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Axilla

The Experts below are selected from a list of 327 Experts worldwide ranked by ideXlab platform

R E Mansel – 1st expert on this subject based on the ideXlab platform

  • sentinel lymph node biopsy in male breast cancer patients
    Ejso, 2004
    Co-Authors: Amit Goyal, Kieran Horgan, M W Kissin, Constantinos Yiangou, Mark Sibbering, Mark Lansdown, R G Newcombe, R E Mansel

    Abstract:

    The concept of sentinel node biopsy has been validated for female breast cancer patients whereas, ALND remains the standard of care for male breast cancer patients with similar tumours. We evaluated the results of SLN biopsy in male breast cancer patients with clinically negative Axillae. This study included all male breast cancer patients who underwent SLN biopsy between February 1998 and October 2003. All patients had negative Axillae on clinical examination. All patients underwent pre-operative lymphoscintigraphy. SLN biopsy was performed using a combination of Patent blue V and 99mTc-radiolabelled colloidal albumin injected peritumourally. Nine patients, 26-79 years of age, were included in the study. Pre-operative lymphoscinitgraphy identified SLNs in all patients. Intraoperatively, SLNs were successfully localised in all patients. The mean number of SLNs encountered was 2.4. Five patients had a positive SLN, four a negative SLN. Five patients (one with a negative SLN, four with a positive SLN) had been elected pre-operatively to undergo ALND regardless of findings on SLN biopsy. ALND confirmed the SLN to be negative in one patient (false-negative rate: 0%) and three of the four patients with positive SLN(s) had additional positive nodes in the Axilla. SLN biopsy accurately predicted Axillary lymph node status in these five patients. These findings compare favourably with findings reported in the literature regarding SLN biopsy in female breast cancer patients. SLN biopsy accurately staged the Axilla in male breast cancer patients and should be considered for Axillary staging in male breast cancer patients with clinically negative Axillae.

E Th J Rutgers – 2nd expert on this subject based on the ideXlab platform

  • reduction in the number of sentinel lymph node procedures by preoperative ultrasonography of the Axilla in breast cancer
    European Journal of Cancer, 2003
    Co-Authors: Eline E Deurloo, Pieter J Tanis, Kenneth G A Gilhuijs, S H Muller, R Kroger, J L Peterse, E Th J Rutgers, R Valdes A Olmos, L Schultze J Kool

    Abstract:

    Currently, breast cancer patients without clinically suspicious lymph nodes are candidates for sentinel lymph node procedures (SLNPs). The aims of this study were to investigate whether preoperative Axillary ultrasonography and fine-needle aspiration cytology (FNA) can reduce the number of the more time-consuming SLNPs, and to identify a subset of quantitative nodal features to predict metastatic involvement. 268 Axillae were ultrasonographically examined. FNA was performed on suspicious nodes (smallest diameter ⩾5 mm or atypical cortex appearance). SLNP was omitted if a tumour-positive node was found on FNA. Length, width, maximum cortex thickness and appearance of cortex and hilus were ultrasonographically established. In 93 Axillae (35%), at least one node was detected with ultrasound. FNA was performed once per Axilla on 66 nodes; 37 (56%) contained tumour cells. 31% of all tumour-positive Axillae (macro-+micrometastases) was found by ultrasound and FNA (37/121). 41% of all Axillae containing macrometastases was found by ultrasound and FNA (36/87). SLNPs were reduced by 14% (37/268). Maximum cortex thickness is the main feature to predict metastatic involvement (area under Receiver Operating Characteristic (ROC) curve (AZ)=0.87).

  • clinical relevance of sentinel lymph nodes outside the Axilla in patients with breast cancer
    British Journal of Surgery, 2000
    Co-Authors: L Jansen, E Th J Rutgers, R Valdes A Olmos, M H E Doting, J De Vries, O E Nieweg

    Abstract:

    Background

    Lymphatic mapping in patients with breast cancer can reveal sentinel lymph nodes that are not located at level I–II of the Axilla. Little is known about the clinical relevance of these nodes.

    Methods

    Some 113 consecutive patients with clinical stage T1—3 N0 M0 breast cancer were studied. Based on preoperative lymphoscintigraphy, sentinel node biopsy was performed guided by a γ probe and patent blue dye. All sentinel nodes that were visible on lymphoscintigraphy were sought. Pathological examination of the sentinel nodes included step-sections and staining with CAM 5·2. Axillary node dissection was performed regardless of sentinel lymph node status.

    Results

    Twenty-one (19 per cent) of 113 patients had sentinel lymph nodes outside level I–II of the Axilla, mostly in the internal mammary chain. Twenty-two of the 30 sentinel nodes at these sites were harvested. Three patients had sentinel nodes only outside the Axilla. Four other patients had metastases outside the Axilla. This changed postoperative treatment in three patients. No postoperative complication occurred.

    Conclusion

    Sentinel lymph nodes outside level I–II of the Axilla were present in 19 per cent of patients with breast cancer in this series. Biopsy of these nodes was technically demanding but was performed without additional morbidity. The clinical impact was limited; treatment changed in only 3 per cent. © 2000 British Journal of Surgery Society Ltd

R Valdes A Olmos – 3rd expert on this subject based on the ideXlab platform

  • reduction in the number of sentinel lymph node procedures by preoperative ultrasonography of the Axilla in breast cancer
    European Journal of Cancer, 2003
    Co-Authors: Eline E Deurloo, Pieter J Tanis, Kenneth G A Gilhuijs, S H Muller, R Kroger, J L Peterse, E Th J Rutgers, R Valdes A Olmos, L Schultze J Kool

    Abstract:

    Currently, breast cancer patients without clinically suspicious lymph nodes are candidates for sentinel lymph node procedures (SLNPs). The aims of this study were to investigate whether preoperative Axillary ultrasonography and fine-needle aspiration cytology (FNA) can reduce the number of the more time-consuming SLNPs, and to identify a subset of quantitative nodal features to predict metastatic involvement. 268 Axillae were ultrasonographically examined. FNA was performed on suspicious nodes (smallest diameter ⩾5 mm or atypical cortex appearance). SLNP was omitted if a tumour-positive node was found on FNA. Length, width, maximum cortex thickness and appearance of cortex and hilus were ultrasonographically established. In 93 Axillae (35%), at least one node was detected with ultrasound. FNA was performed once per Axilla on 66 nodes; 37 (56%) contained tumour cells. 31% of all tumour-positive Axillae (macro-+micrometastases) was found by ultrasound and FNA (37/121). 41% of all Axillae containing macrometastases was found by ultrasound and FNA (36/87). SLNPs were reduced by 14% (37/268). Maximum cortex thickness is the main feature to predict metastatic involvement (area under Receiver Operating Characteristic (ROC) curve (AZ)=0.87).

  • clinical relevance of sentinel lymph nodes outside the Axilla in patients with breast cancer
    British Journal of Surgery, 2000
    Co-Authors: L Jansen, E Th J Rutgers, R Valdes A Olmos, M H E Doting, J De Vries, O E Nieweg

    Abstract:

    Background

    Lymphatic mapping in patients with breast cancer can reveal sentinel lymph nodes that are not located at level I–II of the Axilla. Little is known about the clinical relevance of these nodes.

    Methods

    Some 113 consecutive patients with clinical stage T1—3 N0 M0 breast cancer were studied. Based on preoperative lymphoscintigraphy, sentinel node biopsy was performed guided by a γ probe and patent blue dye. All sentinel nodes that were visible on lymphoscintigraphy were sought. Pathological examination of the sentinel nodes included step-sections and staining with CAM 5·2. Axillary node dissection was performed regardless of sentinel lymph node status.

    Results

    Twenty-one (19 per cent) of 113 patients had sentinel lymph nodes outside level I–II of the Axilla, mostly in the internal mammary chain. Twenty-two of the 30 sentinel nodes at these sites were harvested. Three patients had sentinel nodes only outside the Axilla. Four other patients had metastases outside the Axilla. This changed postoperative treatment in three patients. No postoperative complication occurred.

    Conclusion

    Sentinel lymph nodes outside level I–II of the Axilla were present in 19 per cent of patients with breast cancer in this series. Biopsy of these nodes was technically demanding but was performed without additional morbidity. The clinical impact was limited; treatment changed in only 3 per cent. © 2000 British Journal of Surgery Society Ltd