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1. McLaughlin RA, Scolaro L, Robbins P, Hamza S, Saunders C, Sampson DD: Imaging of human lymph nodes using optical coherence tomography: potential for staging cancer. Cancer Res; 2010 Apr 1;70(7):2579-84
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  • [Title] Imaging of human lymph nodes using optical coherence tomography: potential for staging cancer.
  • Histologic assessment is the gold standard technique for the identification of metastatic involvement of lymph nodes in malignant disease, but can only be performed ex vivo and often results in the unnecessary excision of healthy lymph nodes, leading to complications such as lymphedema.
  • In this morphologic study, we show the capability of OCT to image nodal microarchitecture through an assessment of fresh, unstained ex vivo lymph node samples.
  • Examples include both benign human axillary lymph nodes and nodes containing metastatic breast carcinoma.
  • Through accurate correlation with the histologic gold standard, OCT is shown to enable differentiation of lymph node tissue from surrounding adipose tissue, reveal nodal structures such as germinal centers and intranodal vessels, and show both diffuse and well circumscribed patterns of metastatic node involvement.
  • [MeSH-major] Lymph Nodes / pathology. Neoplasms / pathology. Tomography, Optical Coherence / methods
  • [MeSH-minor] Breast Neoplasms / pathology. Breast Neoplasms / ultrastructure. Carcinoma, Ductal, Breast / pathology. Carcinoma, Ductal, Breast / ultrastructure. Female. Humans. Lymphatic Metastasis. Neoplasm Staging / methods

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  • (PMID = 20233873.001).
  • [ISSN] 1538-7445
  • [Journal-full-title] Cancer research
  • [ISO-abbreviation] Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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2. Port ER, Patil S, Stempel M, Morrow M, Cody HS 3rd: Number of lymph nodes removed in sentinel lymph node-negative breast cancer patients is significantly related to patient age and tumor size: a new source of bias in morbidity assessment? Cancer; 2010 Apr 15;116(8):1987-91
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  • [Title] Number of lymph nodes removed in sentinel lymph node-negative breast cancer patients is significantly related to patient age and tumor size: a new source of bias in morbidity assessment?
  • BACKGROUND: Sentinel lymph node (SLN) biopsy has been well-established for axillary lymph node staging for patients with breast cancer.
  • For lymph node-negative patients, planned "backup" axillary lymph node dissection (ALND) is rarely indicated.
  • Among patients with negative SLNs, the authors observed variation by tumor size and patient age in the total number of lymph nodes removed (SLNs plus non-SLNs).
  • METHODS: Retrospective review of this institution's SLN database identified 4103 SLN biopsy procedures between 1997 and 2004 in which SLN biopsy was performed for prophylactic mastectomy, ductal carcinoma in situ, or T1 to T2 invasive cancers, and the SLNs were benign.
  • RESULTS: The mean number of SLNs, non-SLNs, and total lymph nodes for all tumor sizes was 2.8, 1.5, and 4.3, respectively, and increased with tumor size (more lymph nodes were removed for T2 than for T1 tumors: 6.3 vs 4.3; P < .0001).
  • More total lymph nodes were also removed in patients aged <or=50 years than in those aged >50 years (4.6 lymph nodes vs 4.2 lymph nodes; P = .006).
  • In approximately 8% of patients (322 of 4103 patients), >or=10 lymph nodes were removed.
  • CONCLUSIONS: The morbidity of SLN biopsy is less than that of ALND, but for pN0 patients, the total number of lymph nodes removed increased with tumor size and younger patient age.
  • [MeSH-major] Breast Neoplasms / pathology. Lymph Node Excision / methods. Lymphatic Metastasis / pathology. Sentinel Lymph Node Biopsy / adverse effects
  • [MeSH-minor] Adult. Age Factors. Aged. Aged, 80 and over. Axilla / surgery. Bias (Epidemiology). Female. Humans. Lymph Nodes / pathology. Lymph Nodes / surgery. Middle Aged. Neoplasm Staging. Prognosis

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  • [Copyright] (c) 2010 American Cancer Society.
  • (PMID = 20151427.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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3. Korula A, Varghese J, Thomas M, Vyas F, Korula A: Malignant phyllodes tumour with intraductal and invasive carcinoma and lymph node metastasis. Singapore Med J; 2008 Nov;49(11):e318-21
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  • [Title] Malignant phyllodes tumour with intraductal and invasive carcinoma and lymph node metastasis.
  • Metastasis is usually haematogeneous, and axillary lymph node dissection is not routinely performed.
  • Carcinoma in a phyllodes tumour is distinctly uncommon, but has been known to occur in benign phyllodes tumours.
  • Though the carcinoma was found to be invasive based on the presence of carcinomatous lymph node metastasis, extensive sampling did not yield an invasive component within the breast, probably because of the marked stromal overgrowth of the phyllodes.
  • A malignant phyllodes tumour with foci of intraductal carcinoma and axillary lymph node metastases was diagnosed rather than carcinosarcoma.
  • There is little consensus on the treatment and prognosis in these cases, and it is recommended that treatment be tailored to individual patients, based on the presence of invasion, lymph node metastasis and/or distant metastasis.
  • [MeSH-minor] Breast / pathology. Breast / surgery. Female. Humans. Immunohistochemistry. Lymph Nodes / pathology. Lymphatic Metastasis. Middle Aged. Neoplasm Invasiveness. Neoplasm Metastasis. Treatment Outcome

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  • (PMID = 19037540.001).
  • [ISSN] 0037-5675
  • [Journal-full-title] Singapore medical journal
  • [ISO-abbreviation] Singapore Med J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Singapore
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4. Bleiweiss IJ, Nagi CS, Jaffer S: Axillary sentinel lymph nodes can be falsely positive due to iatrogenic displacement and transport of benign epithelial cells in patients with breast carcinoma. J Clin Oncol; 2006 May 1;24(13):2013-8
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  • [Title] Axillary sentinel lymph nodes can be falsely positive due to iatrogenic displacement and transport of benign epithelial cells in patients with breast carcinoma.
  • PURPOSE: Immunohistochemical (IHC) staining for cytokeratins (CK) is common practice in evaluating sentinel lymph nodes (SLNs) in patients with breast carcinoma.
  • Iatrogenic epithelial cell displacement and benign transport of breast epithelial cells into axillary lymph nodes are recently described phenomena.
  • We report 25 cases in which these factors probably resulted in benign epithelial cells in axillary SLNs (ie, false positivity).
  • RESULTS: In all cases, the cytologic features of the epithelial cells in the SLNs were benign, and 22 matched those of corresponding intraductal papillomas that were involved by or were separate from the DCIS in the original cores or surgical biopsies.
  • Nineteen cases showed benign epithelial cell displacement at the biopsy site.
  • Sentinel lymph nodes in breast carcinoma can be falsely positive.
  • [MeSH-major] Breast Neoplasms / pathology. Carcinoma, Ductal, Breast / pathology. Sentinel Lymph Node Biopsy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Axilla. Cell Movement. Epithelial Cells / pathology. False Positive Reactions. Female. Humans. Immunohistochemistry. Keratins / analysis. Middle Aged. Neoplasm Metastasis

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  • [CommentIn] J Clin Oncol. 2006 May 1;24(13):1978-9 [16606969.001]
  • (PMID = 16606970.001).
  • [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
  • [Chemical-registry-number] 68238-35-7 / Keratins
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5. De Cesare A, Fiori E, Burza A, Ciardi A, Bononi M, Izzo L, Volpino P, Cavallaro A, Cangemi V: Malignant fibrous histiocytoma of the breast. Report of two cases and review of the literature. Anticancer Res; 2005 Jan-Feb;25(1B):505-8
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  • Two cases of this neoplasm are reported, with histological findings and surgical treatment.
  • A review of the available literature evaluates the histopathological and biological features of MFH of the breast, for which there are no prospective trials, owing to the rarity of this kind of neoplasm.
  • The extent of surgery or role of axillary lymph nodes dissection and multimodality therapy are discussed.
  • [MeSH-major] Breast Neoplasms / diagnosis. Histiocytoma, Benign Fibrous / diagnosis

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  • (PMID = 15816619.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
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6. Al-Khawari H, Kovacs A, Athyal R, Al-Manfouhi H, Fayaz MS, Madda JP: Breast magnetic resonance imaging: initial experience in Kuwait. Med Princ Pract; 2009;18(2):143-8
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  • SUBJECTS AND METHODS: In 58 patients ranging in age from 25 to 64 years, breast MRI was performed as a problem-solving tool (29); for suspicious local relapse of the treated breast (6); to search for a primary breast cancer in patients with metastatic axillary lymph nodes (5); for local staging of breast cancer (5); breast implants (6); screening in high-risk patients (3), and differentiation between inflammation and inflammatory carcinoma (4).
  • RESULTS: Seventy breast lesions (25 malignant, 38 benign and 7 lesions detected by MRI only) were identified in the 58 patients.
  • [MeSH-minor] Adult. Female. Humans. Kuwait. Magnetic Resonance Imaging. Mass Screening / methods. Middle Aged. Neoplasm Staging / methods. Sensitivity and Specificity

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  • [Copyright] Copyright 2009 S. Karger AG, Basel.
  • (PMID = 19204434.001).
  • [ISSN] 1423-0151
  • [Journal-full-title] Medical principles and practice : international journal of the Kuwait University, Health Science Centre
  • [ISO-abbreviation] Med Princ Pract
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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7. Ding GP, Ye CS, Liu MF, Zhen LF, Liao JJ: [Relationship between D2-40-labeled lymphatic vessel invasion and lymph node metastasis of breast cancer]. Nan Fang Yi Ke Da Xue Xue Bao; 2010 Oct;30(10):2301-3
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  • [Title] [Relationship between D2-40-labeled lymphatic vessel invasion and lymph node metastasis of breast cancer].
  • METHODS: Immunohistochemistry was used to detect the expression of D2-40 and lymphatic invasion in 72 cases of breast cancer and 15 benign breast tumor tissues, and their correlations to the clinicopathological factors were analyzed.
  • In patients with lymph node metastasis, the positivity rate of LVI was significantly higher than that in patients without lymph node involvement (85.7% vs 54.1%, P<0.01), and LVI was found to be positively correlated to axillary lymph node metastasis (r=0.382).
  • LVI is positively correlated to axillary lymph node metastasis and occurs earlier than the latter, therefore should be included in routine clinicopathological testing.
  • [MeSH-minor] Adult. Aged. Female. Humans. Lymph Nodes / pathology. Lymphatic Metastasis / diagnosis. Lymphatic Metastasis / pathology. Middle Aged. Neoplasm Staging

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  • (PMID = 20965831.001).
  • [ISSN] 1673-4254
  • [Journal-full-title] Nan fang yi ke da xue xue bao = Journal of Southern Medical University
  • [ISO-abbreviation] Nan Fang Yi Ke Da Xue Xue Bao
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal
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8. Corben AD, Nehhozina T, Garg K, Vallejo CE, Brogi E: Endosalpingiosis in axillary lymph nodes: a possible pitfall in the staging of patients with breast carcinoma. Am J Surg Pathol; 2010 Aug;34(8):1211-6
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  • [Title] Endosalpingiosis in axillary lymph nodes: a possible pitfall in the staging of patients with breast carcinoma.
  • The occurrence of benign epithelial inclusions in lymph nodes is well documented and can sometimes mimic metastatic carcinoma.
  • Benign müllerian inclusions, such as endometriosis and endosalpingiosis, are common in pelvic and para-aortic lymph nodes, but their presence in supradiaphragmatic lymph nodes is a rare event.
  • We report our experience with 3 patients found to have endosalpingiosis in axillary sentinel lymph nodes obtained for staging of breast carcinoma.
  • Endosalpingiosis involved a single lymph node in 1 patient, and 2 nodes in each of the other 2; it was present in the lymph node capsule in all the 3 cases, with few glands scattered within the lymph node parenchyma in 2 of the patients.
  • Endosalpingiosis had been misinterpreted as metastatic carcinoma at another hospital in 1 of the 3 patients, with subsequent dissection of 19 additional benign axillary lymph nodes.
  • We conclude that endosalpingiosis can involve axillary lymph nodes and closely simulate metastatic mammary carcinoma.
  • Morphologic identification of ciliated cells and "peg" cells is most helpful to recognize this benign inclusion, and positive immunoreactivity for WT1 and/or PAX8 can be used to support the diagnosis.
  • [MeSH-major] Breast Neoplasms / pathology. Carcinoma / pathology. Diagnostic Errors / prevention & control. Epithelial Cells / pathology. Lymph Nodes / pathology
  • [MeSH-minor] Aged. Aged, 80 and over. Biomarkers, Tumor / analysis. Cilia. Female. Humans. Immunohistochemistry. Lymphatic Metastasis. Neoplasm Staging. Paired Box Transcription Factors / analysis. Predictive Value of Tests. Sentinel Lymph Node Biopsy. Unnecessary Procedures. WT1 Proteins / analysis

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  • (PMID = 20631604.001).
  • [ISSN] 1532-0979
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / PAX8 protein, human; 0 / Paired Box Transcription Factors; 0 / WT1 Proteins
  • [Number-of-references] 32
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9. Koelliker SL, Chung MA, Mainiero MB, Steinhoff MM, Cady B: Axillary lymph nodes: US-guided fine-needle aspiration for initial staging of breast cancer--correlation with primary tumor size. Radiology; 2008 Jan;246(1):81-9
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  • [Title] Axillary lymph nodes: US-guided fine-needle aspiration for initial staging of breast cancer--correlation with primary tumor size.
  • PURPOSE: To retrospectively assess the sensitivity and specificity of ultrasonographic (US)-guided fine-needle aspiration (FNA) of axillary lymph nodes for preoperative staging of breast cancer across a range of primary tumor sizes, by using histologic findings as a reference standard.
  • Lymph nodes were classified as benign, indeterminate, or suspicious on the basis of US characteristics at retrospective review.
  • US-guided FNA in the most suspicious node at US, or the largest node if all appeared benign, was performed.
  • Final pathologic results (sentinel lymph node biopsy [SNB] or axillary lymph node dissection [ALND]) were compared with US and preoperative US-guided FNA results.
  • CONCLUSION: US-guided FNA of axillary lymph nodes in patients with newly diagnosed breast cancer had a sensitivity that increased with increasing size of the primary tumor.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Axilla. Female. Humans. Lymphatic Metastasis / pathology. Lymphatic Metastasis / ultrasonography. Middle Aged. Neoplasm Staging. Retrospective Studies. Sensitivity and Specificity

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  • [Copyright] RSNA, 2007
  • (PMID = 17991784.001).
  • [ISSN] 1527-1315
  • [Journal-full-title] Radiology
  • [ISO-abbreviation] Radiology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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10. 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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  • [Title] Significance of intramammary lymph nodes in the staging of breast cancer: correlation with tumor characteristics and outcome.
  • Intramammary lymph nodes (intraMLNs) have received little attention as potential prognostic indicators for patients with breast carcinoma.
  • In all, 59 patients (50.8%) were found in association with benign breast conditions and the remaining 57 (49.2%) with primary breast carcinoma.
  • Primary tumor characteristics and axillary lymph node (AxLN) status were recorded.
  • Most patients (80%) who had intraMLN metastases also had axillary metastases; however, an isolated intraMLN metastasis was documented in one patient (7%).
  • [MeSH-major] Breast Neoplasms / pathology. Lymph Nodes. Mammary Glands, Human / pathology
  • [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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11. 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.
  • The lymph node status of a breast cancer is one of the main prognostic criterias.
  • 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.
  • In the evaluation of lymph nodes, the sonographic criteria were centric echogenity, thickening of cortex, length/width ratio (L/W) and the diameter of lymph nodes.
  • Hyperechogenic hilus was accepted as a benign finding.
  • The thickening of the cortex less than 50% of the thickening of the centric echogenic hilus was also accepted as a benign finding.
  • 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

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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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12. Mainiero MB, Cinelli CM, Koelliker SL, Graves TA, Chung MA: Axillary ultrasound and fine-needle aspiration in the preoperative evaluation of the breast cancer patient: an algorithm based on tumor size and lymph node appearance. AJR Am J Roentgenol; 2010 Nov;195(5):1261-7
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  • [Title] Axillary ultrasound and fine-needle aspiration in the preoperative evaluation of the breast cancer patient: an algorithm based on tumor size and lymph node appearance.
  • OBJECTIVE: The objective of our study was to evaluate the utility of ultrasound-guided fine-needle aspiration (FNA) of the axillary lymph nodes in breast cancer patients depending on the size of the primary tumor and the appearance of the lymph nodes.
  • SUBJECTS AND METHODS: Data were collected about tumor size, lymph node appearance, and the results of ultrasound-guided FNA and axillary surgery of 224 patients with breast cancer undergoing 226 ultrasound-guided FNA.
  • Lymph nodes were classified as benign if the cortex was even and measured < 3 mm, indeterminate if the cortex was even but measured ≥ 3 mm or measured < 3 mm but was focally thickened, and suspicious if the cortex was focally thickened and measured ≥ 3 mm or the fatty hilum was absent.
  • The results of ultrasound-guided FNAs were analyzed by the sonographic appearance of the axillary lymph nodes and by the size of the primary tumor.
  • The sensitivity and specificity of ultrasound-guided FNA were calculated with axillary surgery as the reference standard.
  • The sensitivity and specificity of axillary ultrasound to predict the ultrasound-guided FNA result were calculated.
  • The sensitivity of ultrasound-guided FNA in patients with normal-appearing lymph nodes was 11%; indeterminate lymph nodes, 44%; and suspicious lymph nodes, 93%.
  • Sonographic characterization of lymph nodes as suspicious or indeterminate was 94% sensitive and 72% specific in predicting positive findings at ultrasound-guided FNA.
  • CONCLUSION: Ultrasound-guided FNA of the axillary lymph nodes is most useful in the preoperative assessment of patients with large tumors (> 2 cm) or lymph nodes that appear abnormal.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Breast Neoplasms, Male / pathology. Breast Neoplasms, Male / surgery. Breast Neoplasms, Male / ultrasonography. Female. Humans. Male. Middle Aged. Neoplasm Staging. Preoperative Care. Prospective Studies. Sensitivity and Specificity. Sentinel Lymph Node Biopsy

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  • [CommentIn] AJR Am J Roentgenol. 2011 Jul;197(1):W194; author reply W195 [21700988.001]
  • (PMID = 20966338.001).
  • [ISSN] 1546-3141
  • [Journal-full-title] AJR. American journal of roentgenology
  • [ISO-abbreviation] AJR Am J Roentgenol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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13. Zhao TT, Li JG, Li YM: [Performance of 18F-FDG PET/CT in the detection of primary breast cancer and staging of the regional lymph nodes]. Zhonghua Zhong Liu Za Zhi; 2007 Mar;29(3):206-9
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  • [Title] [Performance of 18F-FDG PET/CT in the detection of primary breast cancer and staging of the regional lymph nodes].
  • OBJECTIVE: To evaluate the performance of 18F-FDG PET/CT in the detection of primary breast cancer, and the staging of regional lymph nodes.
  • 32 breast lesions were evaluated by histology, revealing 25 breast carcinomas and 7 benign pathological changes.
  • 23 patients had histological diagnosis of the breast tumor and regional lymph nodes.
  • 10 patients were proved to have lymph node metastasis, and PET/CT got a sensitivity of 60.0%.
  • But the accuracy of FDG PET/CT seems to be not high enough to identify patients who might avoid axillary lymph nodes dissection.
  • [MeSH-major] Breast Neoplasms / diagnosis. Carcinoma, Ductal, Breast / diagnosis. Lymph Nodes / pathology. Positron-Emission Tomography / methods. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Adult. Aged. Female. Fibroadenoma / diagnosis. Fibroadenoma / pathology. Fluorodeoxyglucose F18. Humans. Lymphatic Metastasis. Middle Aged. Neoplasm Staging. Reproducibility of Results. Sensitivity and Specificity

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  • (PMID = 17649638.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0Z5B2CJX4D / Fluorodeoxyglucose F18
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14. Britton PD, Goud A, Godward S, Barter S, Freeman A, Gaskarth M, Rajan P, Sinnatamby R, Slattery J, Provenzano E, O'Donovan M, Pinder S, Benson JR, Forouhi P, Wishart GC: Use of ultrasound-guided axillary node core biopsy in staging of early breast cancer. Eur Radiol; 2009 Mar;19(3):561-9
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  • [Title] Use of ultrasound-guided axillary node core biopsy in staging of early breast cancer.
  • The aim of this study was to see how effective ultrasound-guided needle biopsy was at detecting lymph node involvement in patients with early breast cancer.
  • Patients with newly diagnosed invasive breast cancer underwent axillary ultrasound (US) where lymph node size and morphology were noted.
  • Patients with benign CBs proceeded to sentinel lymph node (SLN) biopsy, whereas those with malignancy underwent axillary lymph node dissection (ALND).
  • One hundred and thirty-nine patients were examined, of whom 52.5% had lymph node metastases on final histology.
  • One hundred and twenty-one patients (87%) underwent axillary node CB.
  • The overall sensitivity of CB for detecting lymph node metastases was 53.4% (60.3% for macrometastases; 26.7% for micrometastases).
  • However, one third of patients with normal lymph node morphology had nodal metastases, and only 12% of these were diagnosed on CB.
  • CB of axillary lymph nodes can diagnose a substantial number of patients with lymph node metastases, allowing these patients to proceed directly to ALND, avoiding unnecessary SLN biopsy.
  • [MeSH-major] Breast Neoplasms / diagnosis. Breast Neoplasms / diagnostic imaging. Lymph Nodes / diagnostic imaging. Lymph Nodes / pathology. Neoplasm Staging / methods. Sentinel Lymph Node Biopsy / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Axilla / pathology. Early Detection of Cancer. Female. Humans. Lymphatic Metastasis. Middle Aged. Neoplasm Metastasis. Sensitivity and Specificity. Ultrasonography

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  • (PMID = 18797874.001).
  • [ISSN] 1432-1084
  • [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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15. Kim MJ, Park BW, Lim JB, Kim HS, Kwak JY, Kim SJ, Park SH, Sohn YM, Moon HJ, Kim EK: Axillary lymph node metastasis: CA-15-3 and carcinoembryonic antigen concentrations in fine-needle aspirates for preoperative diagnosis in patients with breast cancer. Radiology; 2010 Mar;254(3):691-7
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  • [Title] Axillary lymph node metastasis: CA-15-3 and carcinoembryonic antigen concentrations in fine-needle aspirates for preoperative diagnosis in patients with breast cancer.
  • PURPOSE: To assess whether concentrations of the tumor markers breast cancer antigen 15-3 (CA-15-3) and carcinoembryonic antigen (CEA) in fine-needle aspirates (FNAs) differ between benign and malignant lymph nodes and whether FNA concentrations of the tumor markers can improve the sensitivity of axillary lymph node (ALN) FNA in patients with breast cancer.
  • Of the 134 ALNs, 86 were malignant and 48 were benign.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / analysis. Biopsy, Fine-Needle. Female. Humans. Middle Aged. Neoplasm Staging. Predictive Value of Tests. Sensitivity and Specificity. Ultrasonography, Interventional. Ultrasonography, Mammary

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  • (PMID = 20123899.001).
  • [ISSN] 1527-1315
  • [Journal-full-title] Radiology
  • [ISO-abbreviation] Radiology
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Carcinoembryonic Antigen; 0 / Mucin-1
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16. Snider HC Jr, Rubin E, Henson R: Axillary ultrasonography to detect recurrence after sentinel node biopsy in breast cancer. Ann Surg Oncol; 2006 Apr;13(4):501-7
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  • [Title] Axillary ultrasonography to detect recurrence after sentinel node biopsy in breast cancer.
  • Initial reports of follow-up show lower axillary recurrence rates than expected.
  • We performed axillary ultrasonography to determine whether occult recurrences could be detected.
  • METHODS: In a community hospital setting, 289 patients who had SNB for breast cancer in a single surgeon's practice underwent axillary examination by the surgeon followed by axillary ultrasonography by a dedicated breast radiologist.
  • Five patients with suspicious nodes had ultrasound-guided fine-needle aspiration, and one had a core biopsy.
  • RESULTS: No patient had suspicious nodes on clinical examination.
  • Five patients had benign cytological characteristics, and one had a benign core biopsy result.
  • No evidence of axillary recurrence was found in any patient.
  • CONCLUSIONS: Axillary ultrasonography did not detect occult metastases in any patient and is not recommended for routine follow-up after SNB.
  • [MeSH-major] Axilla / pathology. Breast Neoplasms / pathology. Neoplasm Recurrence, Local / ultrasonography. Sentinel Lymph Node Biopsy

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  • (PMID = 16511672.001).
  • [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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17. Nakaguro M, Suzuki Y, Ichihara S, Kobayashi TK, Ono K: Epithelial inclusion cyst arising in an intramammary lymph node: case report with cytologic findings. Diagn Cytopathol; 2009 Mar;37(3):199-202
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  • [Title] Epithelial inclusion cyst arising in an intramammary lymph node: case report with cytologic findings.
  • The occurrence of epithelial inclusion cysts (EIC) in axillary lymph nodes is a rare but well recognized entity, arising either from direct implantation or from embryonal rests.
  • Theoretically, EIC can occur in intramammary lymph nodes, but there has been only one prior report of such a lesion.
  • Here, we describe a case of an EIC arising in an intramammary lymph node of a 37-year-old woman.
  • On FNA, the EIC arising in an intramammary lymph node was characterized by mature lymphocytes, squamous epithelial cells, and keratinizing material.
  • Contrary to these more sinister diagnoses, EIC arising in an intramammary lymph node is a benign condition.
  • As this rare lesion sometimes mimics a neoplasm both clinically and radiographically, awareness of this entity is important to prevent over treatment.
  • [MeSH-major] Breast Cyst / pathology. Breast Neoplasms / pathology. Lymph Nodes / pathology

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  • (PMID = 19177497.001).
  • [ISSN] 1097-0339
  • [Journal-full-title] Diagnostic cytopathology
  • [ISO-abbreviation] Diagn. Cytopathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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18. Fajdić J, Gotovac N, Hrgović Z, Kristek J, Horvat V, Kaufmann M: Phyllodes tumors of the breast diagnostic and therapeutic dilemmas. Onkologie; 2007 Mar;30(3):113-8
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  • Axillary lymphadenectomy was performed in patients with positive lymph nodes.
  • RESULTS: Histology showed the phyllodes tumors to be benign in 27 (75.0%), malignant in 6 (16.6%), and borderline in 3 (8.3%) cases.
  • In this period, recurrences of 3 (8.3%) malignant and 2 (5.6%) benign phyllodes tumors were diagnosed and treated.
  • Axillary lymphadenectomy in malignant phyllodes tumors is, in our opinion, still controversial.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Breast / pathology. Diagnosis, Differential. Female. Humans. Lymph Node Excision. Lymph Nodes / pathology. Lymphatic Metastasis / pathology. Mammography. Mastectomy. Mastectomy, Segmental. Middle Aged. Mitotic Index. Necrosis. Neoplasm Invasiveness / pathology. Neoplasm Recurrence, Local / diagnosis. Neoplasm Recurrence, Local / mortality. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / surgery. Prognosis. Reoperation. Survival Rate

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  • (PMID = 17341897.001).
  • [ISSN] 0378-584X
  • [Journal-full-title] Onkologie
  • [ISO-abbreviation] Onkologie
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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19. Kunz U, Friedrich T: [Malignant fibrous histiocytoma. Clinical meaning of a rare entity]. Praxis (Bern 1994); 2007 Apr 25;96(17):681-6
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  • MFH should be included in the differential diagnosis in cases of large tumour diameters, rapidly progressive tumour growth and absence of axillary lymph nodes or distant metastasis.
  • [MeSH-major] Breast Neoplasms. Histiocytoma, Benign Fibrous
  • [MeSH-minor] Aged. Aged, 80 and over. Breast / pathology. Diagnosis, Differential. Female. Follow-Up Studies. Humans. Lymph Node Excision. Neoplasm Recurrence, Local / surgery. Time Factors. Treatment Outcome. Wound Healing

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  • (PMID = 17491198.001).
  • [ISSN] 1661-8157
  • [Journal-full-title] Praxis
  • [ISO-abbreviation] Praxis (Bern 1994)
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Switzerland
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20. Acs G, Dumoff KL, Solin LJ, Pasha T, Xu X, Zhang PJ: Extensive retraction artifact correlates with lymphatic invasion and nodal metastasis and predicts poor outcome in early stage breast carcinoma. Am J Surg Pathol; 2007 Jan;31(1):129-40
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  • We noticed that retraction artifact seemed to be more common around groups of breast cancer cells compared with benign acini, and when extensively present, metastasis to axillary lymph nodes was often seen.
  • [MeSH-major] Artifacts. Breast Neoplasms / pathology. Carcinoma, Ductal, Breast / secondary. Histocytological Preparation Techniques. Lymph Nodes / pathology
  • [MeSH-minor] Biomarkers, Tumor / metabolism. Early Diagnosis. Female. Humans. Lymphatic Metastasis. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Prognosis. ROC Curve. Receptors, Estrogen / metabolism. Receptors, Progesterone / metabolism. Survival Rate

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  • (PMID = 17197929.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Receptors, Estrogen; 0 / Receptors, Progesterone
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21. Lanng C, Hoffmann J, Galatius H, Engel U: Assessment of clinical palpation of the axilla as a criterion for performing the sentinel node procedure in breast cancer. Eur J Surg Oncol; 2007 Apr;33(3):281-4
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  • AIMS: Clinically palpable lymph nodes (LNs) are regarded as a contraindication for performing the sentinel node (SN) procedure.
  • Many studies have shown, however, that clinical assessment of axillary LNs is inaccurate.
  • This study evaluated the reliability of clinical axillary LN assessment by experts and assessed whether inaccuracy can be related to LN size.
  • METHODS: Three hundred and one consecutive breast cancer patients undergoing either axillary dissection or SN were studied prospectively.
  • RESULTS: The risk of having metastasis to the LN was 40.4% if the preoperative clinical assessment was "non-palpable LN", 61.5% if the assessment was "palpable but benign LN" and 84.4% if it was "suspicious LN".
  • CONCLUSIONS: The clinical assessment of axillary LNs as a criterion for offering the SN procedure is of little value.
  • [MeSH-major] Breast Neoplasms / pathology. Palpation. Sentinel Lymph Node Biopsy
  • [MeSH-minor] Adult. Axilla / surgery. Chi-Square Distribution. Female. Humans. Lymphatic Metastasis. Neoplasm Invasiveness. Neoplasm Staging. Predictive Value of Tests. Prospective Studies

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  • (PMID = 17084579.001).
  • [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
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22. Bembenek A, Fischer J, Albrecht H, Kemnitz E, Gretschel S, Schneider U, Dresel S, Schlag PM: Impact of patient- and disease-specific factors on SLNB in breast cancer patients. Are current guidelines justified? World J Surg; 2007 Feb;31(2):267-75
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  • BACKGROUND: The evidence on which to base guidelines for sentinel lymph node biopsy (SLNB) in breast cancer is still limited.
  • Calculation of the false-negative rate was based on patients who underwent a backup axillary dissection.
  • RESULTS: Among 455 consecutively enrolled patients, a significant inverse association to the detection rate was found for extracapsular extension of non-SLN metastases, body mass index (BMI), number of involved lymph nodes, pT category, tumor size, and age.
  • CONCLUSION: Our results indicate that SLNB can be safely used in elderly and obese patients with multicentric tumors and those having undergone prior surgery for benign breast disease.
  • [MeSH-major] Breast Neoplasms / pathology. Sentinel Lymph Node Biopsy
  • [MeSH-minor] Adult. Age Factors. Aged. Aged, 80 and over. Body Mass Index. Female. Humans. Middle Aged. Neoplasm Invasiveness. Practice Guidelines as Topic. Predictive Value of Tests. Prospective Studies. Reproducibility of Results

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  • (PMID = 17180478.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
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23. Kinkor Z, Skálová A, Michal M, Janousek M, Kheck M: [Metastasing and relapsing "low grade" adenosquamous metaplastic breast cancer--is there a really indolent lesion? A description of three cases and review of literature]. Ceska Gynekol; 2005 May;70(3):211-6
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  • There were recognized metastases by one woman in two ipsilateral axillary lymph nodes mimicking benign breast heterotopia in one of them.
  • In two women with aggressive course the original biopsy was falsely interpreted, once as phyllodes tumor and secondly as benign sclerosing pseudotumor.
  • Low-grade adenosquamous carcinoma, however, has nothing to do with syringomatous adenoma of the nipple, which is a benign tumor of the skin adnexa.
  • The rarity of this neoplasm does not exclude deep knowledge.

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  • (PMID = 16047925.001).
  • [ISSN] 1210-7832
  • [Journal-full-title] Ceska gynekologie
  • [ISO-abbreviation] Ceska Gynekol
  • [Language] CZE
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Czech Republic
  • [Number-of-references] 12
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24. Volmar KE, Cummings TJ, Wang WH, Creager AJ, Tyler DS, Xie HB: Clear cell hidradenoma: a mimic of metastatic clear cell tumors. Arch Pathol Lab Med; 2005 May;129(5):e113-6
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  • Clear cell hidradenoma is a benign skin appendage tumor that may mimic conventional-type renal cell carcinoma.
  • We report the rare case of a patient with renal cell carcinoma who underwent excision of an axillary clear cell hidradenoma, which was clinically suggestive of cutaneous metastatic disease.
  • [MeSH-minor] Axilla. Biomarkers, Tumor / analysis. Diagnosis, Differential. Humans. Immunohistochemistry. Lymph Nodes / pathology. Lymph Nodes / surgery. Male. Middle Aged. Mitotic Index. Neoplasm Metastasis / diagnosis. Treatment Outcome

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  • (PMID = 15859654.001).
  • [ISSN] 1543-2165
  • [Journal-full-title] Archives of pathology & laboratory medicine
  • [ISO-abbreviation] Arch. Pathol. Lab. Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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25. Shin JH, Han BK, Choe YH, Nam SJ, Park W, Im YH: Ultrasonographic detection of occult cancer in patients after surgical therapy for breast cancer. J Ultrasound Med; 2005 May;24(5):643-9
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  • The questionable lesions were lymph nodes in 42 and masses in 15; of these lesions, 24 were malignant (true-positive) and 33 were benign (false-positive).
  • The locations of the recurrent lesions were the regional lymph nodes in 14 cases (4, axillary fossa; 4, interpectoral; 4, internal mammary; and 2, supraclavicular lymph nodes) and the breast and mastectomy bed in 7 cases.
  • The mean size of the malignant lymph nodes was larger than that of the benign lymph nodes.
  • [MeSH-major] Breast Neoplasms / surgery. Carcinoma, Intraductal, Noninfiltrating / ultrasonography. Mastectomy. Neoplasm Recurrence, Local / ultrasonography. Ultrasonography, Mammary
  • [MeSH-minor] Adult. Aged. Biopsy, Needle. Combined Modality Therapy. Diagnostic Errors. Female. Follow-Up Studies. Humans. Middle Aged. Neoplasm Staging. Retrospective Studies. Sensitivity and Specificity

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  • (PMID = 15840796.001).
  • [ISSN] 0278-4297
  • [Journal-full-title] Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
  • [ISO-abbreviation] J Ultrasound Med
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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26. Sakurai K, Enomoto K, Amano S: [Long-term results of surgical therapy for phyllodes tumor of the breast]. Gan To Kagaku Ryoho; 2010 Nov;37(12):2784-5
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  • Twenty-one cases were performed local excision with at least 1 cm surgical margin, and seven cases were performed muscle preserving mastectomy without axillary lymph nodes dissection.
  • The patients with local recurrence were diagnosed the benign phyllodes tumor of the breast at the first operation.
  • If the pathological diagnosis was benign phyllodes tumor and surgical margin was negative at the first operation, it is necessary to follow up the patients, because there is a risk of local and distant metastasis.
  • [MeSH-minor] Adult. Aged. Female. Follow-Up Studies. Humans. Mastectomy / methods. Middle Aged. Neoplasm Recurrence, Local. Treatment Outcome

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  • (PMID = 21224712.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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27. Kumasaka T, Seyama K, Mitani K, Souma S, Kashiwagi S, Hebisawa A, Sato T, Kubo H, Gomi K, Shibuya K, Fukuchi Y, Suda K: Lymphangiogenesis-mediated shedding of LAM cell clusters as a mechanism for dissemination in lymphangioleiomyomatosis. Am J Surg Pathol; 2005 Oct;29(10):1356-66
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Recent studies indicate that LAM cells can migrate or metastasize to form new lesions in multiple organs, although they show a morphologically benign appearance.
  • In this study, we further focused on the lymphatic abnormalities in LAM: LAM-associated chylous fluid (5 pleural effusion and 2 ascites), surgically resected diaphragm (1 patient), and axial lymphatic system including the thoracic duct, lymph nodes at various regions, and diaphragmatic lymphatic system (5 autopsy cases).
  • We identified LAM lesion in the diaphragm (2 of 5 autopy cases and one surgical specimen), thoracic duct (5 of 5), and lymph nodes (retroperitoneal (5 of 5), mediastinal (4 of 5), left venous angle (5 of 5) with total positive rate of 68% to 88% at each region of the lymph node, but less frequent or none at remote lymph nodes located away from the axial lymph trunk (cervical [1 of 5] and axillary [0 of 5]).
  • [MeSH-major] Endothelial Cells / pathology. Lymphangiogenesis. Lymphangioleiomyomatosis / pathology. Neoplasm Metastasis / pathology. Neoplastic Cells, Circulating / pathology

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  • (PMID = 16160479.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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28. Atalay C, Atalay G, Yilmaz KB, Altinok M: The role of anti-CENP-B and anti-SS-B antibodies in breast cancer. Neoplasma; 2005;52(1):32-5
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  • In this study, anti-SS-B and anti-CENP-B autoantibodies were studied in breast cancer patients and compared to a control group surgically treated due to benign diseases.
  • Fifty-five patients with breast cancer and 25 patients with benign diseases were prospectively included in the study.
  • Besides, anti-SS-B positivity was detected more frequently in breast cancer patients with axillary involvement (63% vs. 24%) (p=0.006) and increased as the number of involved lymph nodes increased in the axilla (p=0.03).
  • [MeSH-major] Antibodies, Antinuclear / immunology. Antibodies, Neoplasm / blood. Autoantigens / immunology. Breast Diseases / immunology. Breast Neoplasms / immunology. Chromosomal Proteins, Non-Histone / immunology. DNA-Binding Proteins / immunology

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  • (PMID = 15739023.001).
  • [ISSN] 0028-2685
  • [Journal-full-title] Neoplasma
  • [ISO-abbreviation] Neoplasma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Slovakia
  • [Chemical-registry-number] 0 / Antibodies, Antinuclear; 0 / Antibodies, Neoplasm; 0 / Autoantigens; 0 / CENPB protein, human; 0 / Centromere Protein B; 0 / Chromosomal Proteins, Non-Histone; 0 / DNA-Binding Proteins; 0 / SS-B antibodies
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29. Dhillon R, Depree P, Metcalf C, Wylie E: Screen-detected mucinous breast carcinoma: potential for delayed diagnosis. Clin Radiol; 2006 May;61(5):423-30
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • A significant number of lesions (13/34) were evident on the previous screening examination where they were misinterpreted as benign lesions.
  • However, none of these cases had positive axillary lymph nodes at final diagnosis.
  • CONCLUSION: Although mammographically benign appearances of mucinous carcinoma caused a delay in diagnosis in 38% of the present cases, mucinous breast carcinomas have a favourable prognosis, as they are often low-grade tumours and rarely metastasize.
  • [MeSH-minor] Age Distribution. Aged. Aged, 80 and over. Carcinoma, Ductal, Breast / pathology. Carcinoma, Ductal, Breast / radiography. Carcinoma, Ductal, Breast / ultrasonography. Databases, Factual. Female. Humans. Mammography / methods. Middle Aged. Neoplasm Invasiveness. Ultrasonography, Mammary / methods

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  • (PMID = 16679116.001).
  • [ISSN] 0009-9260
  • [Journal-full-title] Clinical radiology
  • [ISO-abbreviation] Clin Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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30. Dapri G, Himpens J, Ntounda R, Alard S, Dereeper E, Cadière GB: Enucleation of a leiomyoma of the mid-esophagus through a right thoracoscopy with the patient in prone position. Surg Endosc; 2010 Jan;24(1):215-8
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  • BACKGROUND: Leiomyoma is the most common benign esophageal neoplasm.
  • Preoperative work-up showed the presence of 50 x 28-mm leiomyoma of the middle esophagus, without satellite lymph nodes.
  • A 30 degrees scope was introduced in the right 7th intercostal space on the posterior axillary line.
  • Benign pathology was confirmed.

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  • (PMID = 19517189.001).
  • [ISSN] 1432-2218
  • [Journal-full-title] Surgical endoscopy
  • [ISO-abbreviation] Surg Endosc
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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