scholarly journals Residual lymph node tumour burden following removal of a single axillary sentinel lymph with macrometastatic disease in women with screen-detected invasive breast cancer

BJS Open ◽  
2020 ◽  
Vol 5 (2) ◽  
Author(s):  
R V Dave ◽  
S Cheung ◽  
M Sibbering ◽  
O Kearins ◽  
J Jenkins ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Invasive Breast Cancer ◽  
Tumour Size ◽  
Growth Factor Receptor ◽  
Breast Conserving Surgery ◽  
Lymph Node Biopsy ◽  
Axillary Node ◽  
Axillary Node Clearance

Abstract Background Women with screen-detected invasive breast cancer who have macrometastatic disease on axillary sentinel lymph node biopsy (SLNB) are usually offered either surgical axillary node clearance (ANC) or axillary radiotherapy. These treatments can lead to significant complications for patients. The aim of this study was to identify a group of patients who may not require completion ANC. Methods Data from the NHS Breast Screening Programme between 1 April 2012 and 31 March 2017 were interrogated to identify women with invasive breast carcinoma and a single sentinel lymph node (SLN) with macrometastatic disease who subsequently proceeded to completion ANC. Univariable and multivariable analyses were performed to identify patients with a single positive SLN who had no further lymph node metastasis on ANC. Results Of the 2401 women included in the cohort, the presence of non-sentinel node disease was significantly affected by: the number of nodes obtained at SLNB (odds ratio (OR) 0.49 for retrieval of more than 1 node), invasive size of tumour (OR 1.63 for size greater than 20 mm), surgical treatment (OR 1.34 for mastectomy), human epidermal growth factor receptor (HER) 2 status (OR 0.71 for HER2 positivity), and patient age (OR 1.10 for age less than 50 years; OR 1.46 for age greater than 70 years). Patients aged less than 70 years, with tumour size smaller than 2 cm, more than one node retrieved on SLNB, and who had breast-conserving surgery had a lower chance of positive non-sentinel nodes on completion ANC compared with other patients. Conclusion This study, of a purely screen-detected breast cancer cohort, identified a subset of patients who may be spared completion ANC in the event of a single axillary SLN with macrometastasis.

scholarly journals Is It Contralateral Axillary Metastasis or Occult Breast Cancer: A Confusing Case Report

2015 ◽  
Vol 8 (3) ◽  
pp. 498-502 ◽  
Author(s):  
Yong Gi Son ◽  
Woon Won Kim ◽  
Ki Hoon Kim ◽  
Jin Soo Kim
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Growth Factor Receptor ◽  
Immunohistochemical Analysis ◽  
Breast Conserving Surgery ◽  
Left Breast ◽  
Lymph Node Biopsy ◽  
Adjuvant Radiation ◽  
Axillary Lymph ◽  
Axillary Metastasis

We report the case of a 43-year-old woman with primary left breast cancer presenting metastatic lymphadenopathy in the contralateral axilla. This patient represents a diagnostic and therapeutic challenge because primary breast cancer, occult contralateral breast cancer, and extra-mammary primary lesion can all be the source of the contralateral axillary metastasis. Left breast-conserving surgery, left sentinel lymph node biopsy, right breast mass excision, and right axillary lymph node dissection were performed. Immunohistochemical analysis revealed that the left breast cancer specimen was positive for estrogen receptor (ER) and progesterone receptor (PR), but negative for human epidermal growth factor receptor 2 (HER2). In contrast, the right axillary lymphadenopathy specimen was negative for ER and PR, but positive for HER2. Further investigation revealed no evidence of occult primary cancers or extra-mammary tumors. After surgical intervention, the patient was treated with adjuvant chemotherapy, adjuvant radiation therapy, and targeted therapy with trastuzumab. Two years after diagnosis, she is free of disease and presently being treated with tamoxifen.

The Accuracy of Sentinel Lymph Node Biopsy in the Treatment of Multicentric Invasive Breast Cancer Using a Subareolar Injection of Tracer

2008 ◽  
Vol 32 (11) ◽  
pp. 2483-2487 ◽  
Author(s):  
Calogero Cipolla ◽  
Salvatore Vieni ◽  
Salvatore Fricano ◽  
Daniela Cabibi ◽  
Giuseppa Graceffa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Invasive Breast Cancer ◽  
Lymph Node Biopsy ◽  
Subareolar Injection ◽  
Node Biopsy

Negative predictive value of ipsilateral axillary ultrasound in the pre-operative assessment of invasive breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12080-e12080 ◽  
Author(s):  
Bita Ameri ◽  
Riti Kanesa-Thasan ◽  
Maysa M. Abu-Khalaf ◽  
Adam C. Berger ◽  
Tara Eisenberg ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Negative Predictive Value ◽  
Invasive Breast Cancer ◽  
Predictive Value ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Axillary Ultrasound ◽  
Node Biopsy

e12080 Objective: To determine if a negative preoperative axillary ultrasound predicts a negative sentinel lymph node biopsy at surgery. Background: Axillary lymph node involvement is an important prognostic indicator in patients with breast cancer. Sentinel lymph node biopsy (SLNB) is currently the gold standard for determining the presence or absence of axillary metastases. Pre-operative axillary ultrasound is often used to evaluate axillary lymph node status prior to surgery and SLNB. Although there are no established guidelines on when preoperative axillary ultrasound is performed, at our institution we evaluate the axilla when invasive breast cancer is suspected. This study evaluated the negative predictive value (NPV) of axillary ultrasound compared to the pathology results of SLNB. Methods: In this single-center IRB-approved retrospective study, 3 years of breast imaging data (2014-2016) were reviewed. 137 patients had pathology verified invasive breast cancer with negative preoperative axillary ultrasound and subsequent SLNB. All patients had clinically negative axillae. Based upon the pathology results of SLNB, the negative predictive value of preoperative axillary ultrasound was calculated. Negative axillary ultrasound is defined as the absence of morphologically abnormal lymph nodes on imaging. A lymph node is considered morphologically normal when there is preserved fatty hilum and a uniform cortex measuring 3 mm or less. Results: Out of 137 patients with invasive breast cancer who had negative preoperative axillary ultrasound, 122 had negative SLNB results and 15 had positive SLNB results. Preoperative axillary ultrasound demonstrated a NPV of 89.1% for the detection of axillary metastatic disease at the time of SLNB. Conclusions: Negative axillary ultrasound excluded axillary metastatic disease in 89.1% of patients. This data suggests that negative axillary ultrasound may have a role in the setting of failed SLNB (no lymph nodes found at the time of surgery) in deciding whether to pursue axillary dissection.

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