Journal ArticleDOI
Wire guided localisation for targeted axillary node dissection is accurate in axillary staging in node positive breast cancer following neoadjuvant chemotherapy.
Rajesh Balasubramanian,Catrin Morgan,Elina Shaari,Elina Shaari,Tibor Kovacs,Sarah E Pinder,Hisham Hamed,Ali R Sever,Ashutosh Kothari +8 more
TLDR
Targeted axillary dissection is a feasible technique following excellent response to NACT in selected patients with limited volume ALN metastasis, at diagnosis.Abstract:
Aim This study investigated whether wire localisation of the histologically proven positive, clipped axillary lymph node (ALN) with subsequent targeted axillary dissection (TAD) following neoadjuvant chemotherapy (NACT) improves axillary staging in breast cancer. Materials and methods We performed a retrospective review of patients with primary breast cancer and core biopsy proven metastatic ALNs, that had an excellent nodal radiological response following NACT, treated at our centre between January 2016 and December 2018. The initial cohort of patients (Group 1) underwent sentinel lymph node biopsy (SLNB), with a minimum of three nodes were sampled. The subsequent cohort (Group 2) had a marker clip inserted in the metastatic ALN prior to NACT. This cohort underwent wire guided excision of the clipped node in addition to SLNB, with a minimum of three nodes sampled. Results A total of 47 patients were identified. Group 1 comprised 22 patients with a sentinel lymph node (SLN) identification rate (IR) of 95%. 25 patients (Group 2) underwent wire guided clip location and the SLN IR was 100% with a 92% clipped node IR. Evidence of pathological complete response (pCR) in the clipped node was associated with pCR in other nodes. Conclusion Targeted axillary dissection is a feasible technique following excellent response to NACT in selected patients with limited volume ALN metastasis, at diagnosis. The identification of the positive ALN during surgery is vital and the IR can be improved by clipping the node prior to NACT and wire guided localisation at the time of surgery.read more
Citations
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Use of Hologic LOCalizer radiofrequency identification (RFID) tags to localise impalpable breast lesions and axillary nodes: experience of the first 150 cases in a UK breast unit.
TL;DR: The RFID tag system demonstrates many advantages over guidewires, and is effective at targeting axillary lymph nodes and multiple sites within the same breast, including the first reported use of RFID tags in the axilla.
Journal ArticleDOI
Metal Nanoparticles for Photodynamic Therapy: A Potential Treatment for Breast Cancer
TL;DR: In this article, the authors summarized the current development and application status of photodynamic therapy for breast cancer, especially the latest developments in the application of metal nanocarriers in breast cancer PDT, and highlight some of the recent synergistic therapies, hopefully providing an accessible overview of the current knowledge that may act as a basis for new ideas or systematic evaluations.
Journal ArticleDOI
The applicability of Magseed® for targeted axillary dissection in breast cancer patients treated with neoadjuvant chemotherapy.
TL;DR: In this paper, a non-radioactive magnetic marker was used to mark the biopsied positive TLNs after NAC, and the TLNs were identified with the Sentimag® probe and excised in all patients.
Journal ArticleDOI
AGO Recommendations for the Surgical Therapy of the Axilla After Neoadjuvant Chemotherapy: 2021 Update
Michael W. Friedrich,Thorsten Kühn,Wolfgang Janni,Volkmar Müller,Maggie Banys-Pachulowski,Cornelia Kolberg-Liedtke,Christian Jackisch,David Krug,Ute-Susann Albert,Ingo Bauerfeind,Jens Uwe Blohmer,Wilfried Budach,Peter Dall,Eva Maria Fallenberg,Peter A. Fasching,Tanja Fehm,Bernd Gerber,Oleg Gluz,Volker Hanf,Nadia Harbeck,Jörg Heil,Jens Huober,H.H. Kreipe,Sherko Kümmel,Sibylle Loibl,Diana Lüftner,Michael P. Lux,Nicolai Maass,Volker Möbus,Christoph Mundhenke,Ulrike Nitz,Tjoung-Won Park-Simon,Toralf Reimer,Kerstin Rhiem,Achim Rody,Marcus Schmidt,Andreas Schneeweiss,Florian Schütz,Hans-Peter Sinn,Christine Solbach,Erich-Franz Solomayer,Elmar Stickeler,Christoph Thomssen,Michael Untch,Isabell Witzel,Achim Wöckel,Marc Thill,Nina Ditsch +47 more
TL;DR: In this paper, the axilla dissection is performed after neoadjuvant chemotherapy and the significance of isolated tumour cells and micro-metastasis after axillary dissection was discussed.
Journal ArticleDOI
Surgical Management of the Axilla in Clinically Node-Positive Breast Cancer Patients Converting to Clinical Node Negativity through Neoadjuvant Chemotherapy: Current Status, Knowledge Gaps, and Rationale for the EUBREAST-03 AXSANA Study
Maggie Banys-Paluchowski,Maria Luisa Gasparri,Jana de Boniface,Oreste Gentilini,Elmar Stickeler,Steffi Hartmann,Marc Thill,Isabel T. Rubio,Rosa Di Micco,Eduard-Alexandru Bonci,Laura Niinikoski,Michalis Kontos,Guldeniz Karadeniz Cakmak,Michael Hauptmann,Florentia Peintinger,David Pinto,Zoltan Matrai,Dawid Murawa,Geeta Kadayaprath,L Dostalek,Helidon Nina,Petr Krivorotko,Jean-Marc Classe,Ellen Schlichting,Matilda Appelgren,Peter Paluchowski,Christine Solbach,Jens-Uwe Blohmer,Thorsten Kühn +28 more
TL;DR: A literature review on axillary staging strategies and their place in international recommendations is presented in this article, where the authors define knowledge gaps associated with specific procedures, summarizes currently ongoing clinical trials that address these unsolved issues and provide the rationale for further research.
References
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Journal ArticleDOI
Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: A randomized clinical trial
Armando E. Giuliano,Kelly K. Hunt,Karla V. Ballman,Peter D. Beitsch,Pat Whitworth,Peter W. Blumencranz,A. Marilyn Leitch,Sukamal Saha,Linda M. McCall,Monica Morrow +9 more
TL;DR: Among patients with limited SLN metastatic breast cancer treated with breast conservation and systemic therapy, the use of SLND alone compared with ALND did not result in inferior survival, and overall survival was the primary end point, with a noninferiority margin of a 1-sided hazard ratio of less than 1.3 indicating thatSLND alone is noninherited.
Journal ArticleDOI
Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes.
Umberto Veronesi,Giovanni Paganelli,Viviana Galimberti,Giuseppe Viale,Stefano Zurrida,Marilia Bedoni,Alberto Costa,Concetta De Cicco,James Geraghty,Alberto Luini,Virgilio Sacchini,Paolo Veronesi +11 more
TL;DR: Patients without clinical involvement of the axilla should undergo sentinel-node biopsy routinely, and may be spared complete axillary dissection when the sentinel node is disease-free, and thereby provide important information about the status of axillary nodes.
Journal ArticleDOI
Randomized Multicenter Trial of Sentinel Node Biopsy Versus Standard Axillary Treatment in Operable Breast Cancer: The ALMANAC Trial
Robert E. Mansel,Lesley Fallowfield,Mark Kissin,Amit Goyal,Robert G. Newcombe,J Michael Dixon,Constantinos Yiangou,Kieran Horgan,Nigel J Bundred,I. Monypenny,David England,Mark Sibbering,Tholkifl I. Abdullah,Lester Barr,Utheshtra Chetty,Dudley H. Sinnett,Anne Fleissig,Dayalan Clarke,Peter J. Ell +18 more
TL;DR: Sentinel lymph node biopsy is associated with reduced arm morbidity and better quality of life than standard axillary treatment and should be the treatment of choice for patients who have early-stage breast cancer with clinically negative nodes.
Journal ArticleDOI
Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial
David N. Krag,Stewart J. Anderson,Thomas B. Julian,Ann M. Brown,Seth P. Harlow,Joseph P. Costantino,Takamaru Ashikaga,Donald L. Weaver,Eleftherios P. Mamounas,Lynne M. Jalovec,Thomas G. Frazier,R. Dirk Noyes,André Robidoux,Hugh M.C. Scarth,Norman Wolmark +14 more
TL;DR: Overall survival, disease-free survival, and regional control were statistically equivalent between groups, and outcome analyses were done in patients who were assessed as having pathologically negative sentinel nodes and for whom follow-up data were available.
Journal ArticleDOI
Sentinel Lymph Node Surgery After Neoadjuvant Chemotherapy in Patients With Node-Positive Breast Cancer: The ACOSOG Z1071 (Alliance) Clinical Trial
Judy C. Boughey,Vera J. Suman,Elizabeth A. Mittendorf,Gretchen M. Ahrendt,Lee G. Wilke,Bret Taback,A. Marilyn Leitch,Henry Mark Kuerer,Monet Bowling,Teresa S. Flippo-Morton,David R. Byrd,David W. Ollila,Thomas B. Julian,Sarah A. McLaughlin,Linda M. McCall,W. Fraser Symmans,Huong T. Le-Petross,Bruce G. Haffty,Thomas A. Buchholz,Heidi Nelson,Kelly K. Hunt +20 more
TL;DR: The application of SLN surgery for staging the axilla following chemotherapy for women who initially had node-positive cN1 breast cancer is unclear because of high false-negative results reported in previous studies as mentioned in this paper.
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