Breast Journal最新文献

{"title":"Survival Outcomes of Breast-Conserving Therapy versus Mastectomy in Early-Stage Breast Cancer, Including Centrally Located Breast Cancer: A SEER-Based Study","authors":"Tianshui Yu,&nbsp;Weilun Cheng,&nbsp;Ting Wang,&nbsp;Ziang Chen,&nbsp;Yu Ding,&nbsp;Jianyuan Feng,&nbsp;Yunqiang Duan,&nbsp;Anbang Hu,&nbsp;Mingcui Li,&nbsp;Hanyu Zhang,&nbsp;Yanling Li,&nbsp;Fei Ma,&nbsp;Baoliang Guo","doi":"10.1155/2022/5325556","DOIUrl":"10.1155/2022/5325556","url":null,"abstract":"<div>\u0000 <p><i>Purpose</i>. This study aims to analyze the survival outcomes of breast cancer (BC) patients, especially centrally located breast cancer (CLBC) patients undergoing breast-conserving therapy (BCT) or mastectomy. <i>Methods</i>. Surveillance, epidemiology, and end results (SEER) data of patients with T1-T2 invasive ductal or lobular breast cancer receiving BCT or mastectomy were reviewed. We used X-tile software to convert continuous variables to categorical variables. Chi-square tests were utilized to compare baseline information. The multivariate logistic regression model was performed to evaluate the relationship between predictive variables and treatment choice. Survival outcomes were visualized by Kaplan–Meier curves and cumulative incidence function curves and compared using multivariate analyses, including the Cox proportional hazards model and competing risks model. Propensity score matching was performed to alleviate the effects of baseline differences on survival outcomes. <i>Result</i>. A total of 180,495 patients were enrolled in this study. The breast preservation rates fluctuated around 60% from 2000 to 2015. Clinical features including invasive ductal carcinoma (IDC), lower histologic grade, smaller tumor size, fewer lymph node metastases, positive ER and PR status, and chemotherapy use were independently correlated with BCT in both BC and CLBC cohorts. In all the classic Cox models and competing risks models, BCT was an independent favorable prognostic factor for BC, including CLBC patients in most subgroups. In addition, despite the low breast-conserving rate compared with tumors located in the other areas, CLBC did not impair the prognosis of BCT patients. <i>Conclusion</i>. BCT is optional and preferable for most early-stage BC, including CLBC patients.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2022 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2022-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9440848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40356315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Value of Additional Primary Tumour Excision Combined with Systemic Therapy Administered in Different Sequences for Patients with de Novo Metastatic Breast Cancer","authors":"Siyi Zhu","doi":"10.1155/2022/5049445","DOIUrl":"10.1155/2022/5049445","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Uncertainty still remains regarding the survival improvement derived from immediate surgery or subsequent surgery in addition to systemic therapy for patients with de novo metastatic breast cancer. The current study aimed to examine the effect of combined treatment administered in different sequences on the survival of these patients. <i>Materials and Methods</i>. We conducted a retrospective cohort study of patients with de novo stage IV breast cancer in the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2019. Patients were categorized into 3 groups: (1) systemic therapy without primary surgery, (2) systemic therapy after primary surgery, and (3) systemic therapy before primary surgery. Cumulative incidence curves with Gray’s test were used to compare breast cancer-specific death (BCSD) between groups. Kaplan–Meier curves with the log-rank test were applied to compare overall survival (OS) between groups. A competing risk model and a proportional hazards model were generated to adjust for important prognostic factors. Propensity score matching (PSM) was performed in the primary survival analysis. Stratified analysis was also performed. <i>Results</i>. Patients who underwent systemic therapy after primary surgery and who underwent systemic therapy before primary surgery both showed a significantly reduced risk of BCSD compared to patients who received systemic therapy without primary surgery [subdistribution hazard ratio (SHR): 0.74; 95% confidence interval (CI): 0.69–0.79; and <i>P</i> &lt; 0.001, and SHR: 0.62; 95% CI: 0.56–0.67; and <i>P</i> &lt; 0.001, respectively]. A statistically significant disparity was also noted in OS. In the setting of single-organ metastasis, including the bone, lung, and liver, patients receiving the combination therapy showed an improved prognosis compared with patients receiving systemic therapy without primary surgery. <i>Conclusions</i>. Additional primary tumour excision, whether before or after systemic therapy, may provide survival benefits for patients presenting with de novo metastatic breast cancer, especially for patients with single-organ disease involving the bone, lung, and liver but not the brain. Further investigations mainly focused on these carefully selected candidates are required to improve personalized treatment for metastatic breast cancer.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2022 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9436631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33454563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences of Clinicopathological Features between Metaplastic Breast Carcinoma and Nonspecific Invasive Breast Carcinoma and Prognostic Profile of Metaplastic Breast Carcinoma","authors":"Yue Qiu,&nbsp;Yuhui Chen,&nbsp;Li Zhu,&nbsp;Hongye Chen,&nbsp;Yongjing Dai,&nbsp;Baoshi Bao,&nbsp;Lin Tian,&nbsp;Xiaopeng Hao,&nbsp;Jiandong Wang","doi":"10.1155/2022/2500594","DOIUrl":"10.1155/2022/2500594","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Metaplastic breast carcinoma is a rare special type of breast cancer, which has distinguished clinical characteristics. We aimed to evaluate the clinicopathological features of metaplastic breast carcinoma compared with nonspecific invasive breast carcinoma and study the prognosis of metaplastic breast carcinoma. <i>Methods</i>. We reviewed metaplastic breast carcinoma cases (<i>n</i> = 37) from January 2000 to December 2021 and nonspecific invasive breast carcinoma cases (<i>n</i> = 433) from January 2019 to December 2020 extracted from our institution retrospectively. The following variables were recorded, including the patients’ general information, complications, T stage, expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, Ki-67, molecular subtyping, lymph node status, skin or chest wall involvement, vessel carcinoma embolus, therapy modality (surgical treatments, chemotherapy, and radiotherapy), and survival. <i>Results</i>. Patients with metaplastic breast carcinoma had more advanced disease than patients with nonspecific invasive breast carcinoma (T stage: <i>P</i> = 0.0011). A greater proportion of metaplastic breast carcinoma presented with triple-negative breast cancer than nonspecific invasive breast carcinoma (79.41% vs. 12.47%, <i>P</i> ≤ 0.001). Our study showed that the skin or chest wall invasion was more frequent in metaplastic breast carcinoma patients (11.76% vs. 1.62%, <i>P</i> = 0.005). The 5-year survival rate for metaplastic breast carcinoma patients was 57.66% (95% CI: 0.3195∼0.7667). No local recurrence was observed while distant metastasis occurred in 33.33% of patients with metaplastic breast carcinoma. Death due to disease occurred in 24.24% of patients with metaplastic breast carcinoma. <i>Conclusion</i>. The majority of metaplastic breast carcinoma patients had more advanced disease and triple-negative disease than nonspecific invasive breast carcinoma patients. Also, metaplastic breast carcinoma patients had frequent skin or chest wall invasion and a high rate of distant metastasis and mortality.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2022 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40342666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast Cancer Patients with Brain Metastases: A Cross-Sectional Study","authors":"Melih Simsek,&nbsp;Altay Aliyev,&nbsp;Tuba Baydas,&nbsp;Mehmet Besiroglu,&nbsp;Tarik Demir,&nbsp;Abdallah TM Shbair,&nbsp;Mesut Seker,&nbsp;H. Mehmet Turk","doi":"10.1155/2022/5763810","DOIUrl":"10.1155/2022/5763810","url":null,"abstract":"<div>\u0000 <p>The prognosis of breast cancer patients with brain metastasis is poor. It was aimed to define the clinicopathological features of breast cancer patients with brain metastases and to determine the risk factors and survival outcomes associated with brain metastasis. This is a single-center, retrospective, cross-sectional study. A total number of 127 patients diagnosed with breast cancer and who developed brain metastasis between January 2011 and March 2021 were retrospectively analyzed. The survival and clinicopathological data of these patients according to 4 biological subtypes were evaluated (luminal A, luminal B, HER-2 overexpressing, and triple-negative). The median overall survival for all patients was 45.6 months. The median time from the diagnosis of breast cancer to the occurrence of brain metastasis was 29.7 months, and the median survival time after brain metastasis was 7.2 months. The time from the diagnosis of breast cancer to brain metastasis development was significantly shorter in HER-2 overexpressing and triple-negative subtypes than in luminal A and B subtypes. The median time from breast cancer diagnosis to brain metastasis was 33.5 months in luminal A, 40.6 months in luminal B, 16.8 months in HER-2 overexpressing, and 22.8 months in the triple-negative groups (<i>p</i> = 0.003). We found the worst median survival after brain metastasis in the triple-negative group with 3.5 months. Early and close surveillance of high-risk patients may help early diagnosis of brain metastasis and may provide to perform effective treatments leading to longer overall survival times for this patient population.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2022 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9417791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40342665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological Features of Inflammatory Myofibroblastic Tumor in the Breast","authors":"Shifei Liu,&nbsp;Rui Yuan,&nbsp;Yulan Jin,&nbsp;Chunyan He,&nbsp;Xingzheng Zheng,&nbsp;Yang Zhan","doi":"10.1155/2022/1863123","DOIUrl":"10.1155/2022/1863123","url":null,"abstract":"<div>\u0000 <p>Inflammatory myofibroblastic tumor (IMT) is a mesenchymal spindle cell tumour with low malignant potential which is extremely rare in breasts. Because of the lack of typical imaging and clinical characteristics of IMT, it is easy to misdiagnose before operation. We now report a case of a 37-year-old woman presenting with a mass in her left breast. Ultrasound showed a well-circumscribed lesion in the lower outer quadrant. The patient underwent lumpectomy, and histopathology revealed a tumor which was composed of fusiform cells and inflammatory cells. Immunohistochemistry (IHC) showed tumor cells are positive for vimentin, ALK, BCL2, and SMA. The FISH test demonstrated ALK (2p23) chromosomal translocation (ALK positive). The final diagnosis of breast IMT was rendered with nonclassical morphology. Postoperative 30-month follow-up no evidence showed residual tumor or recurrence. As a very rare tumor, breast IMT could be easily misdiagnosed clinically and pathologically. Complete surgical resection of the tumor is preferred, and it has the risk of recurrence and metastasis.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2022 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9578916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40454630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating DNA Methylation in Random Fine Needle Aspirates from the Breast to Inform Cancer Risk","authors":"Kala Visvanathan,&nbsp;Ashley Cimino-Mathews,&nbsp;Mary Jo Fackler,&nbsp;Pritesh S. Karia,&nbsp;Christopher J. VandenBussche,&nbsp;Mikiaila Orellana,&nbsp;Betty May,&nbsp;Marissa J. White,&nbsp;Mehran Habibi,&nbsp;Julie Lange,&nbsp;David Euhus,&nbsp;Vered Stearns,&nbsp;John Fetting,&nbsp;Melissa Camp,&nbsp;Lisa Jacobs,&nbsp;Saraswati Sukumar","doi":"10.1155/2022/9533461","DOIUrl":"10.1155/2022/9533461","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Critical regulatory genes are functionally silenced by DNA hypermethylation in breast cancer and premalignant lesions. The objective of this study was to examine whether DNA methylation assessed in random fine needle aspirates (rFNA) can be used to inform breast cancer risk. <i>Methods</i>. In 20 women with invasive breast cancer scheduled for surgery at Johns Hopkins Hospital, cumulative methylation status was assessed in a comprehensive manner. rFNA was performed on tumors, adjacent normal tissues, and all remaining quadrants. Pathology review was conducted on blocks from all excised tissue. The cumulative methylation index (CMI) for 12 genes was assessed by a highly sensitive QM-MSP assay in 280 aspirates and tissue from 11 incidental premalignant lesions. Mann–Whitney and Kruskal Wallis tests were used to compare median CMI by patient, location, and tumor characteristics. <i>Results</i>. The median age of participants was 49 years (interquartile range [IQR]: 44–58). DNA methylation was detectable at high levels in all tumor aspirates (median CMI = 252, IQR: 75–111). Methylation was zero or low in aspirates from adjacent tissue (median CMI = 11, IQR: 0–13), and other quadrants (median CMI = 2, IQR: 1–5). Nineteen incidental lesions were identified in 13 women (4 malignant and 15 premalignant). Median CMI levels were not significantly different in aspirates from quadrants (<i>p</i> = 0.43) or adjacent tissue (<i>p</i> = 0.93) in which 11 methylated incidental lesions were identified. <i>Conclusions</i>. The diagnostic accuracy of methylation based on rFNA alone to detect premalignant lesions or at-risk quadrants is poor and therefore should not be used to evaluate cancer risk. A more targeted approach needs to be evaluated.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2022 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2022-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11401740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48038347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and Limitations of Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy in Breast Cancer Patients with Positive Nodes","authors":"Sofia Aragon-Sanchez,&nbsp;M. Reyes Oliver-Perez,&nbsp;Ainhoa Madariaga,&nbsp;M. Jose Tabuenca,&nbsp;Mario Martinez,&nbsp;Alberto Galindo,&nbsp;M. Luisa Arroyo,&nbsp;Marta Gallego,&nbsp;Marta Blanco,&nbsp;Eva M. Ciruelos-Gil","doi":"10.1155/2022/1507881","DOIUrl":"10.1155/2022/1507881","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Axillary surgical management in patients with node-positive breast cancer at the time of diagnosis converted to negative nodes through neoadjuvant chemotherapy (NAC) remains unclear. Removal of more than two sentinel nodes (SLNs) in these patients may decrease the false negative rate (FNR) of sentinel lymph node biopsies (SLNBs). We aim to analyse the detection rate (DR) and the FNR of SLNB assessment according to the number of SLNs removed. <i>Methods</i>. A retrospective study was performed from October 2012 to December 2018. Patients with invasive breast cancer who had a clinically node-positive disease at diagnosis and with a complete axillary response after neoadjuvant chemotherapy were selected. Patients included underwent SLNB and axillary lymph node dissection (ALND) after NAC. The SLN was considered positive if any residual disease was detected. Descriptive statistics were used to describe the clinicopathologic features and the results of SLNB and ALND. The DR of SLNB was defined as the number of patients with successful identification of SLN. Presence of residual disease in ALND and negative SLN was considered false negative. <i>Results</i>. A total of 368 patients with invasive breast cancer who underwent surgery after complete NAC were studied. Of them, 85 patients met the eligibility criteria and were enrolled in the study. The mean age at diagnosis was 50.8 years. Systematic lymphadenectomy was performed in all patients, with an average of 10 lymph nodes removed. The DR of SLNB was 92.9%, and the FNR was 19.1. The median number of SLNs removed was 3, and at least, three SLNs were obtained in 42 patients (53.2%). When at least three sentinel nodes were removed, the FNR decreased to 8.7%. <i>Conclusions</i>. In this cohort, the SLN assessment was associated with an adequate DR and a high FNR. Removing three or more SLNs decreased the FNR from 19.1% to 8.7%. Complementary approaches may be considered for axillary lymph node staging after neoadjuvant chemotherapy. The study was approved by our institution’s ethics committee (Instituto de Investigacion Sanitaria Hospital 12 de Octubre (imas12), Universidad Complutense de Madrid, Madrid, Spain) (https://clinicaltrials.gov/ct2/show/NCEI:20/0048).</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2022 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2022-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9411000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40340691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective Double-Blinded Randomized Controlled Trial Comparing the Intraoperative Injection of Technetium Tc 99m Tilmanocept with Technetium Tc 99m Sulfur Colloid in Breast Cancer Lymphatic Mapping","authors":"Anyul Ferez-Pinzon,&nbsp;Samuel L. Corey,&nbsp;Haresh Rochani,&nbsp;Elena A. Rehl,&nbsp;William E. Burak Jr","doi":"10.1155/2022/9421489","DOIUrl":"10.1155/2022/9421489","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Technetium-labeled sulfur colloid (TSC) is a radiolabeled mapping agent commonly used for sentinel lymph node biopsy (SLNBx). Tilmanocept, a CD206 receptor-targeted mapping agent, has gained recent popularity due to potential advantages of rapid and quick uptake to the SLNs. The objectives of this study were to assess (1) the difference in the number of SLNs harvested using tilmanocept versus TSC and (2) the difference in time to transcutaneous localization when using an intraoperative injection approach. <i>Methods</i>. Patients undergoing breast conservation and SLNBx were consented and randomized to receive either 0.5 mCi of filtered TSC or 0.5 mCi of tilmanocept injected intradermally immediately after induction of anesthesia. Axillary transcutaneous gamma detector probe counts were taken at 1-minute intervals until a hot spot was identified. SLNs were then identified and excised. Additional nodes were excised if their counts per second (cps) were greater than 10% of the cps of the hottest SLN. The number of SLNs was based on both number of nodes collected intraoperatively and the number recorded in the final pathology report. <i>Results</i>. The study population consisted of 86 patients, 48 randomized to tilmanocept and 38 to TSC. There were no significant differences in patient or tumor characteristics between the two groups. Localization rates were 100% for both cohorts. The mean number of SLNs identified and removed was not significantly different (<i>p</i> = 0.34, intraoperatively; <i>p</i> = 0.57, pathology reported). Time to transcutaneous localization was 3.3 ± 2.0 minutes for tilmanocept and 3.9 ± 2.3 minutes for TSC (<i>p</i> = 0.19). The average cps for the hottest node was 2,180.0 ± 2,460.5 in the tilmanocept group compared to 2,679.3 ± 2,687.5 in the TSC group (<i>p</i> = 0.94). <i>Conclusion</i>. There was no significant difference in the number of SLNs harvested or in the time to transcutaneous localization when using tilmanocept versus TSC as the radiolabeled mapping agents for intraoperative injection and mapping. Either agent can be used without any significant difference in performance.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2022 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2022/9421489","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49244960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Luminal A Breast Cancer: How Feasible is Omitting Axillary Dissection Without Neoadjuvant Therapy","authors":"Cemil Yüksel,&nbsp;Bülent Aksel,&nbsp;Lütfi Doğan","doi":"10.1155/2022/8284814","DOIUrl":"10.1155/2022/8284814","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Luminal A breast cancer has a good prognosis and the criteria for adjuvant and neoadjuvant chemotherapy (NAC) are not clear. The aim of this study was to present our results of upfront surgery and long-term survival in luminal A tumors as well as the rates of protection from axillary dissection. <i>Material and Methods</i>. 271 Luminal A breast cancer patients who had operated at our center were evaluated retrospectively. In patients with 2 or less sentinel lymph node (SLN) positivity who did not receive neoadjuvant therapy and underwent breast-conserving surgery, axillary lymph node dissection was omitted (OAD). Axillary lymph node dissection (ALND) was performed in patients with positive SLN who did not meet these criteria (axillary dissection after sentinel/ADAS). <i>Results</i>. While Sentinel Lymph Node Biopsy (SLNB) was performed in 212 (77.9%) patients, SLNB + Axillary Dissection (AD) was performed in 58 (21.3%), and direct axillary dissection was performed in 1 (0.8%) patient. OAD was applied to 18 (23.6%) of the positive patients. <i>Discussion/Conclusions</i>. ALND rates are still strikingly high in luminal A breast cancer treatment, despite the disease’s milder clinical course. In order to avoid complications of axillary dissection, patients should be considered for NAC as much as possible. Novel neoadjuvant or other therapy options are also required.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2022 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9356774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40619130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Axillary Lymph Node Marking with Magseed® before and after Neoadjuvant Systemic Therapy in Breast Cancer Patients: MAGNET Study","authors":"María Martínez,&nbsp;Sara Jiménez,&nbsp;Florentina Guzmán,&nbsp;Marta Fernández,&nbsp;Elena Arizaga,&nbsp;Consuelo Sanz","doi":"10.1155/2022/6111907","DOIUrl":"10.1155/2022/6111907","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Due to the high false negative rate (FNR) associated with sentinel lymph node biopsy (SLNB) after neoadjuvant systemic therapy (NAST), the standard surgical treatment for patients with an initially positive axilla and indicated for NAST is axillary lymph node dissection (ALND). To avoid unnecessary ALND, this multicenter, prospective, observational study aimed to determine the effectiveness and ease of using magnetic seeds (Magseed®) for targeted axillary dissection (TAD) when the seeds are placed before or after NAST. <i>Materials and Methods</i>. We recruited 81 patients diagnosed with T1-T3 breast cancer, with clinically/radiologically positive nodal involvement (cN1, 75 patients with 1–3 nodes suspected nodes and 6 patients with up to 4 suspected nodes) prior to NAST. Positive nodes detected by fine-needle aspiration biopsy or core needle biopsy were marked with a stainless steel marker coil and after NAST with Magseed® prior to surgery (Post-NAST group), or directly with Magseed® before NAST (Pre-NAST group). The correlation between lymph nodes marked with Magseed® (MLNs) and sentinel lymph nodes (SLNs) was calculated based on pathologic assessment with the OSNA assay (Sysmex Corporation, Kobe) or conventional sectioning and staining techniques according to the standard protocols of each center. <i>Results</i>. All magnetic seeds were successfully identified and retrieved in just over 10 minutes of surgery, guided by the Sentimag® magnetometer system. The overall concordance rate between MLNs and SLNs was 81.5%, and the concordance between MLNs and SLNs with metastasis was 93.8%. Metastasis was detected in 54.3% of the MLNs compared with 48.1% of SLNs. In cases that presented negative MLN and negative SLN (negative TAD), the FNR was 0%. No significant differences were found between the Post-NAST and Pre-NAST groups. <i>Conclusions</i>. Our results validate the use of Magseed® for long-term marking of axillary lymph nodes and show that when used in combination with SLNB for TAD, a FNR of 0% can be achieved, avoiding unnecessary ALND.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2022 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2022-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9288346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40537469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}