LymphedemaV1, Pmc, Corpus, bibRecord, 002785

OPTIMAL NUMBER OF RADIOACTIVE SENTINEL LYMPH NODES TO REMOVE FOR ACCURATE AXILLARY STAGING OF BREAST CANCER1

Identifieur interne : 002785 ( Pmc/Corpus ); précédent : 002784; suivant : 002786

OPTIMAL NUMBER OF RADIOACTIVE SENTINEL LYMPH NODES TO REMOVE FOR ACCURATE AXILLARY STAGING OF BREAST CANCER1

Auteurs : Melanie A. Lynch ; Jeshaun Jackson ; Julian A. Kim ; Rosemary A. Leeming

Source :

Surgery [ 0039-6060 ] ; 2008.

RBID : PMC:2574506

Abstract

Background

Although sentinel lymph node (SLN) biopsy is the standard technique for staging the axilla of clinically node negative breast cancer, the optimal number of radioactive SLN to remove to ensure accuracy and minimize morbidity is still actively debated. The purpose of this study was to determine the minimum number of SLNs to excise to ensure accurate axillary staging of SLN positive patients.

Methods

One hundred twenty six patients with invasive breast cancer underwent SLN biopsy by periareolar injection of radiolabeled technetium sulfur colloid on the day of surgery. The sequence in which SLNs were removed and the corresponding ex vivo radioactive counts were recorded. SLNs were removed until radioactive counts in the axilla were <10% the ex vivo counts of the hottest SLN.

Results

A radioactive SLN was identified in every patient. The mean number of SLNs identified was 2.86 (range: 1–8). Clinicopathologic features associated with a positive SLN included a palpable tumor (p=0.0035), increasing tumor size (p=0.0039), increasing histologic grade (p=0.0234), and angiolymphatic invasion (p<0.001). The highest radioactive counts were found in the first node in 100 patients (79.4%), the second node in 15 (11.9%) and the third or later node in 11 patients (8.7%). Among the 38 patients with a positive SLN (30.2%), the hottest node was the first positive SLN in 27 patients (71.1%). The first positive SLN was the first node removed in 31 patients (81.6%), following the second node in 37 patients (97.4%) and was removed in all patients by the third SLN.

Conclusion

These data support the trend of limiting SLN biopsy to 3 lymph nodes. Removing all SLN with radioactive counts > 10% of the ex vivo counts of the hottest SLN did not increase accuracy.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2574506

DOI: 10.1016/j.surg.2008.06.005
PubMed: 18847635
PubMed Central: 2574506

Links to Exploration step

PMC:2574506

Le document en format XML

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</title>
<author><name sortKey="Lynch, Melanie A" sort="Lynch, Melanie A" uniqKey="Lynch M" first="Melanie A" last="Lynch">Melanie A. Lynch</name>
</author>
<author><name sortKey="Jackson, Jeshaun" sort="Jackson, Jeshaun" uniqKey="Jackson J" first="Jeshaun" last="Jackson">Jeshaun Jackson</name>
</author>
<author><name sortKey="Kim, Julian A" sort="Kim, Julian A" uniqKey="Kim J" first="Julian A" last="Kim">Julian A. Kim</name>
</author>
<author><name sortKey="Leeming, Rosemary A" sort="Leeming, Rosemary A" uniqKey="Leeming R" first="Rosemary A" last="Leeming">Rosemary A. Leeming</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">OPTIMAL NUMBER OF RADIOACTIVE SENTINEL LYMPH NODES TO REMOVE FOR ACCURATE AXILLARY STAGING OF BREAST CANCER<xref ref-type="fn" rid="FN2">1</xref>
</title>
<author><name sortKey="Lynch, Melanie A" sort="Lynch, Melanie A" uniqKey="Lynch M" first="Melanie A" last="Lynch">Melanie A. Lynch</name>
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<author><name sortKey="Jackson, Jeshaun" sort="Jackson, Jeshaun" uniqKey="Jackson J" first="Jeshaun" last="Jackson">Jeshaun Jackson</name>
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<author><name sortKey="Kim, Julian A" sort="Kim, Julian A" uniqKey="Kim J" first="Julian A" last="Kim">Julian A. Kim</name>
</author>
<author><name sortKey="Leeming, Rosemary A" sort="Leeming, Rosemary A" uniqKey="Leeming R" first="Rosemary A" last="Leeming">Rosemary A. Leeming</name>
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<series><title level="j">Surgery</title>
<idno type="ISSN">0039-6060</idno>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Although sentinel lymph node (SLN) biopsy is the standard technique for staging the axilla of clinically node negative breast cancer, the optimal number of radioactive SLN to remove to ensure accuracy and minimize morbidity is still actively debated. The purpose of this study was to determine the minimum number of SLNs to excise to ensure accurate axillary staging of SLN positive patients.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">One hundred twenty six patients with invasive breast cancer underwent SLN biopsy by periareolar injection of radiolabeled technetium sulfur colloid on the day of surgery. The sequence in which SLNs were removed and the corresponding ex vivo radioactive counts were recorded. SLNs were removed until radioactive counts in the axilla were <10% the ex vivo counts of the hottest SLN.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">A radioactive SLN was identified in every patient. The mean number of SLNs identified was 2.86 (range: 1–8). Clinicopathologic features associated with a positive SLN included a palpable tumor (p=0.0035), increasing tumor size (p=0.0039), increasing histologic grade (p=0.0234), and angiolymphatic invasion (p<0.001). The highest radioactive counts were found in the first node in 100 patients (79.4%), the second node in 15 (11.9%) and the third or later node in 11 patients (8.7%). Among the 38 patients with a positive SLN (30.2%), the hottest node was the first positive SLN in 27 patients (71.1%). The first positive SLN was the first node removed in 31 patients (81.6%), following the second node in 37 patients (97.4%) and was removed in all patients by the third SLN.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">These data support the trend of limiting SLN biopsy to 3 lymph nodes. Removing all SLN with radioactive counts > 10% of the ex vivo counts of the hottest SLN did not increase accuracy.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
  <pmc-dir>properties manuscript</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">0417347</journal-id>
<journal-id journal-id-type="pubmed-jr-id">7662</journal-id>
<journal-id journal-id-type="nlm-ta">Surgery</journal-id>
<journal-title>Surgery</journal-title>
<issn pub-type="ppub">0039-6060</issn>
<issn pub-type="epub">1532-7361</issn>
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<article-id pub-id-type="doi">10.1016/j.surg.2008.06.005</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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<title-group><article-title>OPTIMAL NUMBER OF RADIOACTIVE SENTINEL LYMPH NODES TO REMOVE FOR ACCURATE AXILLARY STAGING OF BREAST CANCER<xref ref-type="fn" rid="FN2">1</xref>
</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Lynch</surname>
<given-names>Melanie A</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Jackson</surname>
<given-names>Jeshaun</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Kim</surname>
<given-names>Julian A</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Leeming</surname>
<given-names>Rosemary A</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<aff id="A1">Division of Surgical Oncology, Department of Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, Ohio 44106</aff>
</contrib-group>
<author-notes><corresp id="cor1">Corresponding Author: Julian A Kim, MD, Division of Surgical Oncology, Department of Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, Ohio 44106, 216 844-8410 (business), 216 844-2888 (fax), <email>julian.kim@uhhospitals.org</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>10</day>
<month>10</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="epub"><day>10</day>
<month>8</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="ppub"><month>10</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>1</day>
<month>10</month>
<year>2009</year>
</pub-date>
<volume>144</volume>
<issue>4</issue>
<fpage>525</fpage>
<lpage>532</lpage>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Although sentinel lymph node (SLN) biopsy is the standard technique for staging the axilla of clinically node negative breast cancer, the optimal number of radioactive SLN to remove to ensure accuracy and minimize morbidity is still actively debated. The purpose of this study was to determine the minimum number of SLNs to excise to ensure accurate axillary staging of SLN positive patients.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">One hundred twenty six patients with invasive breast cancer underwent SLN biopsy by periareolar injection of radiolabeled technetium sulfur colloid on the day of surgery. The sequence in which SLNs were removed and the corresponding ex vivo radioactive counts were recorded. SLNs were removed until radioactive counts in the axilla were <10% the ex vivo counts of the hottest SLN.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">A radioactive SLN was identified in every patient. The mean number of SLNs identified was 2.86 (range: 1–8). Clinicopathologic features associated with a positive SLN included a palpable tumor (p=0.0035), increasing tumor size (p=0.0039), increasing histologic grade (p=0.0234), and angiolymphatic invasion (p<0.001). The highest radioactive counts were found in the first node in 100 patients (79.4%), the second node in 15 (11.9%) and the third or later node in 11 patients (8.7%). Among the 38 patients with a positive SLN (30.2%), the hottest node was the first positive SLN in 27 patients (71.1%). The first positive SLN was the first node removed in 31 patients (81.6%), following the second node in 37 patients (97.4%) and was removed in all patients by the third SLN.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">These data support the trend of limiting SLN biopsy to 3 lymph nodes. Removing all SLN with radioactive counts > 10% of the ex vivo counts of the hottest SLN did not increase accuracy.</p>
</sec>
</abstract>
<contract-num rid="CA1">K23 CA109115-02</contract-num>
<contract-sponsor id="CA1">National Cancer Institute : NCI</contract-sponsor>
</article-meta>
</front>
</pmc>
</record>

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OPTIMAL NUMBER OF RADIOACTIVE SENTINEL LYMPH NODES TO REMOVE FOR ACCURATE AXILLARY STAGING OF BREAST CANCER1

OPTIMAL NUMBER OF RADIOACTIVE SENTINEL LYMPH NODES TO REMOVE FOR ACCURATE AXILLARY STAGING OF BREAST CANCER1

Source :

Abstract

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki