreviation] Surg. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 49
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49. Cserni G: Evaluation of sentinel lymph nodes in breast cancer. Histopathology; 2005 Jun;46(6):697-702
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  • Sentinel lymph node biopsy is an accurate method for the detection of axillary metastases in cases of breast carcinoma and is of value as a replacement for axillary dissection.
  • [MeSH-major] Breast Neoplasms / pathology. Lymph Nodes / pathology. Lymphatic Metastasis / diagnosis. Sentinel Lymph Node Biopsy / methods

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  • (PMID = 15910602.001).
  • [ISSN] 0309-0167
  • [Journal-full-title] Histopathology
  • [ISO-abbreviation] Histopathology
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Chemical-registry-number] 68238-35-7 / Keratins
  • [Number-of-references] 33
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50. Waljee JF, Newman LA: Neoadjuvant systemic therapy and the surgical management of breast cancer. Surg Clin North Am; 2007 Apr;87(2):399-415, ix
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  • Preoperative chemotherapy can offer women less morbid surgical treatment by down-staging both the primary breast tumor and axillary metastases.
  • Finally, response to chemotherapy can inform clinicians of the chemosensitivity of the tumor, and can predict long-term outcome for women who have breast cancer.
  • [MeSH-minor] Chemotherapy, Adjuvant. Disease-Free Survival. Female. Humans. Lymphatic Metastasis / pathology. Neoplasm Staging. Sentinel Lymph Node Biopsy. Survival Rate. Treatment Outcome

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  • (PMID = 17498534.001).
  • [ISSN] 0039-6109
  • [Journal-full-title] The Surgical clinics of North America
  • [ISO-abbreviation] Surg. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 74
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56. Schlichting E, Harr ME, Sauer T, Babovic A, Kåresen R: [Sentinel lymph node biopsy in breast cancer]. Tidsskr Nor Laegeforen; 2006 Aug 24;126(16):2098-100
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  • BACKGROUND: Sentinel lymph node (SN) biopsy is a technique for identifying axillary metastases from primary breast cancer.
  • Metastases to SN were detected in 25 % of the patients and 52 % of these had no further positive nodes in the axilla.
  • Thus, axillary lymph node clearance was omitted in 948 patients.
  • Three patients had local recurrence in the axilla within one year after the successful SN procedure.
  • Ductal carcinoma in situ grade 3 was diagnosed preoperatively in 162 patients (cytology); 88 had the diagnosis after histology and the rest had invasive cancer or combinations with in situ lesions of other grades.
  • Axillary metastases were found in 4.8 % of these patients.
  • Isolated tumour cells (< 0.2 mm diameter) were found in 9 patients for whom axillary clearance has not been performed.
  • INTERPRETATION: SN biopsy has replaced routine axillary clearance as a routine operation in breast cancer.
  • The method is safe when performed correctly, as metastases in the axilla after a negative SN rarely occur.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Axilla. Carcinoma in Situ / pathology. Carcinoma in Situ / surgery. Carcinoma, Ductal, Breast / pathology. Carcinoma, Ductal, Breast / surgery. Clinical Competence. Female. Humans. Lymphatic Metastasis / pathology. Middle Aged. Prospective Studies

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  • (PMID = 16932777.001).
  • [ISSN] 0807-7096
  • [Journal-full-title] Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
  • [ISO-abbreviation] Tidsskr. Nor. Laegeforen.
  • [Language] nor
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Norway
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57. Mathijssen IM, Strijdhorst H, Kiestra SK, Wereldsma JC: Added value of ultrasound in screening the clinically negative axilla in breast cancer. J Surg Oncol; 2006 Oct 1;94(5):364-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Added value of ultrasound in screening the clinically negative axilla in breast cancer.
  • BACKGROUND: For staging purposes in breast cancer it is current practice to perform a sentinel node biopsy in a clinically negative axilla, followed by an axillary lymph node dissection if metastases are found in the sentinel node.
  • To limit the number of surgical procedures it is therefore of importance to try and identify as much patients as possible who have axillary metastases.
  • Clinical staging of the axillary nodes in breast cancer is mainly based on palpation, but ultrasound has been shown to be of additional value in detecting pathological nodes.
  • METHODS: In this paper, we report our results of screening 131 breast cancer patients without palpable axillary nodes through ultrasound.
  • RESULTS: Out of the 53 patients with axillary node involvement, 18 were identified as such by our radiologist, resulting in a detection score of 34%.
  • [MeSH-minor] Axilla. Female. Humans. Lymph Node Excision. Lymphatic Metastasis. Palpation. Predictive Value of Tests. Sensitivity and Specificity. Sentinel Lymph Node Biopsy

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  • [Copyright] Copyright (c) 2006 Wiley-Liss, Inc.
  • (PMID = 16967456.001).
  • [ISSN] 0022-4790
  • [Journal-full-title] Journal of surgical oncology
  • [ISO-abbreviation] J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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58. Bénard F, Turcotte E: Imaging in breast cancer: Single-photon computed tomography and positron-emission tomography. Breast Cancer Res; 2005;7(4):153-62
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  • Useful in characterizing indeterminate palpable masses and in the detection of axillary metastases, these techniques are insufficiently sensitive to detect subcentimetric tumor deposits.
  • Their role in staging nodal involvement of the axillary areas therefore currently remains limited.
  • Several other ligands targeting proliferative activity, protein synthesis, and hormone and cell-membrane receptors may complement this approach by providing unique information about biological characteristics of breast cancer across primary and metastatic tumor sites.
  • [MeSH-minor] Amino Acids. Cell Proliferation. Female. Fluorodeoxyglucose F18. Humans. Ligands. Lymphatic Metastasis / radionuclide imaging. Neoplasm Recurrence, Local / radionuclide imaging. Nucleosides. Protein Biosynthesis. Radiopharmaceuticals. Receptors, Estrogen / biosynthesis. Treatment Outcome

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  • (PMID = 15987467.001).
  • [ISSN] 1465-542X
  • [Journal-full-title] Breast cancer research : BCR
  • [ISO-abbreviation] Breast Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Amino Acids; 0 / Ligands; 0 / Nucleosides; 0 / Radiopharmaceuticals; 0 / Receptors, Estrogen; 0Z5B2CJX4D / Fluorodeoxyglucose F18
  • [Number-of-references] 113
  • [Other-IDs] NLM/ PMC1175073
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59. Jung J, Park H, Park J, Kim H: Accuracy of preoperative ultrasound and ultrasound-guided fine needle aspiration cytology for axillary staging in breast cancer. ANZ J Surg; 2010 Apr;80(4):271-5
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  • [Title] Accuracy of preoperative ultrasound and ultrasound-guided fine needle aspiration cytology for axillary staging in breast cancer.
  • BACKGROUND: The aims of this study were to evaluate the accuracy of preoperative ultrasound and ultrasound-guided fine needle aspiration (FNA) cytology (US-FNAC) for detecting axillary metastases, and to assess how often sentinel node biopsy could be avoided.
  • METHODS: Axillary ultrasound, as a part of routine preoperative staging, was performed in 189 patients with histologically proven breast cancer.
  • US-FNAC was performed on all lymph nodes (LNs) with features suggestive of metastatic disease on ultrasound characteristics and LNs larger than 1 cm regardless of whether the nodes appear normal or abnormal.
  • The cytologic results were compared with the final histological diagnosis.
  • RESULTS: The sensitivity, specificity and positive and negative predictive values of the ultrasound alone of axillary LNs for metastatic breast cancer were 54, 91, 75 and 81%, retrospectively.
  • CONCLUSIONS: Preoperative axillary ultrasound in combination with US-FNAC provides a simple, minimally invasive and reliable approach to the initial determination of the axillary LN status.
  • Those who are US-FNAC positive can be referred for axillary LN dissection without sentinel LN biopsy.
  • [MeSH-minor] Axilla. Biopsy, Fine-Needle / instrumentation. Biopsy, Fine-Needle / methods. Female. Humans. Neoplasm Staging. Preoperative Period. Sensitivity and Specificity. Ultrasonography, Interventional. Ultrasonography, Mammary

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  • (PMID = 20575955.001).
  • [ISSN] 1445-2197
  • [Journal-full-title] ANZ journal of surgery
  • [ISO-abbreviation] ANZ J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Australia
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60. Fearmonti RM, Batista LI, Meric-Bernstam F, Bedrosian I, Kuerer HM, Hunt KK, Eva Singletary S, Babiera GV: False negative rate of sentinel lymph node biopsy in multicentric and multifocal breast cancers may be higher in cases with large additive tumor burden. Breast J; 2009 Nov-Dec;15(6):645-8
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  • [Title] False negative rate of sentinel lymph node biopsy in multicentric and multifocal breast cancers may be higher in cases with large additive tumor burden.
  • Presence of preoperative axillary metastases was confirmed by FNA.
  • Both cases with FN SLNB had multicentric disease, pathologic stage III breast cancer and a larger tumor burden compared with the study population.
  • SLNB using sub-areolar injection is feasible for patients with multicentric/multifocal breast cancer yet may be associated with a higher FN rate in patients with large additive tumor burden.

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  • (PMID = 19735388.001).
  • [ISSN] 1524-4741
  • [Journal-full-title] The breast journal
  • [ISO-abbreviation] Breast J
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P30 CA016672; United States / NCI NIH HHS / CA / 3 P30 CA16672-29S
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
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61. Nori J, Vanzi E, Bazzocchi M, Bufalini FN, Distante V, Branconi F, Susini T: Role of axillary ultrasound examination in the selection of breast cancer patients for sentinel node biopsy. Am J Surg; 2007 Jan;193(1):16-20
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  • [Title] Role of axillary ultrasound examination in the selection of breast cancer patients for sentinel node biopsy.
  • BACKGROUND: Sentinel node biopsy (SNB) is a time-consuming procedure that can be avoided in presence of axillary metastases.
  • The aim of this study was to assess the accuracy of ultrasound scan (US) in the prediction of axillary nodes status in patients scheduled for SNB.
  • METHODS: Axillary US was performed and when feasible, a core biopsy of suspicious nodes was taken.
  • RESULTS: Of the 132 patients enrolled, 31 (23.5%) had suspicious axillary nodes according to US; 19 (61.3%) were true positive, whereas 12 cases (38.7%) were not.
  • CONCLUSIONS: The US of axillary nodes, possibly associated with core biopsy, improved the preoperative evaluation of breast cancer patients scheduled for SNB.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Axilla / ultrasonography. False Positive Reactions. Female. Humans. Lymphatic Metastasis / ultrasonography. Middle Aged

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  • (PMID = 17188081.001).
  • [ISSN] 1879-1883
  • [Journal-full-title] American journal of surgery
  • [ISO-abbreviation] Am. J. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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62. Leidenius MH: Sentinel node biopsy in breast cancer. Acta Radiol; 2005 Dec;46(8):791-801
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  • In breast cancer, sentinel node biopsy (SNB) has replaced diagnostic axillary clearance (AC) in nodal staging in numerous breast surgery units all over the world.
  • SNB has been validated in nodal staging of small, unifocal, clinically axillary-node-negative tumors, with a false-negative rate of approximately 5%, of all axillary-node-positive cases.
  • Despite the false-negative results, the method is assumed to provide accurate nodal staging, revealing metastases that remain undetected in AC.
  • Furthermore, clinically overt axillary metastases have been rare when omitting AC relying on tumor-negative sentinel node findings, at least during a short follow-up.

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  • (PMID = 16392603.001).
  • [ISSN] 0284-1851
  • [Journal-full-title] Acta radiologica (Stockholm, Sweden : 1987)
  • [ISO-abbreviation] Acta Radiol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Sweden
  • [Number-of-references] 123
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63. Alameda F, Pijuan L, Lloveras B, Romero E, Carreras R, Serrano S: Axillary metastasis in a patient with double neoplasia: a case report. Acta Cytol; 2010 Nov-Dec;54(6):1133-5
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  • [Title] Axillary metastasis in a patient with double neoplasia: a case report.
  • BACKGROUND: Axillary lymph node metastases in women are most frequently associated with breast cancer.
  • CASE: A 72-year-old woman presenting endometrial and breast cancer developed axillary metastasis 2 months after diagnosis of breast cancer.
  • A diagnosis of metastasis from endometrial cancer was made on the basis of cytological characteristics.
  • CONCLUSION: The morphologic features in this case (emperipolesis) oriented as axillary metastases from primary endometrial cancer.
  • [MeSH-major] Breast Neoplasms / pathology. Carcinoma, Ductal, Breast / pathology. Carcinoma, Endometrioid / secondary. Endometrial Neoplasms / pathology. Lymph Nodes / pathology. Neoplasms, Multiple Primary / pathology
  • [MeSH-minor] Aged. Axilla. Biopsy, Fine-Needle. Emperipolesis. Female. Humans. Lymphatic Metastasis

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  • (PMID = 21428162.001).
  • [ISSN] 0001-5547
  • [Journal-full-title] Acta cytologica
  • [ISO-abbreviation] Acta Cytol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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64. Gu GL, Wang SL, Wei XM, Ren L, Zou FX: Axillary metastasis as the first manifestation of male breast cancer: a case report. Cases J; 2008;1(1):285
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  • [Title] Axillary metastasis as the first manifestation of male breast cancer: a case report.
  • BACKGROUND: Breast cancer is very rare in men, and the occurrence of occult breast cancer which present axillary metastasis as the first manifestation is even rarer in men.
  • CASE PRESENTATION: We report a 72-year-old male Han-Chinese patient who presented axillary metastasis as the first manifestation of breast cancer and got correctly diagnoses by histological examination.
  • He underwent modified radical mastectomy and axillary dissection on 11 Apr 2006.
  • The histopathologic examination showed that no tumor focus was found in his breast tissue, but two out of fifteen of axillary lymph nodes were invaded by infiltrating ductal carcinoma.
  • He is alive without any residual or metastasis disease 29 months after being diagnosed.
  • CONCLUSION: This is the first case in our hospital that presents axillary metastases as the first manifestation of male breast cancer.


65. AlSahaf M, AlShaban B, Mulsow J, Power C, Leen E, Walsh TN: Intra-operative examination of the sentinel node in breast cancer. Ir Med J; 2008 Apr;101(4):120-2
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  • Intra-operative sentinel node analysis allows immediate progression to axillary clearance in patients with node positive breast cancer and reduces the need for re-operation.
  • Twelve patients had axillary metastases.
  • The sensitivity of intra-operative analysis in identifying nodal metastases was 92%.
  • Intra-operative analysis of the sentinel node allowed re-operation to be avoided in 92% of patients with axillary node metastases.

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  • (PMID = 18557516.001).
  • [ISSN] 0332-3102
  • [Journal-full-title] Irish medical journal
  • [ISO-abbreviation] Ir Med J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Technetium Tc 99m Aggregated Albumin
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66. Altomare V, Guerriero G, Carino R, Battista C, Primavera A, Altomare A, Vaccaro D, Esposito A, Ferri AM, Rabitti C: Axillary lymph node echo-guided fine-needle aspiration cytology enables breast cancer patients to avoid a sentinel lymph node biopsy. Preliminary experience and a review of the literature. Surg Today; 2007;37(9):735-9
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  • [Title] Axillary lymph node echo-guided fine-needle aspiration cytology enables breast cancer patients to avoid a sentinel lymph node biopsy. Preliminary experience and a review of the literature.
  • PURPOSE: For many years, the status of the axillary lymph nodes has been determined by an axillary lymphadenectomy.
  • However, a sentinel lymph node biopsy has been shown to effectively replace the need for an axillary lymphadenectomy in order to determine the axillary staging.
  • This study presents the preliminary results regarding the efficacy of fine-needle aspiration cytology (FNAC) to identify metastatic axillary lymph nodes in the pre-operative phase.
  • The diagnostic accuracy (sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV]) for the axillary metastases was evaluated based on the histological findings of either a sentinel lymph node biopsy or an axillary lymphadenectomy as a reference standard.
  • Echo-guided FNAC of the axillary lymph nodes should thus be included among the regular diagnostic procedures of presurgical staging.
  • [MeSH-major] Axilla / pathology. Biopsy, Fine-Needle. Breast Neoplasms / diagnosis. Lymph Nodes / pathology. Sentinel Lymph Node Biopsy
  • [MeSH-minor] Adult. Aged. Female. Humans. Lymph Node Excision. Middle Aged. Neoplasm Staging. Prospective Studies. Sensitivity and Specificity

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  • (PMID = 17713725.001).
  • [ISSN] 0941-1291
  • [Journal-full-title] Surgery today
  • [ISO-abbreviation] Surg. Today
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 40
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67. Pugliese M, Stempel M, Patil S, Hsu M, Ho A, Traina T, Morrow M, Cody H 3rd, Gemignani ML: The clinical impact and outcomes of immunohistochemistry-only metastasis in breast cancer. Am J Surg; 2010 Sep;200(3):368-73
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  • [Title] The clinical impact and outcomes of immunohistochemistry-only metastasis in breast cancer.
  • BACKGROUND: Modern surgical and pathological techniques can detect small-volume axillary metastases in breast cancer with unknown clinical significance.
  • METHODS: A retrospective database review from 1996 through 2004 identified all patients with immunohistochemical (IHC)-only sentinel node (IHC-SN) metastases and compared them with negative controls (Neg-SN).
  • In 123 IHC-SN patients treated with axillary dissection (axillary lymph node dissection), 16% had positive non-SLNs.
  • CONCLUSIONS: IHC-only sentinel lymph node (SLN) metastases were associated with worse prognostic features and higher rates of systemic therapy.
  • [MeSH-major] Axilla / pathology. Breast Neoplasms / pathology. Immunohistochemistry / methods. Lymphatic Metastasis / diagnosis

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  • [Copyright] 2010 Elsevier Inc. All rights reserved.
  • (PMID = 20800716.001).
  • [ISSN] 1879-1883
  • [Journal-full-title] American journal of surgery
  • [ISO-abbreviation] Am. J. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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68. Sebastian G: [Cutaneous malignant melanoma. Excision margins and lymph node dissections]. Hautarzt; 2006 Sep;57(9):756-63
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  • [Title] [Cutaneous malignant melanoma. Excision margins and lymph node dissections].
  • Excision is the treatment of choice in stage I malignant melanoma.
  • The most common sign of tumor progression is involvement of regional lymph nodes.
  • The treatment of choice in patients with neck metastases is the radical, modified or selective neck dissection.
  • In the case of axillary metastases, levels I-III of the axillary lymph nodes are excised.
  • With groin metastases, superficial inguinal dissection is usually preferred.
  • [MeSH-major] Lymph Node Excision / methods. Lymph Nodes / pathology. Lymph Nodes / surgery. Melanoma / secondary. Melanoma / surgery. Skin Neoplasms / pathology. Skin Neoplasms / surgery
  • [MeSH-minor] Humans. Lymphatic Metastasis. Practice Guidelines as Topic. Practice Patterns, Physicians'. Sentinel Lymph Node Biopsy / methods

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  • (PMID = 16874532.001).
  • [ISSN] 0017-8470
  • [Journal-full-title] Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete
  • [ISO-abbreviation] Hautarzt
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 31
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69. Guth AA, Mercado C, Roses DF, Hiotis K, Skinner K, Diflo T, Cangiarella J: Intramammary lymph nodes and breast cancer: a marker for disease severity, or just another lymph node? Am J Surg; 2006 Oct;192(4):502-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND: Axillary lymph node status is still considered the most significant prognostic factor for breast cancer outcome, and treatment decisions are based on the presence or absence of nodal disease.
  • Intramammary lymph nodes (IMLNs) can be a site of regional spread.
  • RESULTS: IMLNs were identified in 64 breast cancer patients, with metastatic spread in 20 patients, and benign IMLNs described in 44 patients.
  • Positive IMLNs were associated with more aggressive disease, including higher rates of invasive versus noninvasive cancers (5% ductal carcinoma-in-situ [DCIS] with positive IMLNs vs. 23% with negative IMLNs), lymphovascular invasion (55% vs. 11%), and a higher rate of axillary lymph node involvement (72% vs. 18%).
  • CONCLUSIONS: IMLN metastases are a marker for disease severity; recognition of this may influence choice of adjuvant therapy.
  • The presence of metastatic disease in an IMLN is associated with a high rate of axillary nodal involvement, and should mandate axillary dissection.
  • Preoperative lymphoscintigraphy may help identify these extra-axillary metastases.
  • [MeSH-major] Breast Neoplasms / pathology. Carcinoma, Ductal, Breast / secondary. Carcinoma, Intraductal, Noninfiltrating / secondary. Carcinoma, Lobular / secondary. Lymph Nodes / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Axilla. Female. Humans. Mammary Glands, Human / pathology. Mastectomy. Middle Aged. Retrospective Studies

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  • (PMID = 16978960.001).
  • [ISSN] 0002-9610
  • [Journal-full-title] American journal of surgery
  • [ISO-abbreviation] Am. J. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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70. Douglas-Jones AG, Woods V: Molecular assessment of sentinel lymph node in breast cancer management. Histopathology; 2009 Jul;55(1):107-13
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  • Sentinel lymph node biopsy (SLNB) is becoming accepted as standard of care for axillary staging in breast cancer.
  • World Health Organization (WHO) re-classification of axillary metastases into macrometastases, micrometastases and individual tumour cells has highlighted the issues of sampling and further histological examination of the initially negative SLNB.
  • Molecular detection of metastatic breast cancer cells in lymph nodes is now available as a commercial kit for intraoperative use and can resolve the sampling issue.
  • Semiquantitative assessment of axillary lymph node tumour burden can now be made using two separate technologies (histology and reverse transcriptase-polymerase chain reaction).
  • The clinical implications of low metastatic axillary lymph node tumour burden are not clear, and future trials need to include molecular data.
  • [MeSH-minor] Female. Humans. Intraoperative Period. Keratin-19 / genetics. Keratin-19 / metabolism. Lymph Nodes / metabolism. Lymph Nodes / pathology. Mammaglobin A. Neoplasm Proteins / genetics. Neoplasm Proteins / metabolism. Polymerase Chain Reaction / methods. Uteroglobin / genetics. Uteroglobin / metabolism

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  • (PMID = 19469912.001).
  • [ISSN] 1365-2559
  • [Journal-full-title] Histopathology
  • [ISO-abbreviation] Histopathology
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Keratin-19; 0 / Mammaglobin A; 0 / Neoplasm Proteins; 0 / SCGB2A2 protein, human; 9060-09-7 / Uteroglobin
  • [Number-of-references] 54
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71. Gimbergues P, Abrial C, Durando X, Le Bouedec G, Cachin F, Penault-Llorca F, Mouret-Reynier MA, Kwiatkowski F, Maublant J, Tchirkov A, Dauplat J: Clinicopathological factors and nomograms predicting nonsentinel lymph node metastases after neoadjuvant chemotherapy in breast cancer patients. Ann Surg Oncol; 2009 Jul;16(7):1946-51
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  • [Title] Clinicopathological factors and nomograms predicting nonsentinel lymph node metastases after neoadjuvant chemotherapy in breast cancer patients.
  • Our goal was to determine clinicopathological factors correlating with the presence of non-SLN metastases in patients after NAC and to assess the validity of nomograms predicting additional axillary metastases.
  • At surgery, SLN biopsy followed by axillary lymph node dissection was performed.
  • RESULTS: In univariate analysis, tumor size (P = 0.016) and the size of SLN metastases (P = 0.0055) were significantly correlated with the presence of non-SLN metastases.
  • In multivariate analysis, SLN macrometastases (P = 0.047) conferred significantly increased risk of non-SLN metastases.
  • The Memorial Sloan-Kettering Cancer Center nomogram was not reliably predictive for non-SLN metastases (area under the receiver operating characteristic curve, AUC, of 0.542), whereas the MD Anderson (AUC 0.716) and Tenon scoring systems (AUC 0.778) were validated.
  • [MeSH-minor] Adult. Aged. Axilla. Female. Humans. Lymph Node Excision. Lymphatic Metastasis. Middle Aged. Neoadjuvant Therapy. Nomograms. Predictive Value of Tests. Sentinel Lymph Node Biopsy

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  • (PMID = 19408057.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Validation Studies
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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72. Straver ME, Rutgers EJ, Russell NS, Oldenburg HS, Rodenhuis S, Wesseling J, Vincent A, Peeters MT: Towards rational axillary treatment in relation to neoadjuvant therapy in breast cancer. Eur J Cancer; 2009 Sep;45(13):2284-92
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  • [Title] Towards rational axillary treatment in relation to neoadjuvant therapy in breast cancer.
  • AIMS: The purpose of this study is to analyse nodal staging and axillary response in breast cancer patients treated with neoadjuvant chemotherapy (NAC) to explore venues to safely spare patients axillary clearance whenever it could be avoided.
  • In patients with proven metastasis we analysed the axillary response after NAC.
  • The SNB was negative in 53 patients, thus in these patients axillary clearance could be avoided.
  • All 274 patients with proven axillary metastases at diagnosis underwent axillary clearance after NAC.
  • Twenty percent of the cytology-positive patients (50/252) had an axillary pathological complete remission (pCR) and 68% of the SNB-positive patients (15/22) had no lymph node (LN) metastasis after NAC.
  • Subgroups with a high axillary pCR rate were patients with triple-negative tumours (57%) and human epidermal growth-factor receptor 2 (HER2)-positive tumours (68%) who had a pCR of the primary tumour.
  • CONCLUSIONS: Twenty percent of the patients with proven metastasis by cytology prior to NAC have an axillary pCR.
  • The axillary pCR rate is very high in certain subgroups.
  • Identification of these patients, could result in more axilla-conserving therapies.
  • [MeSH-minor] Adult. Aged. Axilla. Female. Humans. Lymphatic Metastasis. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging. Prognosis. Remission Induction. Retrospective Studies. Sentinel Lymph Node Biopsy. Ultrasonography, Interventional


73. Williams RN, Jones L, Stotter A: Lymph nodes in the tail of the breast can be missed in standard axillary dissection. Eur J Surg Oncol; 2009 Mar;35(3):271-5
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  • [Title] Lymph nodes in the tail of the breast can be missed in standard axillary dissection.
  • AIMS: To determine whether excision of the tail of the breast usually by mastectomy or occasionally wide excision together with formal level 1 axillary node dissection (AND) for early breast cancer influences the quantity of harvested lymph nodes and the detection of axillary metastases.
  • CONCLUSIONS: The results of this study indicate that low axillary nodes may be missed by AND without excision of the tail of the breast and support the use of targeted sentinel node biopsy that should identify an involved node at any site.
  • [MeSH-minor] Axilla. Biopsy. Female. Humans. Lymph Node Excision. Lymphatic Metastasis. Regression Analysis. Retrospective Studies

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  • (PMID = 18407454.001).
  • [ISSN] 1532-2157
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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74. Mendez JE, Fey JV, Cody H, Borgen PI, Sclafani LM: Can sentinel lymph node biopsy be omitted in patients with favorable breast cancer histology? Ann Surg Oncol; 2005 Jan;12(1):24-8
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  • BACKGROUND: The widespread use of sentinel lymph node biopsy (SLNB) to replace axillary dissection has broadened the indications for axillary staging in breast cancer.
  • METHODS: We conducted a retrospective review of a prospective database of SLNBs performed at Memorial Sloan-Kettering Cancer Center from 1996 to 2003 to determine the incidence of lymph node metastases by histological subtype.
  • For the favorable subtypes, the patient's age, tumor size, estrogen receptor status, lymphovascular invasion, nuclear grade, and histological grade were compared by nodal status to determine their predictive value.
  • When compared by nodal status, the patient's age, tumor size, estrogen receptor status, lymphovascular invasion, nuclear grade, and histological grade failed to predict those with positive SLNs.
  • CONCLUSIONS: Patients with favorable breast cancer histology have a small risk of axillary SLN metastases.
  • The use of SLNB in these patients should be individualized, taking into consideration the small incidence of axillary metastases and the risks and benefits associated with the SLN procedure.
  • [MeSH-major] Breast Neoplasms / pathology. Carcinoma, Adenoid Cystic / pathology. Lymphatic Metastasis / diagnosis. Neoplasm Staging / methods. Sentinel Lymph Node Biopsy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Axilla. Child. Databases, Factual. Female. Humans. Middle Aged. Neoplasm Invasiveness. Patient Care Planning. Prognosis. Retrospective Studies. Risk Factors

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  • [CommentIn] Ann Surg Oncol. 2005 Jan;12(1):6-8 [15827770.001]
  • (PMID = 15827774.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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75. Gentilini O, Trifirò G, Soteldo J, Luini A, Intra M, Galimberti V, Veronesi P, Silva L, Gandini S, Paganelli G, Veronesi U: Sentinel lymph node biopsy in multicentric breast cancer. The experience of the European Institute of Oncology. Eur J Surg Oncol; 2006 Jun;32(5):507-10
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  • METHODS: Between May 2001 and May 2004, 42 patients with multicentric breast cancer and a clinically negative axilla underwent lymphatic mapping either by a single subareolar (n = 25) or a double peritumoral/subdermal injection (n = 17) of 99Tc-HSA nanocolloids.
  • The sentinel lymph node (SLN) was evaluated by intraoperative frozen section and axillary dissection was performed only in case of positive SLN.
  • After a median follow-up of 24 months no overt axillary metastases occurred in patients with negative SLN.
  • CONCLUSIONS: The number of SLNs is not dependent on the number and site of injections.
  • SLNB is our standard procedure for nodal staging in patients with multicentric breast cancer and a clinically negative axilla.
  • [MeSH-minor] Adult. Aged. Axilla. Breast / pathology. Breast / radionuclide imaging. Female. Follow-Up Studies. Frozen Sections. Humans. Injections, Subcutaneous. Intraoperative Care. Lymph Node Excision. Lymph Nodes / pathology. Lymph Nodes / radionuclide imaging. Mastectomy. Mastectomy, Segmental. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Nipples / pathology. Nipples / radionuclide imaging. Radiopharmaceuticals / administration & dosage. Technetium Tc 99m Aggregated Albumin / administration & dosage

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  • (PMID = 16595168.001).
  • [ISSN] 0748-7983
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0 / Technetium Tc 99m Aggregated Albumin; 0 / technetium Tc 99m nanocolloid
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76. Piekarski JH, Biernat W: Clinical significance of CK5/6 and PTEN protein expression in patients with bilateral breast carcinoma. Histopathology; 2006 Sep;49(3):248-55
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  • The hazard ratio of development of distant metastasis in patients in whom at least one cancer was CK5/6+ was 99.8 (P=0.037) and in patients with at least one carcinoma with reduced PTEN expression it was 10.8 (P=0.044).
  • Reduced PTEN expression was correlated with presence of axillary metastases (P<0.01), with very strong expression of c-erbB-2 (P<0.05) and with reduced expression of oestrogen receptor (P<0.05).
  • [MeSH-minor] Biomarkers, Tumor / analysis. Female. Genes, erbB-2. Humans. Immunohistochemistry. Lymphatic Metastasis / pathology. Prognosis. Receptors, Estrogen / metabolism. Receptors, Progesterone / metabolism. Survival Analysis. Survival Rate. Tumor Suppressor Protein p53

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  • (PMID = 16918971.001).
  • [ISSN] 0309-0167
  • [Journal-full-title] Histopathology
  • [ISO-abbreviation] Histopathology
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Receptors, Estrogen; 0 / Receptors, Progesterone; 0 / Tumor Suppressor Protein p53; 68238-35-7 / Keratins; EC 3.1.3.48 / PTEN protein, human; EC 3.1.3.67 / PTEN Phosphohydrolase
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77. Herceg D, Vrbanec D: [The role of taxanes in breast cancer chemotherapy: what's new 15 years after?]. Lijec Vjesn; 2009 May-Jun;131(5-6):133-41
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  • The results of recent meta-analysis were not influenced by the number of axillary metastases or by estrogen receptor expression.
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Drug Administration Schedule. Female. Humans. Lymphatic Metastasis

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  • (PMID = 19642533.001).
  • [ISSN] 0024-3477
  • [Journal-full-title] Lijec̆nic̆ki vjesnik
  • [ISO-abbreviation] Lijec Vjesn
  • [Language] hrv
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Croatia
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Taxoids
  • [Number-of-references] 51
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78. Tamiolakis D, Antoniou C: Axillary nodal metastasis of occult breast primary cancer. Chirurgia (Bucur); 2008 Jul-Aug;103(4):467-71
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  • [Title] Axillary nodal metastasis of occult breast primary cancer.
  • Occult breast cancer presenting with axillary metastases is an unusual presentation and can be a diagnostic and therapeutic challenge.
  • A comprehensive work-up, including mammogram, sonogram, magnetic resonance imaging, and even pathologic examination of the mastectomy specimen may not disclose the primary tumor in up to one third of patients.
  • We report a case of a 42-year-old female with occult breast cancer presenting axillary nodal metastasis.
  • She complained of a swelling of the right axillary lymph node, but no breast mass was palpable.
  • Biopsy of the lymph node was performed and histological examination showed a metastatic carcinoma.
  • Calcifications were obtained by mammography and ultrasonography of the right axillary node contained metastasis.
  • [MeSH-major] Breast Neoplasms / pathology. Carcinoma, Ductal, Breast / secondary. Lymph Nodes / pathology. Neoplasms, Unknown Primary / pathology
  • [MeSH-minor] Adult. Axilla. Female. Humans. Lymphatic Metastasis. Mastectomy, Modified Radical. Treatment Outcome

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  • (PMID = 18780622.001).
  • [ISSN] 1221-9118
  • [Journal-full-title] Chirurgia (Bucharest, Romania : 1990)
  • [ISO-abbreviation] Chirurgia (Bucur)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Romania
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79. Erhan Y, Ciris M, Zekioglu O, Erhan Y, Kapkac M, Makay O, Ozdemir N: Do clinical and immunohistochemical findings of pure mucinous breast carcinoma differ from mixed mucinous breast carcinoma? Acta Chir Belg; 2009 Mar-Apr;109(2):204-8
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  • It has a favourable prognosis with a low risk of axillary metastases.
  • The aim of the study is to determine suitable candidates for breast or axillary conservation in mucinous carcinoma subtypes.
  • MMC displayed greater metastatic potential (p < 0.05), p53 positivity (p < 0.05) and c-erbB-2 positivity (p <0.001) than PMCs.
  • PMCs smaller than 2 cm had less metastatic capacity and extranodal invasion compared to MMCs smaller than 2 cm (p < 0.001 and p < 0.01, respectively).
  • Even if PMCs and especially smaller PMCs display more favourable prognostic features, including less axillary lymph node involvement, it is appropriate to use sentinel lymph node biopsy to make better axillary assessment.
  • [MeSH-major] Adenocarcinoma, Mucinous / metabolism. Breast Neoplasms / metabolism. Breast Neoplasms / pathology. Carcinoma, Ductal, Breast / metabolism. Mixed Tumor, Malignant / metabolism

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  • (PMID = 19499682.001).
  • [ISSN] 0001-5458
  • [Journal-full-title] Acta chirurgica Belgica
  • [ISO-abbreviation] Acta Chir. Belg.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Belgium
  • [Chemical-registry-number] 0 / Receptors, Estrogen; 0 / Receptors, Progesterone; EC 2.7.10.1 / Receptor, ErbB-2
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80. Meretoja TJ, Leidenius MH, Heikkilä PS, Joensuu H: Sentinel node biopsy in breast cancer patients with large or multifocal tumors. Ann Surg Oncol; 2009 May;16(5):1148-55
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  • BACKGROUND: The axillary recurrence (AR) rate after negative sentinel node biopsy (SNB) in patients with high risk of axillary metastases is largely unknown.
  • No axillary clearance was performed in 1,309 cases with a negative SNB, including 1,138 small unifocal tumors, 121 small multifocal tumors, 48 large unifocal tumors, and 2 large multifocal tumors.
  • Instead of tumor size and multifocality, estrogen receptor negativity (p < 0.001), nuclear grade III (p < 0.001), Her-2 status (p = 0.002), no radiotherapy (p = 0.005), and mastectomy (p = 0.005) were found to be associated with AR.
  • CONCLUSIONS: A remarkable proportion of patients with large unifocal tumors and small multifocal tumors may avoid unnecessary AC due to tumor negative SNB, without an excessive risk of AR.
  • [MeSH-major] Breast Neoplasms / pathology. Lymph Nodes / pathology. Neoplasm Recurrence, Local / pathology. Sentinel Lymph Node Biopsy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Axilla. Female. Humans. Lymphatic Metastasis. Middle Aged. Registries. Risk Factors


81. Khan A, Sabel MS, Nees A, Diehl KM, Cimmino VM, Kleer CG, Schott AF, Hayes DF, Chang AE, Newman LA: Comprehensive axillary evaluation in neoadjuvant chemotherapy patients with ultrasonography and sentinel lymph node biopsy. Ann Surg Oncol; 2005 Sep;12(9):697-704
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  • [Title] Comprehensive axillary evaluation in neoadjuvant chemotherapy patients with ultrasonography and sentinel lymph node biopsy.
  • We report the accuracy of comprehensive pre-neoadjuvant CTX and post-neoadjuvant CTX axillary staging via ultrasound imaging, fine-needle aspiration (FNA) biopsy, and SLN biopsy.
  • METHODS: From 2001 to 2004, 91 neoadjuvant CTX patients at the University of Michigan Comprehensive Cancer Center underwent axillary staging by ultrasonography, ultrasound-guided FNA biopsy, SLN biopsy, or a combination of these.
  • RESULTS: Axillary staging was pathologically negative by pre-neoadjuvant CTX SLN biopsy in 53 cases (58%); these patients had no further axillary surgery.
  • In 38 cases (42%), axillary metastases were confirmed at presentation by either ultrasound-guided FNA or SLN biopsy.
  • These 38 patients underwent completion axillary lymph node dissection (ALND) after delivery of neoadjuvant CTX.
  • Residual metastatic disease was identified in 22 cases, and the SLN was falsely negative in 1 (4.5%).
  • CONCLUSIONS: Patients receiving neoadjuvant CTX can have accurate axillary nodal staging by ultrasound-guided FNA or SLN biopsy.
  • In cases of documented axillary metastasis at presentation, repeat axillary staging with SLN biopsy can document the post-neoadjuvant CTX nodal status.
  • [MeSH-minor] Adult. Aged. Axilla. Biopsy, Fine-Needle. Female. Humans. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging. Reproducibility of Results. Time Factors. Ultrasonography, Mammary

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  • (PMID = 16079956.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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82. Weir L, Worsley D, Bernstein V: The value of FDG positron emission tomography in the management of patients with breast cancer. Breast J; 2005 May-Jun;11(3):204-9
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  • Using the database at PETSCAN Vancouver, we identified imaged patients with a diagnosis of breast cancer.
  • The sensitivity of PET in detecting axillary metastases was 28%, and the specificity was 86%.
  • At diagnosis, 5% of patients were diagnosed with distant metastases.
  • Distant metastases were demonstrated in 30% of patients who were thought only to have local-regional recurrence.
  • The first is in the evaluation of patients who are suspected of having a tumor recurrence.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Middle Aged. Neoplasm Metastasis / radionuclide imaging. Neoplasm Recurrence, Local / radionuclide imaging. Sensitivity and Specificity

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  • (PMID = 15871707.001).
  • [ISSN] 1075-122X
  • [Journal-full-title] The breast journal
  • [ISO-abbreviation] Breast J
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
  • [Number-of-references] 20
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83. Newman EA, Sabel MS, Nees AV, Schott A, Diehl KM, Cimmino VM, Chang AE, Kleer C, Hayes DF, Newman LA: Sentinel lymph node biopsy performed after neoadjuvant chemotherapy is accurate in patients with documented node-positive breast cancer at presentation. Ann Surg Oncol; 2007 Oct;14(10):2946-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Previous studies of sentinel node biopsy performed following neoadjuvant chemotherapy have largely reported on patients whose prechemotherapy, pathologic axillary nodal status was unknown.
  • We report findings using a novel comprehensive approach to axillary management of node-positive-patients receiving neoadjuvant chemotherapy.
  • METHODS: We evaluated 54 consecutive breast cancer patients with biopsy-proven axillary nodal metastases at the time of diagnosis that underwent lymphatic mapping with nodal biopsy as well as concomitant axillary lymph node dissection after receiving neoadjuvant chemotherapy.
  • Thirty-six patients (66%) had residual axillary metastases (including eight patients that had undergone resection of metastatic sentinel nodes at the time of diagnosis), and in 12 cases (31%) the residual metastatic disease was limited to the sentinel lymph node.
  • The negative final sentinel node accurately identified patients with no residual axillary disease in 17 cases (32%).
  • CONCLUSIONS: Sentinel lymph node biopsy performed after the delivery of neoadjuvant chemotherapy in patients with documented nodal disease at presentation accurately identified cases that may have been downstaged to node-negative status and can spare this subset of patients (32%) from experiencing the morbidity of an axillary dissection.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / drug therapy. Carcinoma, Ductal, Breast / drug therapy. Carcinoma, Lobular / drug therapy. Lymphatic Metastasis / pathology. Neoadjuvant Therapy. Neoplasms, Multiple Primary / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Axilla. Combined Modality Therapy. Female. Humans. Lymph Node Excision. Lymph Nodes / pathology. Middle Aged. Neoplasm Staging. Neoplasm, Residual / pathology. Neoplasm, Residual / radiotherapy. Neoplasm, Residual / surgery. Predictive Value of Tests. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 17514407.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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84. Fernandez-Aguilar S, Noël JC: Expression of cathepsin D and galectin 3 in tubular carcinomas of the breast. APMIS; 2008 Jan;116(1):33-40
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  • Tubular carcinoma (TC) is a distinctive type of grade I (G1) ductal carcinoma with particularly favourable outcome and low rate of axillary metastases.
  • The higher expression of galectin 3 in TC and its focal staining (apical) pattern suggests that within the group of G1 carcinomas, galectin 3 expression varies according to histological type, and may correlate with prognosis and metastatic potential.
  • We also suggest that cathepsin D could not be involved in neoplastic progression and metastasis in low-grade (G1) ductal breast carcinomas.
  • [MeSH-minor] Adult. Aged. Axilla / pathology. Biomarkers / metabolism. Epithelial Cells / metabolism. Female. Humans. Immunohistochemistry. Lymph Nodes / metabolism. Lymph Nodes / pathology. Lymphatic Metastasis. Middle Aged. Neoplasm Staging. Prognosis. Stromal Cells / metabolism

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  • (PMID = 18254778.001).
  • [ISSN] 0903-4641
  • [Journal-full-title] APMIS : acta pathologica, microbiologica, et immunologica Scandinavica
  • [ISO-abbreviation] APMIS
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Biomarkers; 0 / Galectin 3; EC 3.4.23.5 / Cathepsin D
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85. Lee Ch K, Schwartz J R, Iglesis G R, Vélez F R, Gómez S L: [Occult breast cancer: Report of two cases]. Rev Med Chil; 2006 Sep;134(9):1166-70
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  • [Transliterated title] Cancer de mama oculto: dos casos clínicos analizados según el concepto actual.
  • Occult breast cancer is expressed as a metastatic axillary lymph node without clinical or imaging evidence of a primary tumor in the breast.
  • The treatment of isolated axillary metastases of breast cancer is controversial.
  • An axillary dissection is recommended.
  • However, in patients without radiological lesions in the breast, the tendency is not to perform a radical mastectomy as previously recommended, since the primary tumor will not be found in the surgical specimen in two thirds of cases.
  • We report two patients with a well defined occult breast cancer and based on them, a review of the subject is attempted.
  • [MeSH-major] Breast Neoplasms / pathology. Carcinoma, Ductal, Breast / secondary. Carcinoma, Papillary / secondary. Neoplasms, Unknown Primary / pathology
  • [MeSH-minor] Aged. Axilla. Biopsy. Breast / pathology. Combined Modality Therapy / methods. Female. Humans. Lymph Node Excision. Lymphatic Metastasis. Magnetic Resonance Imaging. Mammography. Mastectomy, Segmental. Middle Aged

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  • (PMID = 17171219.001).
  • [ISSN] 0034-9887
  • [Journal-full-title] Revista médica de Chile
  • [ISO-abbreviation] Rev Med Chil
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Chile
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86. Hogan BV, Peter MB, Shenoy H, Horgan K, Shaaban A: Intramammary lymph node metastasis predicts poorer survival in breast cancer patients. Surg Oncol; 2010 Mar;19(1):11-6
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  • [Title] Intramammary lymph node metastasis predicts poorer survival in breast cancer patients.
  • Involvement of an intramammary lymph node with metastatic breast cancer is an uncommon clinical or radiological presentation.
  • Twenty one contained metastasis.
  • Factors that predicted for intramammary node metastasis were increasing age (p=0.017), lymphovascular invasion (p=0.002) and grade of tumour (p=0.012).
  • The presence of metastasis within the intramammary lymph node was associated with a poorer disease free survival (p=0.007) and reduced overall survival (p=0.035).
  • Sixty seven percent of patients with intramammary node metastasis had further axillary metastases.
  • One patient had an intramammary node metastasis but uninvolved axillary sentinel node.
  • She presented 19 months later with an axillary nodal recurrence.
  • The presence of intramammary lymph node metastasis is associated with poorer outcome in breast cancer patients.
  • Pre-operative detection of intramammary lymph node metastasis is helpful to guide breast and axillary surgeries.
  • Intramammary lymph node metastasis predicts strongly for axillary metastatic disease and axillary node clearance is recommended.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Breast. Databases, Factual. Female. Great Britain. Humans. Lymphatic Metastasis. Middle Aged. Neoplasm Recurrence, Local. Prognosis. Proportional Hazards Models. Retrospective Studies. Sentinel Lymph Node Biopsy. Survival Analysis

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  • [Copyright] Copyright 2008 Elsevier Ltd. All rights reserved.
  • (PMID = 19171479.001).
  • [ISSN] 1879-3320
  • [Journal-full-title] Surgical oncology
  • [ISO-abbreviation] Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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87. Hirche C, Mohr Z, Kneif S, Hünerbein M: The role of nodal staging in breast cancer. Past, present and future. Minerva Chir; 2010 Oct;65(5):537-46
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  • The axillary nodal status is accepted as the most powerful prognostic tool available for early stage breast cancer.
  • In the past radical removal of level I and level II lymph nodes at axillary node dissection (ALND) has been the most accurate method to assess nodal status, and it is the universal standard; however, it is associated with several adverse long-term sequelae.
  • Lymphatic mapping with sentinel lymph node biopsy has emerged as an effective and safe alternative to the ALND for detecting axillary metastases.
  • Multiple studies now confirm that sentinel lymphadenectomy accurately stages the axilla and is associated with less morbidity than axillary dissection.
  • Sentinel node biopsy is now minimally invasive, highly accurate method of axillary staging, and has replaced routine axillary lymph node dissection as the new standard of care in breast cancer.
  • New technologies for axillary nodal staging include innovative imaging techniques such as single photon emission computerized tomography (SPECT) and modern histopathologic evaluation of sentinel nodes using molecular biologic approaches.
  • [MeSH-minor] Female. Forecasting. Humans. Lymphatic Metastasis. Neoplasm Staging. Sentinel Lymph Node Biopsy / trends

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  • (PMID = 21081865.001).
  • [ISSN] 0026-4733
  • [Journal-full-title] Minerva chirurgica
  • [ISO-abbreviation] Minerva Chir
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
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88. Leidenius MH, Krogerus LA, Toivonen TS, von Smitten KA: Sentinel node biopsy is not sensible in breast cancer patients with large primary tumours. Eur J Surg Oncol; 2005 May;31(4):364-8
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  • The advantages of SNB like avoiding axillary clearance (AC) or more accurate staging by detecting micrometastases or parasternal sentinel node metastases were evaluated in relation to the tumour size.
  • RESULTS: Axillary metastases were detected in 351/914 patients with a tumour size of 3 cm or smaller and in 50/70 patients with larger tumours (p<<0.0001).
  • Parasternal sentinel node metastases were detected in 17/914 patients with a tumour size of 3 cm or smaller and 2/70 patients with larger tumours (p=ns).
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Axilla. Chi-Square Distribution. Female. Humans. Lymphatic Metastasis. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Statistics, Nonparametric. Sternum

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  • (PMID = 15837040.001).
  • [ISSN] 0748-7983
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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89. Heuts EM, van der Ent FW, von Meyenfeldt MF, Voogd AC: Internal mammary lymph drainage and sentinel node biopsy in breast cancer - A study on 1008 patients. Eur J Surg Oncol; 2009 Mar;35(3):252-7
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  • INTRODUCTION: Nowadays, axillary sentinel node (SN) biopsy is a standard procedure in the staging of breast cancer.
  • The aim of this study was to determine the likelihood of finding IM lymph node metastases in case of IM hotspots on lymphoscintigraphy and evaluate the relevance of IMSN biopsy as a method to improve staging.
  • Both axillary and IMSNs were sampled, based on lymphoscintigraphy, intraoperative gamma probe detection and blue dye mapping, using 10 mCi (370 MBq) (99m)Tc-nanocolloid injected peritumorally, and 0.5-1.0 ml Patent Blue V injected intradermally.
  • RESULTS: Lymphoscintigraphy showed axillary sentinel nodes in 98% (989/1008) and IMSNs in 20% of the patients (196/1008).
  • Sampling the IM basin, as based on the results of lymphoscintigraphy, was successful in 71% of the patients (139/196) and revealed metastases in 22% (31/139).
  • In 29% of the patients with positive IMSNs (9/31) no axillary metastases were found.
  • Patients with IM hotspots on lymphoscintigraphy have a substantial risk (22%) of metastatic involvement of the IM chain.
  • [MeSH-major] Breast Neoplasms / pathology. Lymph Nodes / pathology. Lymphatic Metastasis / pathology. Mammary Glands, Human / pathology. Sentinel Lymph Node Biopsy / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Axilla. Biopsy, Fine-Needle. Chi-Square Distribution. Female. Humans. Middle Aged. Neoplasm Staging. Prognosis. Prospective Studies. Radionuclide Imaging / methods. Radiopharmaceuticals. Technetium Tc 99m Aggregated Albumin

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  • (PMID = 18684584.001).
  • [ISSN] 1532-2157
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0 / Technetium Tc 99m Aggregated Albumin; 0 / technetium Tc 99m nanocolloid
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90. Jaukovic LDj, Ajdinovic BZ, Jankovic ZD, Strbac M: Technetium-99m-tetrofosmin in diagnosis of breast cancer and axillary lymph node involvement. Nucl Med Rev Cent East Eur; 2006;9(1):30-6
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  • [Title] Technetium-99m-tetrofosmin in diagnosis of breast cancer and axillary lymph node involvement.
  • BACKGROUND: The aim of this study was to evaluate the accuracy of breast cancer seeking agent Tc-99m-Tetrofosmin in the detection of breast malignancy and axillary lymph node metastases.
  • All the patients underwent clinical investigation, Tc-99m Tetrofosmin scintimammography (SMM), mammography (MM) and biopsy/surgery for final histopathologic diagnosis.
  • Planar images were acquired in left and right prone lateral view as well as in the supine position for an anterior view of chest and axillary region.
  • In the group of 23 patients with positive SMM scans 19 had breast malignancy: 15 infiltrating ductal cancer, three patients with one infiltrating lobular, one papillary, one colloidal cancer and one patient with cystosarcoma phyllodes-malignant type.
  • Axillary dissection was performed in 19/20 with malignant disease.
  • Metastatic involvement was confirmed by HP in 9 out of 20 patients.
  • SMM detected axillary metastases with 55% sensitivity and 80% accuracy.
  • Further studies to evaluate the role of SMM in metastatic node involvement are necessary.
  • [MeSH-major] Breast Neoplasms / diagnosis. Breast Neoplasms / radionuclide imaging. Lymphatic Metastasis / diagnosis. Lymphatic Metastasis / radionuclide imaging. Organophosphorus Compounds. Organotechnetium Compounds. Radiopharmaceuticals

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  • (PMID = 16791801.001).
  • [ISSN] 1506-9680
  • [Journal-full-title] Nuclear medicine review. Central & Eastern Europe
  • [ISO-abbreviation] Nucl Med Rev Cent East Eur
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Organophosphorus Compounds; 0 / Organotechnetium Compounds; 0 / Radiopharmaceuticals; 0 / technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane
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91. Marinho VF, Zagury MS, Caldeira LG, Gobbi H: Relationship between histologic features of primary breast carcinomas and axillary lymph node micrometastases: Detection and prognostic significance. Appl Immunohistochem Mol Morphol; 2006 Dec;14(4):426-31
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  • [Title] Relationship between histologic features of primary breast carcinomas and axillary lymph node micrometastases: Detection and prognostic significance.
  • The incidence and prognostic significance of micrometastases (Mic-Met) in axillary lymph nodes (LNs) is still controversial.
  • We compared Mic-Met detection of invasive mammary carcinomas (IMCs) in axillary LNs using second review of hematoxylin and eosin (H&E)-stained slides and immunohistochemistry (IHC) relating them with features of the primary tumor, and determining their influence on overall survival (OS) and disease-free survival (DFS).
  • We studied 188 cases of IMCs with no axillary metastases in the initial reports.
  • Mic-Met detection was correlated to histologic features of primary tumor (size, type, grade, lymphatic/blood vessel invasion).
  • Mic-Met were detected in 26/188 cases (by IHC: 23/188, 12.2%; by H&E: 12/188, 6.4%).
  • There was no relationship between features of primary tumor and Mic-Met detection, including patients with lobular carcinomas or IMCs with lobular features.
  • There was no statistical difference in OS and DFS of patients with and without Mic-Met, but patients with Mic-Met presented lower survival curves.
  • In conclusion, there was no relationship between histologic features of primary tumor and presence of Mic-Met, nor between Mic-Met detection and patients survival.

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  • (PMID = 17122640.001).
  • [ISSN] 1541-2016
  • [Journal-full-title] Applied immunohistochemistry & molecular morphology : AIMM
  • [ISO-abbreviation] Appl. Immunohistochem. Mol. Morphol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 68238-35-7 / Keratins
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92. Kebudi A, Calişkan C, Yetkin G, Celebi S, Işgör A, Mesrur Halefoğlu A, Ezdeşir R, Akgün I: The role of pre-operative B mode ultrasound in the evaluation of the axillary lymph node metastases in the initial staging of breast carcinoma. Acta Chir Belg; 2005 Sep-Oct;105(5):511-4
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  • [Title] The role of pre-operative B mode ultrasound in the evaluation of the axillary lymph node metastases in the initial staging of breast carcinoma.
  • Physical examination alone is not sufficient to assess axillary metastases.
  • Mammographic examination can give us an idea about breast cancer and axillary involvement.
  • Ultrasonographic evaluation can improve the sensitivity of clinical and mammographic examination in assessing axillary lymph node status.
  • In the study, we used axillary B mode ultrasound to evaluate the axillary lymph nodes.
  • Axillary B mode ultrasound was performed to evaluate the axillary lymph nodes for metastatic involvement.
  • L/W ratio below 2 and parameters above 2 cm were accepted as malignant findings.
  • 168 lymph nodes in 42 patients were evaluated pre-operatively with axillary B mode ultrasound.
  • As a result, these lymph nodes were defined as benign in 19 patients (45.2%) and malignant in 23 patients (54.8%).
  • Axillary lymph node status was found as benign in 18 patients (42.9%) and malignant in 24 patients (57.1%) pathologically .
  • Comparative results of ultrasound and axillary lymph node status can be seen on Table III.
  • As a result, the sensitivity of axillary B mode ultrasound to show the metastases was found as 79.1%, specificity was 77.7%, positive predictive value 82.6% and negative predictive value 73.6%.
  • We think some better results may be obtained in the future and these developments may affect the surgeon's decisions concerning axillary dissection for breast cancer operations.
  • [MeSH-major] Breast Neoplasms / pathology. Breast Neoplasms / ultrasonography. Lymphatic Metastasis / ultrasonography. Neoplasm Staging / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Axilla. Female. Humans. Middle Aged. Preoperative Care. Sensitivity and Specificity. Ultrasonography / methods

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  • (PMID = 16315836.001).
  • [ISSN] 0001-5458
  • [Journal-full-title] Acta chirurgica Belgica
  • [ISO-abbreviation] Acta Chir. Belg.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Belgium
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93. Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, Intra M, Veronesi P, Maisonneuve P, Gatti G, Mazzarol G, De Cicco C, Manfredi G, Fernández JR: Sentinel-lymph-node biopsy as a staging procedure in breast cancer: update of a randomised controlled study. Lancet Oncol; 2006 Dec;7(12):983-90
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  • BACKGROUND: In women with breast cancer, sentinel-lymph-node biopsy (SLNB) provides information that allows surgeons to avoid axillary-lymph-node dissection (ALND) if the SLN does not have metastasis, and has a favourable effect on quality of life.
  • Results of our previous trial showed that SLNB accurately screens the ALN for metastasis in breast cancers of diameter 2 mm or less.
  • Analysis was restricted to patients whose tumour characteristics met eligibility criteria after treatment.
  • The main endpoints were the number of axillary metastases in women in the SLN group with negative SLNs, staging power of SLNB, and disease-free and overall survival.
  • One case of overt clinical axillary metastasis was seen in the follow-up of the 167 women in the SLN group who did not receive ALND (ie, one false-negative).
  • The finding that only one overt axillary metastasis occurred during follow-up of patients who did not receive ALND (whereas eight cases were expected) could be explained by various hypotheses, including those from cancer-stem-cell research.
  • [MeSH-major] Breast Neoplasms / pathology. Carcinoma, Ductal, Breast / secondary. Carcinoma, Lobular / secondary. Lymph Nodes / pathology. Sentinel Lymph Node Biopsy / methods
  • [MeSH-minor] Adult. Aged. Axilla. Female. Humans. Incidence. Lymphatic Metastasis. Middle Aged. Neoplasm Staging. Predictive Value of Tests. Survival Rate

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  • (PMID = 17138219.001).
  • [ISSN] 1470-2045
  • [Journal-full-title] The Lancet. Oncology
  • [ISO-abbreviation] Lancet Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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94. Geertsema D, Gobardhan PD, Madsen EV, Albregts M, van Gorp J, de Hooge P, van Dalen T: Discordance of intraoperative frozen section analysis with definitive histology of sentinel lymph nodes in breast cancer surgery: complementary axillary lymph node dissection is irrelevant for subsequent systemic therapy. Ann Surg Oncol; 2010 Oct;17(10):2690-5
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  • [Title] Discordance of intraoperative frozen section analysis with definitive histology of sentinel lymph nodes in breast cancer surgery: complementary axillary lymph node dissection is irrelevant for subsequent systemic therapy.
  • BACKGROUND: In breast cancer surgery, intraoperative frozen section (FS) analysis of sentinel lymph nodes (SLNs) enables axillary lymph node dissection (ALND) during the same operative procedure.
  • In case of discordance between a "negative" FS analysis and definitive histology, an ALND as a second operation is advocated since additional lymph node metastases may be present.
  • MATERIALS AND METHODS: Between November 2000 and May 2008, 879 consecutive breast cancer patients underwent surgery including sentinel lymph node biopsy (SLNB) with intraoperative FS analysis of 2 central cuts from axillary SLNs.
  • RESULTS: FS analysis detected axillary metastases in the SLN(s) in 200 patients (23%), while the definitive pathology examination detected metastases in SLNs in another 151 patients (17%).
  • Additional tumor positive axillary lymph nodes were found in 17 patients (16%), leading to "upstaging" in 7 (6%).
  • In this selection of patients, a substantial proportion had additional lymph node metastases, but postsurgical treatment was rarely adjusted based on the findings of the complementary ALND.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Axilla. Carcinoma, Ductal, Breast / secondary. Carcinoma, Ductal, Breast / surgery. Carcinoma, Lobular / secondary. Carcinoma, Lobular / surgery. Female. Follow-Up Studies. Humans. Intraoperative Period. Lymphatic Metastasis. Middle Aged. Neoplasm Staging. Prognosis. Prospective Studies

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  • (PMID = 20422461.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2941713
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95. Alvarez S, Añorbe E, Alcorta P, López F, Alonso I, Cortés J: Role of sonography in the diagnosis of axillary lymph node metastases in breast cancer: a systematic review. AJR Am J Roentgenol; 2006 May;186(5):1342-8
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  • [Title] Role of sonography in the diagnosis of axillary lymph node metastases in breast cancer: a systematic review.
  • OBJECTIVE: The purpose of our study was to evaluate the accuracy of sonography and sonographically guided biopsy in the preoperative diagnosis of metastatic invasion of the axilla in patients with breast carcinoma.
  • MATERIALS AND METHODS: We performed a MEDLINE search (keywords, "sonography" OR "ultrasound" AND "axillary") and a manual search of the references of relevant studies and reviews of preoperative diagnosis on sonography of possible axillary metastases.
  • The gold standard required was axillary lymph node dissection; we accepted sentinel node biopsy as an alternative gold standard.
  • CONCLUSION: Axillary sonography is moderately sensitive and fairly specific in the diagnosis of axillary metastatic involvement.
  • Negative sonographic results do not exclude axillary lymph node metastases.
  • [MeSH-minor] Axilla. Biopsy. Female. Humans. Lymphatic Metastasis. Reproducibility of Results

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  • (PMID = 16632729.001).
  • [ISSN] 1546-3141
  • [Journal-full-title] AJR. American journal of roentgenology
  • [ISO-abbreviation] AJR Am J Roentgenol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 29
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96. Escalona S, Blasco JA, Reza MM, Andradas E, Gómez N: A systematic review of FDG-PET in breast cancer. Med Oncol; 2010 Mar;27(1):114-29
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  • OBJECTIVE: To assess the safety and efficacy of FDG-PET in breast cancer in the diagnostic of primary tumours, lymph node staging, the detection of recurrent disease/metastases, and the assessment of chemotherapy treatment.
  • In lymph gland staging, FDG-PET does not appear to be accurate enough to detect occult axillary metastases or micrometastases (sensitivity 20 and 50%, respectively); sentinel node biopsy is required for confirmation.
  • In the detection of bone metastases, FDG-PET should be complemented with other tests such as bone gammagraphy or SPECT.
  • Due to the high number of false positives returned, it cannot replace axillary dissection in axillary lymph gland staging.
  • [MeSH-major] Breast Neoplasms / diagnosis. Fluorodeoxyglucose F18. Positron-Emission Tomography. Radiopharmaceuticals

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  • (PMID = 19277913.001).
  • [ISSN] 1559-131X
  • [Journal-full-title] Medical oncology (Northwood, London, England)
  • [ISO-abbreviation] Med. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
  • [Number-of-references] 84
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97. Nassar A, Cohen C, Cotsonis G, Carlson G: Significance of intramammary lymph nodes in the staging of breast cancer: correlation with tumor characteristics and outcome. Breast J; 2008 Mar-Apr;14(2):147-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Significance of intramammary lymph nodes in the staging of breast cancer: correlation with tumor characteristics and outcome.
  • Patients with stage I breast carcinoma and positive intraMLN metastases have been reported to have a poorer prognosis compared to patients with similar stage and negative intraMLN metastases.
  • However, the presence of intraMLN metastases does not appear to influence the survival of patients with stage II breast carcinoma.
  • Primary tumor characteristics and axillary lymph node (AxLN) status were recorded.
  • Statistical analysis was performed to detect correlation between intraMLN and tumor characteristics as well as outcome.
  • IntraMLN metastases were found in 26% of all in-situ and invasive cancer cases (15/57), and 32% (15/47) of invasive cancer cases only.
  • Most patients (80%) who had intraMLN metastases also had axillary metastases; however, an isolated intraMLN metastasis was documented in one patient (7%).
  • Univariate analysis revealed that predictors of intraMLN metastases include: tumor size (p = 0.04), tumor grade (p = 0.04), tumor stage (p < 0.001), and AxLN status (p < 0.001).
  • Furthermore patients with intraMLN positive for metastases have a poorer 4-year overall (40% versus 88%; p < 0.001) and disease-free survival (37% versus 83%; p < 0.001) than patients with negative intraMLN.
  • On multivariate analysis, intraMLN metastasis is not an independent predictor of outcome (disease-free survival: p = 0.350; and overall survival p = 0.138).
  • IntraMLN metastasis is a poor prognostic marker but not an independent predictor of poor outcome in patients with breast carcinoma.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Axilla. Female. Humans. Lymphatic Metastasis. Middle Aged. Neoplasm Staging. Prognosis. Retrospective Studies

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  • (PMID = 18248563.001).
  • [ISSN] 1524-4741
  • [Journal-full-title] The breast journal
  • [ISO-abbreviation] Breast J
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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98. Intra M, Rotmensz N, Veronesi P, Colleoni M, Iodice S, Paganelli G, Viale G, Veronesi U: Sentinel node biopsy is not a standard procedure in ductal carcinoma in situ of the breast: the experience of the European institute of oncology on 854 patients in 10 years. Ann Surg; 2008 Feb;247(2):315-9
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  • SUMMARY BACKGROUND DATA: DCIS cannot give rise to axillary metastases by definition.
  • Axillary dissection is therefore not indicated.
  • RESULTS: SLN metastases were detected in 12 (1.4%) DCIS patients.
  • Eleven patients underwent complete axillary dissection.
  • None of these patients had additional positive axillary lymph nodes.
  • CONCLUSIONS: Because of the low prevalence of metastatic involvement, SLN biopsy should not be considered a standard procedure in the treatment of all patients with DCIS.
  • [MeSH-major] Academies and Institutes. Breast Neoplasms / pathology. Carcinoma in Situ / pathology. Carcinoma, Ductal, Breast / secondary. Lymph Nodes / pathology. Sentinel Lymph Node Biopsy / standards
  • [MeSH-minor] Adult. Aged. Axilla. Biopsy, Fine-Needle. Europe. Female. Follow-Up Studies. Humans. Lymph Node Excision. Lymphatic Metastasis. Medical Oncology. Middle Aged. Neoplasm Staging / methods. Prognosis. Reproducibility of Results. Retrospective Studies. Time Factors

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  • (PMID = 18216539.001).
  • [ISSN] 0003-4932
  • [Journal-full-title] Annals of surgery
  • [ISO-abbreviation] Ann. Surg.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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99. Song XY, Yuan XM, Chen WJ, Pan T, Xie SD, Qin C, Lou C, Jin M, Wang LB, Wu JM: Different criteria for radioactive sentinel lymph nodes has different impact on sentinel node biopsy in breast cancer patients. J Surg Oncol; 2007 Jun 15;95(8):635-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The first four highest radioactive sentinel nodes could accurately predict the status of axillary metastases. J. Surg. Oncol.
  • [MeSH-minor] False Negative Reactions. Female. Humans. Lymphatic Metastasis. Prospective Studies. Sensitivity and Specificity

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  • (PMID = 17252554.001).
  • [ISSN] 0022-4790
  • [Journal-full-title] Journal of surgical oncology
  • [ISO-abbreviation] J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 556Q0P6PB1 / Technetium Tc 99m Sulfur Colloid
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100. Kim HJ, Lee JS, Park EH, Choi SL, Lim WS, Chang MA, Ku BK, Gong GY, Son BH, Ahn SH: Sentinel node biopsy in patients with multiple breast cancer. Breast Cancer Res Treat; 2008 Jun;109(3):503-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Axillary dissection after SLNB was performed on 884 patients, 757 with unifocal and 127 with multiple tumors.
  • RESULTS: In the multiple tumor group, 2.68 +/- 0.84 SLNs were identified in 136 of 139 patients (identification rate, 97.84%); 81.5% of SLNs were identified by scintigram.
  • The incidence of axillary metastases was 29.50% (41/139).
  • The incidence of axillary metastasis was 22.04% (177/803).
  • These findings indicate that SLNB can be used an as alternative to complete axillary lymph node dissection in patients with multiple breast tumors.

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  • (PMID = 17661171.001).
  • [ISSN] 0167-6806
  • [Journal-full-title] Breast cancer research and treatment
  • [ISO-abbreviation] Breast Cancer Res. Treat.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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