Abstract
Background
This study examines whether preoperative ultrasound-assessed tumour diameter and diagnostic core biopsy-determined grade can be used to select those most likely to benefit from SLNB (i.e. those that are “node negative”) before their definitive operation.
Methods
Breast ultrasound (US) and a simultaneous core biopsy was performed in all patients at their initial presentation, and their estimates of tumor size and grade compared with the final pathological specimen (FPS).
Results
Of the T1 group 47% had lymphatic metastases as did 49% of those with grade I or II cancers. By combining these measures, however, subgroups of patients with lower rates of nodal metastases were identified (32% of patients with T1, non-grade III disease had lymphatic disease while only 15% of those with T < 1.5 cm, non-grade III cancers had such metastases).
Conclusion
Combination of the US and ultrasound guided core biopsy (UGCB) may however identify subgroups unlikely to have axillary disease that are therefore suitable for SLNB.
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References
Blanchard DK, Donohue JH, Reynolds C, Grant CS (2003) Relapse and morbidity in patients undergoing sentinel node biopsy alone or with axillary dissection for breast cancer. Arch Surg 138:482–488
Beenkein SW, Urist MM, Zhang Y et al (2003) Axillary lymph node status, but not tumour size, predicts locoregional recurrence and overall survival after mastectomy fro breast cancer. Ann Surg 237(5):732–739
Noguchi M (2002) Sentinel node biopsy and breast cancer. Br J Surg 89:21–34
Karamlou T, Johnson NM, Chan B, Franzini D, Mahin D (2003) Accuracy of intraoperative touch imprint cytologic analysis of sentinel lymph nodes in breast cancer. Am J Surg 185(5):425–428
Mullenix PS, Carter PL, Martin MJ et al (2003) Predictive value of intraoperative touch preparation analysis of sentinel lymph nodes for axillary metastasis in breast cancer. Am J Surg 185(5):420–424
Kaufman CS, Jacobson-Kaufman MFT, Thorndike-Christ T, Kaufman L, Tabar L (2001) A treatment scale for axillary management in breast cancer. Am J Surg 182(4):377–383
Bevilacqua JLB, Cody HS, MacDonald KA et al (2002) A model for the predicting axillary node metastases based on 2000 sentinel node procedures and tumour position. EJSO 28(5):490–500
Alexander FE, Anderson TJ, Hubbard AL (1997) Screening status in relation to biological and chronological characteristics of breast cancers: a cross-sectional survey. J Med Screen 4:152–157
Skinner KA, Silberman H, Sposto R, Silverstein MJ (2001) Palpable breast cancers are inherently different from non-palpable breast cancers. Ann Surg Oncol 8:705–710
Groenendijk RP, Bult P, Tewarie L et al (2000) Screen detected breast cancers have a lower mitotic activity index. Br J Cancer 82:381–384
Bloom HJ, Richardson WW (1957) Histological grading and prognosis in breast cancer. Br J Cancer 11:359–377
Scarff RW, Torloni H (1968) Histological typing of breast tumours. In: Sobin LH (ed) International histological classification of tumours, no. 2, vol 2. World Health Organisation, Geneva, pp 13–20
Giuliano AE, Kirgan DM, Guenther JM, Morton DL (1994) Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg 220:391–401
Krag DN, Weaver DL, Alex JX, Fairbanks JT (1993) Surgical resection and radiolocalisation of the sentinel node in breast cancer using the gamma probe. Surg Oncol 2:335–340
Barth A, Craig PH, Silverstein MJ (1997) Predictors of axillary lymph node metastases in patients with T1 breast carcinoma. Cancer 79:1856–1864
Carter CL, Allen C, Henson DE (1989) Relation of tumour size, lymph node status, and survival in 24,740 breast cancer cases. Cancer 63:181–187
Holland PA, Wall J, Boggis CRM et al (1996) A comparison of axillary lymph node status between cancers detected at the prevalence and first incidence breast screening rounds. Br J Cancer 74:1643–1646
Veronesi U, Paganelli G, Galimberti V et al (1997) Sentinel node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes. Lancet 349:1864–1867
Chadha M, Chabon AB, Friedmann P, Vikram B (1994) Predictors of axillary lymph node metastases in patients with T1 breast cancer. Cancer 73:350–353
Olivotto IA, Jackson JSH, Mates D et al (1998) Prediction of axillary lymph node involvement of women with invasive breast carcinoma. Cancer 83:948–955
Hieken TJ, Harrison J, Herreros J, Velasco JM (2001) Correlating sonography, mammography, and pathology in the assessment of breast cancer size. Am J Surg 182(4):351–354
Groenendijk RP, Bult P, Noppen CM et al (2003) Mitotic activity index in interval breast cancers. Eur J Surg Oncol 29(1):29–31
Tubiana M, Koscielny S (1999) The rationale for early diagnosis of cancer-the example of breast cancer. Acta Oncol 38(3):295–303
Brenin DR, Manasseh DM, El Tamer M et al (2001) Factors correlating with lymph node metastases in Patients with T1 Breast Cancer. Ann Surg Oncol 8(5):432–437
Jakub JW, Ebert MD, Diaz NM et al (2003) Effect of lymphatic mapping on diagnosis and treatment of patients with T1a, T1b favourable breast cancer. Ann Surg 237(6):838–843
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Barry, M., Cahill, R.A., Roche-Nagle, G. et al. Preoperative selection of symptomatic breast cancer patients appropriate for lymphatic mapping and sentinel node biopsy. Ir J Med Sci 176, 91–96 (2007). https://doi.org/10.1007/s11845-007-0034-x
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DOI: https://doi.org/10.1007/s11845-007-0034-x