Smaller is better? Compact vs. Conventional gamma camera for sentinel lymph node localization in patients with breast cancer.

PURPOSE: Sentinel lymph node biopsy (SLNB) has been recognized as "the gold standard" for axillary staging in early breast cancer patients with clinically negative lymph nodes, resulting in significant morbidity decrease and quality of life improvement. This study aims to validate the performance of a newly developed handheld portable gamma camera (PGC) produced by Imagensys (Italy), in detecting and locating sentinel lymph nodes (SLNs) during the preoperative and intraoperative phases in breast cancer patients compared to conventional lymphoscintigraphy. METHODS: Adult female patients with histologically confirmed breast cancer, candidates for surgery and SLNB, were prospectively enrolled in this open-label, pre-marketing clinical trial. All patients underwent pre- operative assessment using both the PGC and conventional lymphoscintigraphy. The performance of the two devices was compared using the Poisson regression model for incidence rate ratios (IRRs). The intrinsic sensitivity of the devices was compared using the Wilcoxon Ranked Sign Test. The utility of PGC during intra-operative procedures was also evaluated. The manoeuvrability of the devices was evaluated using operator-satisfaction questioner. RESULTS: Sixty-eight patients (median age 50 years, BMI 21.4) were enrolled, including two patients with bilateral breast cancer, who underwent SLNB on both axillae. The PGC demonstrated superior preoperative lymph node detection rate (IRR 8.01, 95% CI 6.11-10.50; p < 0.0001) and intrinsic device sensitivity (mean counts per second 409 ± 286 vs. 255 ± 1173 for conventional device, p = 0.0003) compared to the conventional gamma camera. Intra-operative assessment with PGC was performed in 62 patients and no additional lymph nodes were visualised. However, the conventional gamma camera demonstrated superior manoeuvrability (p < 0.0001). CONCLUSION: The PGC handheld gamma camera showed promising results for preoperative SLN assessment in patients with breast cancer. The limited manoeuvrability may be related to the operator's experience leading to higher inter-operator variability. Appropriate training and frequent use of nuclear medicine and surgical equipment could overcome this limitation.

Sentinel lymph node biopsy in cT1-2N0 minor salivary gland cancer in oral cavity.

OBJECTIVE: To evaluate the efficacy of sentinel lymph node biopsy (SLNB) in cT1/2N0 minor salivary gland cancer (mSGC) located within the oral cavity. METHODS: A retrospective analysis was conducted on patients diagnosed with cT1/2N0 oral mSGC, who were categorized into two groups based on neck management approaches. The impact of SLNB versus observation on regional control and overall survival was assessed using a Cox model. RESULTS: A total of 177 patients were included in the study, with 53 cases undergoing SLNB. All patients had at least one sentinel lymph node, with the majority having two sentinel lymph nodes. The sentinel lymph nodes were predominantly situated in level I, followed by level II. Four patients had positive sentinel lymph nodes, all of whom had primary tumors in the tongue or the floor of the mouth, and were classified as cT2 stage. This yielded a sensitivity and specificity of 100%, a false negative rate of 0%, and a negative predictive value of 100% for SLNB in predicting occult metastasis. In terms of regional control, SLNB exhibited a reduced hazard ratio of 0.90 (95% confidence interval: 0.64-0.96) compared to observation. However, SLNB did not confer a superior overall survival benefit compared to observation. CONCLUSION: In patients with cT1/2N0 oral mSGC, SLNB proved to be both technically feasible and oncologically safe. When contrasted with observation, SLNB was associated with enhanced regional control, particularly recommending its use for cases of cT2 mSGC arising from the tongue or the floor of the mouth.

Extrapolating Sentinel Surveillance Information to Estimate National COVID Hospital Admission Rates: A Bayesian Modeling Approach.

The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) was established in March 2020 to monitor trends in hospitalizations associated with SARS-CoV-2 infection. COVID-NET is a geographically diverse population-based surveillance system for laboratory-confirmed COVID-19-associated hospitalizations with a combined catchment area covering approximately 10% of the US population. Data collected in COVID-NET includes monthly counts of hospitalizations for persons with confirmed SARS-CoV-2 infection who reside within the defined catchment area. A Bayesian modeling approach is proposed to estimate US national COVID-associated hospital admission rates based on information reported in the COVID-NET system. A key component of the approach is the ability to estimate uncertainty resulting from extrapolation of hospitalization rates observed within COVID-NET to the US population. In addition, the proposed model enables estimation of other contributors to uncertainty including temporal dependence among reported COVID-NET admission counts, the impact of unmeasured site-specific factors, and the frequency and accuracy of testing for SARS-CoV-2 infection. Based on the proposed model, an estimated 6.3 million (95% uncertainty interval (UI) 5.4-7.3 million) COVID-19-associated hospital admissions occurred in the United States from September 2020 through December 2023. Between April 2020 and December 2023, model-based monthly admission rate estimates ranged from a minimum of 1 per 10,000 population (95% UI 0.7-1.2) in June of 2023 to a highest monthly level of 16 per 10,000 (95% UI 13-19) in January 2022.

Predictive value of methylene blue combined with indocyanine green in sentinel lymph node metastasis in breast cancer: a prospective pilot cohort study.

Background: The status of sentinel lymph nodes is crucial for prognosis and treatment decisions in breast cancer patients. This study aimed to evaluate the predictive value of combined methylene blue and indocyanine green for sentinel lymph node metastasis in breast cancer. Methods: This prospective cohort study enrolled 90 clinically node-negative breast cancer patients. Methylene blue and indocyanine green were injected locally before surgery. Sentinel lymph nodes were grouped based on fluorescence intensity and methylene blue staining. A binary logistic regression model was established using 285 lymph node groups to predict metastatic risk. Results: A total of 475 lymph nodes were identified, with 33 being metastatic. The metastatic risk reached 70% for partially blue-stained and weakly fluorescent lymph nodes between 1-2 cm. The model revealed associations between lymph node size, dye staining patterns, and metastatic risks (P<0.05). The AUC of the ROC curve was 0.855. Conclusions: The staining pattern of combined methylene blue and indocyanine green could predict risks of sentinel lymph node metastasis and facilitate rapid intraoperative identification of high-risk lymph nodes.

Breast and axillary marking in the neoadjuvant setting: survey results from experts of the Brazilian society of mastology.

Introduction/objectives: The precise location of the tumor site is essential for the success of surgical treatment. Neoadjuvant chemotherapy (NAC) is a challenge for preoperative tumor and node localization. Thus, the knowledge and attitudes of the affiliated members of the Brazilian Society of Mastology (SBM) regarding breast and axilla marking were evaluated and a consensus regarding management and treatment was reached. Methods: This was an online survey conducted between June and December 2022. All 1,742 active mastologists affiliated to the SBM were invited anonymously. The online form contained 28 objective questions, of which 22 were formulated on a Likert scale. These questions addressed relevant aspects related to breast and axilla marking in the neoadjuvant setting. Responses that reached 70% agreement were considered consensual. Statistical analysis was performed using the SPSS program version 26.0. Post hoc analysis was performed when appropriate and the significance level was set at p < 0.05. Polychoric regression analyses were conducted using `VGAM` package. Results: In total, 468 mastologists answered the questionnaire (26.8%), with a predominance of professionals aged between 40-49 years (32.1%). Most professionals were board-certified (84,8%). The indication of tumor marking in the breast prior to NAC was consensual (96.4%) and the metal clip was the preferred method (69.7%). There was no consensus regarding the indication of pre-NAC histologically positive lymph node marking (49.8% disagree and 42.8% agree). However, there was consensus that the clinical and imaging evaluation was insufficient for staging the axilla as N1 (71.6%). The contraindication of breast and node marking in T4b tumors (71.2%) was consensual. There was consensus on the indication of sentinel lymph node biopsy (SLNB) for initially cN1 (92.3%) or cN2 (72.7%) tumors that became cN0 after NAC, with 67.5% opting for dual staining with technetium and patent blue. When <3 lymph nodes were retrieved 41.0% of mastologists performed axillary lymphadenectomy. Among the 28 questions, consensus was reached on only 11 (39.3%). Conclusion: The indication of pre-NAC breast marking is consensual among Brazilian mastologists, although axillary nodal marking is not. There is a great divergence of attitudes among Brazilian surgeons in relation to the many issues related to pre-NAC breast and axilla marking.

Assessing para-aortic nodal status in high-grade endometrial cancer patients with negative pelvic sentinel lymph node biopsy.

OBJECTIVE: To determine the accuracy of pelvic sentinel lymph node biopsy (SLN) in detecting positive para-aortic (PA) lymph nodes in high-grade uterine cancer, and to determine the recurrence rate in patients with high-grade uterine cancers who did not receive adjuvant chemotherapy based on negative pelvic SLNs. METHODS: This was a retrospective cohort study of patients with newly diagnosed, high-grade endometrial cancer who underwent surgery, including pelvic SLNs with or without PA node dissection, at a tertiary care institution between 2015 and 2020. Baseline demographics, surgical management, pathology data, and outcomes were analyzed using descriptive statistics, and survival analysis. RESULTS: Postoperative histology of the 110 patients meeting inclusion criteria was 45.5% grade 3 endometrioid, 36.4% serous, 10.9% clear cell, and 7.3% carcinosarcoma. On final pathology, 63.7% were stage 1, and 23.6% were stage 3C with positive nodes. A total of 63 patients (57.3%) had a PA lymph node dissection (56 bilateral, 7 unilateral) in addition to the pelvic SLN. Among this group, 5.8% (95% confidence interval 1.2%-16.0%) had a positive PA node despite a negative pelvic SLN. Among those with a negative pelvic SLN and no adjuvant chemotherapy (n = 75), the rate of distant recurrence was 14.7%, and 3-year recurrence-free survival was 71.9%. CONCLUSION: The rate of isolated PA node metastasis in high-grade endometrial cancers despite a negative pelvic SLN may be significantly higher than the accepted rate of isolated PA node metastasis in low-grade endometrial cancer. This supports adjuvant treatment decisions continuing to incorporate primary tumor pathology and molecular classification.

Real-World Implications of the SOUND Trial.

BACKGROUND: The SOUND trial demonstrated that omission of sentinel lymph node biopsy (SLNB) is noninferior to axillary staging in patients with early-stage breast cancer (BC) and negative axillary ultrasound (AxUS). We examined the generalizability of these findings in patients with hormone receptor (HR)+HER2- disease. METHODS: Patients with cT1N0M0, HR+HER2- BC and negative AxUS undergoing breast conservation with SLNB from 2016 to 2023 were identified from a prospectively maintained database. Clinicopathologic characteristics, disease burden, adjuvant treatment, and oncologic outcomes were examined and compared with the SLNB arm of the SOUND trial. In postmenopausal patients, the impact of nodal status and 21-gene recurrence score on chemotherapy recommendations were also examined. RESULTS: Of 3972 patients with cT1N0M0 HR+HER2- breast cancer, 544 underwent AxUS; 312 met SOUND eligibility criteria. Median age was 57 (interquartile range [IQR] 48-64) years, and 199 (63.8%) were postmenopausal. Median (IQR) tumor size was 1.3 (0.9-1.7) cm, and 260 (83.3%) tumors were grade 1 or 2. Sentinel lymph node biopsy was positive in 38 (12.2%) patients. Only three (0.4%) had ≥ 4 positive lymph nodes. At a median follow-up of 26.2 (IQR 10.8-38.2) months, there were no axillary recurrences and one (0.3%) distant recurrence. Among postmenopausal women with recurrence score ≤ 25, chemotherapy recommendations were not associated with nodal status. CONCLUSIONS: Examination of our real-world HR+ HER2- "SOUND-eligible" population suggests that nodal disease burden and oncologic outcomes are similar to the SOUND trial population, supporting careful implementation of trial results into multidisciplinary practice. In postmenopausal patients, omission of SLNB does not appear to impact adjuvant chemotherapy recommendations.

Sexually transmitted infections in Belgian general practices: a nationwide continuing surveillance study, data from 2015 to 2020.

AIM: The current study aims at describing sexually transmitted infections (STI) surveillance data collected from 2015 to 2020 as well as investigating patients' characteristics and risk factors in the sample population. BACKGROUND: Reported STI cases are continuously increasing in Europe. In Belgium, 94.1% of citizens have a regular general practitioner (GP) or are affiliated to a general practice. By using GPs for surveillance, STIs can be monitored in the general population. Between January 2015 and December 2020, the Sentinel General Practitioners (SGP) network retrospectively reported five STIs: chlamydia, gonorrhoea, genital warts, herpes, and syphilis. METHODS: In the SGP network database on STIs, participating GPs report on case-by-case basis through paper or online registration forms. We performed descriptive statistics, X2 test and logistic regression using SAS® 9.4. Multivariate multiple logistic regression was performed to investigate the relationship between STIs and patients' characteristics. FINDINGS: During the study period, 1009 cases were reported, corresponding to an episode-based incidence estimated at 121 per 100,000 inhabitants. The majority of patients (59.8%) were men, and 83.6% were under age 30. Among female patients 92.7% had heterosexual contacts whereas 64.4% of male patients did. Women were more likely to be diagnosed with chlamydia (odds ratio [OR] 1.56; 95% confidence interval [CI] 1.12-2.17) and herpes (OR 1.72, 95% CI 1.04-2.86) than men.In this study, STI surveillance data were in agreement with literature. Continuous surveillance through the SGP network remains an important tool to obtain information about populations at risk and STI incidence in the general population.

The impact of Substantial LYMphovascular space invasion on sentinel lymph nodes status and recurrence in Endometrial Cancer patients: SLYM-EC a multicenter retrospective study.

INTRODUCTION: To evaluate the prognostic impact of substantial lymph vascular space invasion (LVSI) on the sentinel lymph node involvement and recurrence rate of patients with apparent uterine-confined endometrial cancer. MATERIALS AND METHODS: We enrolled consecutive patients with apparent confined endometrial cancer who underwent surgical staging with sentinel node mapping from 14 European reference centers. LVSI was analyzed semi-quantitatively, according to a 3-tiered scoring system classified as absent, focal, and substantial. RESULTS: Among 2352 eligible patients, 1980 were included in the analysis. Upon final pathology 226 patients (11.4 %) had SLNs involvement. LVSI was diagnosed focal in 152 patients (7.7 %), whereas 357 patients (18.0 %) showed substantial LVSI. Focal or substantial LVSI rate were significantly higher in patients with positive SLNs when compared to patients without SLNs involvement (p < 0.0001). On overall patient-based analysis, the sensitivity, specificity, positive predictive value, and negative predictive value of LVSI for sentinel lymph node metastases were 73 %, 80 %, 32 %, and 96 %, respectively. The 3-year multivariate analysis of recurrence-free survival showed that only the presence of substantial LVSI, and grade 3 disease were associated with relapse. Neither positive sentinel lymph node, deep myometrial infiltration, nor age at surgery were statistically significant. CONCLUSIONS: In patients having undergone sentinel node biopsy, positive LVSI demonstrated moderate sensitivity and reasonable specificity in detecting SLN involvement. LVSI positivity does not correlate with nodal involvement. The presence of substantial LVSI remains a strong independent risk factor for recurrence, indicating a role for potential hematogenous dissemination in patients with early-stage disease.

How Many Sentinel Lymph Nodes Should We Excise in Patients With Melanoma?

INTRODUCTION: The management of many patients with early-stage melanoma includes sentinel lymph node (SLN) biopsy for prognostic and treatment planning purposes. While the minimum necessary number of SLNs to examine has been determined for patients with other malignancies, it has not been delineated in melanoma. The current study evaluates risk factors for SLN positivity and the associated number of SLNs that are necessary to examine for appropriate staging. MATERIALS AND METHODS: The National Cancer Database participant user file from 2018 to 2020 was queried for clinically node-negative patients who underwent SLN biopsy. Descriptive statistics were obtained. Analysis of variance statistical analyses were performed. RESULTS: Eight thousand forty eight melanoma patients out of 48,748 were identified from 2018 to 2020 that had lymph node positivity on SLN biopsy. The median age of patients was 64. The male-to-female ratio was 1.47. Chi-squared analysis revealed that there was a statistically significant difference in positivity rate between at least two groups (P = 0.006) for primary melanoma site, male sex (P < 0.01), race, age, histologic type, Breslow thickness, and lymphovascular invasion (P < 0.001). SLN positivity rate increased with the number of SLNs examined until plateauing at 4 SLNs. There was no statistical difference between positivity for 3 SLNs and larger numbers of SLNs examined. Propensity matching revealed no statistically significant difference in positive rate when more than 2 SLNs were biopsied. CONCLUSIONS: SLN positivity is proportionally related to the number of SLNs examined, suggesting that surgeons should attempt to remove a minimum of 2 SLNs for the optimal staging of patients with melanoma.

[Diagnostic value of fluorescence lymphography for sentinel lymph node biopsy in breast cancer. Summary experience of several specialized centers]. / Diagnosticheskaya tsennost' flyuorestsentnoi limfografii dlya biopsii signal'nykh limfaticheskikh uzlov pri rake molochnoi zhelezy. Obobshchayushchii opyt neskol'kikh spetsializirovannykh tsentrov.

OBJECTIVE: To study the diagnostic value of fluorescent lymphography for sentinel lymph node biopsy in breast cancer. MATERIAL AND METHODS: The cohort study, conducted at 4 specilized centers between June 2019 and March 2024, included 333 patients with cT1-4 N0-1M0 breast cancer. 50 patients received neoadjuvant systemic therapy, 14 of them had single metastases, confirmed by cytological or histological methods, which clinically completely regressed after systemic treatment. Immediately before the operation, 1 ml (5mg) of indocyanine green was injected subareolarly or subcutaneously into the tumor projection. Fluorescence imaging was performed using various devices for ICG navigation in the open surgical field - MARS, IC-Flow, Stryker SPY-PHI, IC-GOR. In 78 patients after sentinel lymph node biopsy standard axillary lymphadenectomy was performed. RESULTS: Detection level was 99.1%. The average number of sentinel lymph nodes was 3.4. Metastatic lesions of sentinel lymph nodes were detected in 54 of 330 patients (16.4%). The average number of metastatic lymph nodes was 1.6; in 90.7% of cases metastases to 1-2 lymph nodes were registered. Intraoperative morphological examination revealed metastases only in 59% of cases. No systemic adverse events were recorded. The false-negative error rate in the group of patients who underwent axillary lymphadenectomy was 6.6%. The overall accuracy of fluorescent lymphography for sentinel lymph node biopsy in breast cancer was 94%. CONCLUSION: The SLNB technique using fluorescence lymphography is safe and highly accurate as a stand-alone method.

Prognostic impact of lateral sentinel lymph node biopsy using indocyanine green on oncological outcomes for clinical stage II/III lower rectal cancer without suspected lateral lymph node metastasis.

PURPOSE: Sentinel lymph node biopsy (SLNB) can detect occult nodal metastasis. We have previously reported the safety and feasibility of indocyanine green (ICG)-guided SLNB for clinical stage II/III lower rectal cancer (RC). However, little is known about the influence of lateral pelvic SLNB using ICG on oncological outcomes. The present study aimed to evaluate the prognostic impact of lateral pelvic SLNB on oncological outcomes compared with prophylactic lateral lymph node dissection (LLND). METHODS: Participants comprised consecutive patients with clinical stage II/III lower RC who underwent lateral pelvic SLNB or prophylactic LLND (Non-SLNB) between January 2010 and December 2020. The primary outcome measure was the 5-year cumulative incidence of local recurrence (LR). Secondary endpoints included cancer-specific survival (CSS), overall survival (OS), recurrence-free survival (RFS), local recurrence-free survival (LRFS), and distant recurrence-free survival (DRFS). RESULTS: Among the 150 eligible patients included, 79 patients underwent lateral pelvic SLNB. Of those 79 patients, 4 patients who were SLNB-positive underwent LLND. LLND was omitted for the 75 patients who were SLNB-negative. Median follow-up was 61.0 months (range, 1.3-143.2 months). The overall recurrence rate was 30.7% (46 patients), with LR in 12.0% (18 patients). LR comprised lateral lymph node recurrence in 2.6% and central pelvic recurrence in 9.4%. No significant differences were seen between groups in terms of the frequency of LR or in CSS, OS, RFS, LRFS, or DRFS. CONCLUSION: Oncological outcomes were not different between the SLNB and Non-SLNB groups. ICG-guided SLNB appears promising as a method for determining indications for LLND.

Enhancing Coffee Agroforestry Systems Suitability Using Geospatial Analysis and Sentinel Satellite Data in Gedeo Zone, Ethiopia.

The Gedeo zone agroforestry systems are the main source of Ethiopia's coffee beans. However, land-use and suitability analyses are not well documented due to complex topography, heterogeneous agroforestry, and lack of information. This research aimed to map the coffee coverage and identify land suitability for coffee plantations using remote sensing, Geographic Information Systems (GIS), and the Analytical Hierarchy Process (AHP) in the Gedeo zone, Southern Ethiopia. Remote sensing classifiers often confuse agroforestry and plantations like coffee cover with forest cover because of their similar spectral signatures. Mapping shaded coffee in Gedeo agroforestry using optical or multispectral remote sensing is challenging. To address this, the study identified and mapped coffee coverage from Sentinel-1 data with a decibel (dB) value matched to actual coffee coverage. The actual field data were overlaid on Sentinel-1, which was used to extract the raster value. Pre-processing, classification, standardization, and reclassification of thematic layers were performed to find potential areas for coffee plantation. Hierarchy levels of the main criteria were formed based on climatological, edaphological, physiographic, and socioeconomic factors. These criteria were divided into 14 sub-criteria, reclassified based on their impact on coffee growing, with their relative weights derived using AHP. From the total study area of 1356.2 km2, the mapped coffee coverage is 583 km2. The outcome of the final computed factor weight indicated that average annual temperature and mean annual rainfall are the primary factors, followed by annual mean maximum temperature, elevation, annual mean minimum temperature, soil pH, Land Use/Land Cover (LULC), soil texture, Cation Exchange Capacity (CEC), slope, Soil Organic Matter (SOM), aspect, distance to roads, and distance to water, respectively. The identified coffee plantation potential land suitability reveals unsuitable (413 km2), sub-suitable (596.1 km2), and suitable (347.1 km2) areas. This study provides comprehensive spatial details for Ethiopian cultivators, government officials, and agricultural extension specialists to select optimal coffee farming locations, enhancing food security and economic prosperity.

Eligibility for Adjuvant Cyclin-Dependent Kinase 4/6 Inhibitors in Endocrine Receptor-Positive and HER2-Negative Early Breast Cancer by Age and Type of Surgery.

Background: Despite early diagnosis, approximately 20% of patients with ER-positive and HER2-negative breast cancer (BC) will experience disease recurrence. Improved survival has been reported with adjuvant treatment combining cyclin-dependent kinase 4/6 inhibitors with endocrine therapy, in high-risk patients with ER-positive and HER2-negative BC, regardless of age. Older patients have higher rates of ER-positive/HER2-negative BC than younger patients. Methods: In this real-world data analysis, MonarchE and NataLEE high-risk patients accounted for 9.5% and 33% of patients undergoing upfront surgery, respectively. Significantly higher eligibility rates were observed in patients who underwent a mastectomy, >70 years and ≤40 years for adjuvant abemaciclib and ribociclib, and in patients >80 years for ribociclib. Results: Eligibility rates in patients ≤40 years and >80 years who underwent mastectomy were 27.8% and 24.7% for abemaciclib, respectively, and 56.6% and 65.2% for ribociclib, respectively. A higher discontinuation rate for abemaciclib was reported in patients aged ≥65 years and it can be assumed that discontinuation rates may increase in even older patients. Conclusions: If the results of the NataLEE trial translate into clinical practice, the number of patients potentially eligible for adjuvant CDK4/6 inhibitors may increase, especially in the elderly population.

Lymphatic mapping in second primary or recurrent oral cavity cancer with prior neck treatment: A case series and scoping review.

OBJECTIVES: Lymphatic mapping is an established technique to map drainage patterns in oral cancer. Its utility in patients who have undergone prior radiation or neck dissection is not well studied. METHODS: Patients presenting to a single tertiary cancer center between 2021-2023 for a recurrent/second oral cancer that underwent lymphatic mapping were considered. All patients had a history of a head and neck cancer treated with either radiation or neck dissection. We further conducted a scoping review in MEDLINE, Embase, and Web of Science of lymphatic mapping in oral cancer patients with previous neck treatment. RESULTS: In our single center review, a total of 11 patients were included. 73 % received prior radiotherapy and 55 % underwent prior neck dissections for a head and neck cancer. Lymphoscintigraphy-directed neck dissections identified sentinel nodes in 9/11 patients, with only one patient who had positive sentinel node disease. There were no reports of regional recurrence at a median of 10 months follow-up. Our scoping review of 980 studies identified 151 additional patients who underwent sentinel node biopsy for a second oral cancer after previous neck treatment. Overall, the negative predictive value of lymphatic mapping in all studies was 96.7 %. CONCLUSION: Lymphatic mapping is feasible in secondary or recurrent oral cavity cancers even in patients with prior radiation or surgical management of the neck. The literature to date demonstrates a negative predictive value of âˆ¼ 97 % for sentinel node mapping and warrants further consideration in the management of salvage oral cancer.

The value of chromosome instability detected by low-pass whole-genome sequencing in preoperative prediction of sentinel lymph node metastasis in breast cancer.

Background: Breast cancer is a malignancy characterized by chromosomal instability (CIN). This study aimed to examine the potential diagnostic value of chromosomal instability, detected by low-pass whole-genome sequencing (LPWGS), in the preoperative evaluation of sentinel lymph node metastasis (SLNM) in breast cancer. Methods: A retrospective investigation of clinical records from 29 patients with breast cancer revealed two distinct groups based on sentinel lymph node biopsy (SLNB) results: the SLN metastasis group (24 cases) and the SLN non-metastasis group (five cases). CIN and CIN scores were evaluated using LPWGS. An analysis of univariate data and binary logistic regression was employed to identify factors influencing SLNM, and a curve with receiver operating characteristics (ROC) was constructed to assess the diagnostic utility of CIN in predicting SLNM. Results: A significant association between the SLNM and CIN high groups was observed in breast cancer (P=0.011). The CIN score in the metastasis group (17,665.055 ± 8,630.691) was higher than that in the non-metastasis group (9,247.973 ± 3,692.873), demonstrating a significant difference (P=0.044). Univariate binary logistic regression analysis indicated that CIN was a significant predictor for SLNM (odds ratio: 4.036, 95% CI: 1.015-16.047, P=0.048). The AUC of CIN for preoperative diagnosis of SLNM was 0.808 (95%CI: 0.635-0.982, P=0.033), with a sensitivity value of 67.0% and specificity of 100.0% at a threshold of 13,563. Conclusion: Detecting CIN through LPWGS demonstrates diagnostic potential in predicting SLNM in patients with breast cancer before surgery. This approach offers a novel method for assessing axillary lymph node status in clinical practice.