Does the Method of Biopsy Affect the Incidence of Sentinel Lymph Node Metastases?
Identifieur interne : 007C82 ( Main/Exploration ); précédent : 007C81; suivant : 007C83Does the Method of Biopsy Affect the Incidence of Sentinel Lymph Node Metastases?
Auteurs : Erika L. Newman ; Amina Kahn ; Kathleen M. Diehl ; Vincent M. Cimmino ; Celina A. Kleer [États-Unis] ; Alfred E. Chang ; Lisa A. Newman ; Michael S. Sabel [États-Unis]Source :
- The Breast Journal [ 1075-122X ] ; 2006-01.
Abstract
Abstract: More detailed examination of the sentinel lymph node (SLN) in breast cancer has raised concerns about the clinical significance of micrometastases, specifically isolated tumor cells detected only through immunohistochemical (IHC) staining. It has been suggested that these cells do not carry the same biologic implications as true metastatic foci and may represent artifact. A retrospective institutional review board‐approved review was conducted on clinically node‐negative breast cancer patients who underwent SLN biopsy (SLNB) between 1997 and 2003. Retrospective analysis of tumor characteristics and the method of the initial diagnostic biopsy were correlated with the presence and nature of metastatic disease in the SLN. Of 537 SLNBs, 123 (23%) were hematoxylin‐eosin (H&E) positive. SLN positivity strongly correlated with tumor size (p < 0.001) and tumor grade (p = 0.025), but not with the method of biopsy (needle versus excisional biopsy). Prior to July 2002, we routinely evaluated H&E‐negative SLNs with IHC (n = 381). Of the 291 H&E‐negative patients, 26 had IHC‐only detected micrometastases (9%). The likelihood of detecting IHC‐only metastases did not correlate with tumor size or grade, but was significantly higher in patients undergoing excisional biopsy than core needle biopsy. While the method of biopsy has no demonstrable effect on the likelihood of finding metastases in the SLN by routine serial sectioning and H&E staining, it may significantly impact the likelihood of finding micrometastases by IHC. IHC should not be used routinely in the evaluation of the SLN and caution should be used when basing treatment decisions (completion axillary lymph node dissection or adjuvant therapy) on IHC‐only detected micrometastases.
Url:
DOI: 10.1111/j.1075-122X.2006.00179.x
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream Istex, to step Corpus: 006C25
- to stream Istex, to step Curation: 006C25
- to stream Istex, to step Checkpoint: 001766
- to stream Main, to step Merge: 007E75
- to stream Main, to step Curation: 007C82
Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Does the Method of Biopsy Affect the Incidence of Sentinel Lymph Node Metastases?</title><author><name sortKey="Newman, Erika L" sort="Newman, Erika L" uniqKey="Newman E" first="Erika L." last="Newman">Erika L. Newman</name></author><author><name sortKey="Kahn, Amina" sort="Kahn, Amina" uniqKey="Kahn A" first="Amina" last="Kahn">Amina Kahn</name></author><author><name sortKey="Diehl, Kathleen M" sort="Diehl, Kathleen M" uniqKey="Diehl K" first="Kathleen M." last="Diehl">Kathleen M. Diehl</name></author><author><name sortKey="Cimmino, Vincent M" sort="Cimmino, Vincent M" uniqKey="Cimmino V" first="Vincent M." last="Cimmino">Vincent M. Cimmino</name></author><author><name sortKey="Kleer, Celina A" sort="Kleer, Celina A" uniqKey="Kleer C" first="Celina A." last="Kleer">Celina A. Kleer</name></author><author><name sortKey="Chang, Alfred E" sort="Chang, Alfred E" uniqKey="Chang A" first="Alfred E." last="Chang">Alfred E. Chang</name></author><author><name sortKey="Newman, Lisa A" sort="Newman, Lisa A" uniqKey="Newman L" first="Lisa A." last="Newman">Lisa A. Newman</name></author><author><name sortKey="Sabel, Michael S" sort="Sabel, Michael S" uniqKey="Sabel M" first="Michael S." last="Sabel">Michael S. Sabel</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:E694BB41CD8E69865BC524D3352DF7403E89DBE0</idno><date when="2006" year="2006">2006</date><idno type="doi">10.1111/j.1075-122X.2006.00179.x</idno><idno type="url">https://api.istex.fr/document/E694BB41CD8E69865BC524D3352DF7403E89DBE0/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">006C25</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">006C25</idno><idno type="wicri:Area/Istex/Curation">006C25</idno><idno type="wicri:Area/Istex/Checkpoint">001766</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Checkpoint">001766</idno><idno type="wicri:doubleKey">1075-122X:2006:Newman E:does:the:method</idno><idno type="wicri:Area/Main/Merge">007E75</idno><idno type="wicri:Area/Main/Curation">007C82</idno><idno type="wicri:Area/Main/Exploration">007C82</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">Does the Method of Biopsy Affect the Incidence of Sentinel Lymph Node Metastases?</title><author><name sortKey="Newman, Erika L" sort="Newman, Erika L" uniqKey="Newman E" first="Erika L." last="Newman">Erika L. Newman</name><affiliation><wicri:noCountry code="no comma">Departments of Surgery and</wicri:noCountry></affiliation></author><author><name sortKey="Kahn, Amina" sort="Kahn, Amina" uniqKey="Kahn A" first="Amina" last="Kahn">Amina Kahn</name><affiliation><wicri:noCountry code="no comma">Departments of Surgery and</wicri:noCountry></affiliation></author><author><name sortKey="Diehl, Kathleen M" sort="Diehl, Kathleen M" uniqKey="Diehl K" first="Kathleen M." last="Diehl">Kathleen M. Diehl</name><affiliation><wicri:noCountry code="no comma">Departments of Surgery and</wicri:noCountry></affiliation></author><author><name sortKey="Cimmino, Vincent M" sort="Cimmino, Vincent M" uniqKey="Cimmino V" first="Vincent M." last="Cimmino">Vincent M. Cimmino</name><affiliation><wicri:noCountry code="no comma">Departments of Surgery and</wicri:noCountry></affiliation></author><author><name sortKey="Kleer, Celina A" sort="Kleer, Celina A" uniqKey="Kleer C" first="Celina A." last="Kleer">Celina A. Kleer</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Michigan</region></placeName><wicri:cityArea>Pathology, University of Michigan Comprehensive Cancer Center, Ann Arbor</wicri:cityArea></affiliation></author><author><name sortKey="Chang, Alfred E" sort="Chang, Alfred E" uniqKey="Chang A" first="Alfred E." last="Chang">Alfred E. Chang</name><affiliation><wicri:noCountry code="no comma">Departments of Surgery and</wicri:noCountry></affiliation></author><author><name sortKey="Newman, Lisa A" sort="Newman, Lisa A" uniqKey="Newman L" first="Lisa A." last="Newman">Lisa A. Newman</name><affiliation><wicri:noCountry code="no comma">Departments of Surgery and</wicri:noCountry></affiliation></author><author><name sortKey="Sabel, Michael S" sort="Sabel, Michael S" uniqKey="Sabel M" first="Michael S." last="Sabel">Michael S. Sabel</name><affiliation></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">The Breast Journal</title><title level="j" type="alt">BREAST JOURNAL</title><idno type="ISSN">1075-122X</idno><idno type="eISSN">1524-4741</idno><imprint><biblScope unit="vol">12</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="53">53</biblScope><biblScope unit="page" to="57">57</biblScope><biblScope unit="page-count">5</biblScope><publisher>Blackwell Publishing Inc</publisher><pubPlace>Malden, USA</pubPlace><date type="published" when="2006-01">2006-01</date></imprint><idno type="ISSN">1075-122X</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1075-122X</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Abstract: More detailed examination of the sentinel lymph node (SLN) in breast cancer has raised concerns about the clinical significance of micrometastases, specifically isolated tumor cells detected only through immunohistochemical (IHC) staining. It has been suggested that these cells do not carry the same biologic implications as true metastatic foci and may represent artifact. A retrospective institutional review board‐approved review was conducted on clinically node‐negative breast cancer patients who underwent SLN biopsy (SLNB) between 1997 and 2003. Retrospective analysis of tumor characteristics and the method of the initial diagnostic biopsy were correlated with the presence and nature of metastatic disease in the SLN. Of 537 SLNBs, 123 (23%) were hematoxylin‐eosin (H&E) positive. SLN positivity strongly correlated with tumor size (p < 0.001) and tumor grade (p = 0.025), but not with the method of biopsy (needle versus excisional biopsy). Prior to July 2002, we routinely evaluated H&E‐negative SLNs with IHC (n = 381). Of the 291 H&E‐negative patients, 26 had IHC‐only detected micrometastases (9%). The likelihood of detecting IHC‐only metastases did not correlate with tumor size or grade, but was significantly higher in patients undergoing excisional biopsy than core needle biopsy. While the method of biopsy has no demonstrable effect on the likelihood of finding metastases in the SLN by routine serial sectioning and H&E staining, it may significantly impact the likelihood of finding micrometastases by IHC. IHC should not be used routinely in the evaluation of the SLN and caution should be used when basing treatment decisions (completion axillary lymph node dissection or adjuvant therapy) on IHC‐only detected micrometastases.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Michigan</li></region></list><tree><noCountry><name sortKey="Chang, Alfred E" sort="Chang, Alfred E" uniqKey="Chang A" first="Alfred E." last="Chang">Alfred E. Chang</name><name sortKey="Cimmino, Vincent M" sort="Cimmino, Vincent M" uniqKey="Cimmino V" first="Vincent M." last="Cimmino">Vincent M. Cimmino</name><name sortKey="Diehl, Kathleen M" sort="Diehl, Kathleen M" uniqKey="Diehl K" first="Kathleen M." last="Diehl">Kathleen M. Diehl</name><name sortKey="Kahn, Amina" sort="Kahn, Amina" uniqKey="Kahn A" first="Amina" last="Kahn">Amina Kahn</name><name sortKey="Newman, Erika L" sort="Newman, Erika L" uniqKey="Newman E" first="Erika L." last="Newman">Erika L. Newman</name><name sortKey="Newman, Lisa A" sort="Newman, Lisa A" uniqKey="Newman L" first="Lisa A." last="Newman">Lisa A. Newman</name></noCountry><country name="États-Unis"><region name="Michigan"><name sortKey="Kleer, Celina A" sort="Kleer, Celina A" uniqKey="Kleer C" first="Celina A." last="Kleer">Celina A. Kleer</name></region><name sortKey="Sabel, Michael S" sort="Sabel, Michael S" uniqKey="Sabel M" first="Michael S." last="Sabel">Michael S. Sabel</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/LymphedemaV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 007C82 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 007C82 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= LymphedemaV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= ISTEX:E694BB41CD8E69865BC524D3352DF7403E89DBE0
|texte= Does the Method of Biopsy Affect the Incidence of Sentinel Lymph Node Metastases?
}}
| This area was generated with Dilib version V0.6.31. |  |