TY - JOUR
T1 - Lymph node wire localization post-chemotherapy
T2 - Towards improving the false negative sentinel lymph node biopsy rate in breast cancer patients
AU - Dashevsky, Brittany Z.
AU - Altman, Ashley
AU - Abe, Hiroyuki
AU - Jaskowiak, Nora
AU - Bao, Jean
AU - Schacht, David V
AU - Sheth, Deepa
AU - Kulkarni, Kirti
PY - 2018/3
Y1 - 2018/3
N2 - Purpose To evaluate whether the disease status of the pre-neoadjuvant chemotherapy (NAC) core biopsied lymph node (preNACBxLN) in patients with node positive breast cancer corresponds to nodal status of all surgically retrieved lymph nodes (LNs) post-NAC and whether wire localization of this LN is feasible. Materials and methods HIPPA compliant IRB approved retrospective study including breast cancer patients (a.) with preNACBxLN confirmed metastases, (b.) who received NAC, and (c.) underwent wire localization of the preNACBxLN. Electronic medical records were reviewed. Fisher's exact test was used to compare differences in residual disease post-NAC among breast cancer subtypes. Results 28 women with node positive breast cancer underwent ultrasound guided wire localization of the preNACBxLN, without complication. There was no evidence of residual nodal disease for 16 patients, with mean 4.4 (median 4) LNs resected. 12 patients had residual nodal metastases, with mean 9.2 (median 7) LNs resected and mean 2.3 (median 2) LNs with tumor involvement. 11 patients had metastases detected within the localized LN. One patient had micrometastasis in a sentinel LN, despite no residual disease in the preNACBxLN. Patients with luminal A/B breast cancer more often had residual nodal metastases (86%) at pathology, as compared to patients with HER2 + (20%) and Triple Negative breast cancer (50%), though not quite achieving statistical significance (p = 0.055). Conclusion Ultrasound guided wire localization of the preNACBxLN is feasible and may improve detection of residual tumor in patients post-NAC.
AB - Purpose To evaluate whether the disease status of the pre-neoadjuvant chemotherapy (NAC) core biopsied lymph node (preNACBxLN) in patients with node positive breast cancer corresponds to nodal status of all surgically retrieved lymph nodes (LNs) post-NAC and whether wire localization of this LN is feasible. Materials and methods HIPPA compliant IRB approved retrospective study including breast cancer patients (a.) with preNACBxLN confirmed metastases, (b.) who received NAC, and (c.) underwent wire localization of the preNACBxLN. Electronic medical records were reviewed. Fisher's exact test was used to compare differences in residual disease post-NAC among breast cancer subtypes. Results 28 women with node positive breast cancer underwent ultrasound guided wire localization of the preNACBxLN, without complication. There was no evidence of residual nodal disease for 16 patients, with mean 4.4 (median 4) LNs resected. 12 patients had residual nodal metastases, with mean 9.2 (median 7) LNs resected and mean 2.3 (median 2) LNs with tumor involvement. 11 patients had metastases detected within the localized LN. One patient had micrometastasis in a sentinel LN, despite no residual disease in the preNACBxLN. Patients with luminal A/B breast cancer more often had residual nodal metastases (86%) at pathology, as compared to patients with HER2 + (20%) and Triple Negative breast cancer (50%), though not quite achieving statistical significance (p = 0.055). Conclusion Ultrasound guided wire localization of the preNACBxLN is feasible and may improve detection of residual tumor in patients post-NAC.
KW - Breast cancer
KW - Lymph node localization
KW - Neoadjuvant chemotherapy
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U2 - 10.1016/j.clinimag.2017.10.003
DO - 10.1016/j.clinimag.2017.10.003
M3 - Article
C2 - 29035756
AN - SCOPUS:85031091341
VL - 48
SP - 69
EP - 73
JO - Clinical Imaging
JF - Clinical Imaging
SN - 0899-7071
ER -