Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 5 de 5
Filter
1.
World J Surg ; 30(9): 1653-7, 2006 Sep.
Article in English | MEDLINE | ID: mdl-16927059

ABSTRACT

OBJECTIVE: The aim of this retrospective study was to identify biological features of primary breast cancer from which to predict the presence of further axillary involvement in patients bearing micrometastases in the sentinel lymph node (SLN). METHODS: From a starting group of 690 patients, we isolated patients with micrometastases in the SLN. Those patients were classified according to the presence/absence of further metastases in nonsentinel lymph nodes (NSLNs). We examined primary tumor features to identify any relevant difference. Analysis of primary tumors evaluated histology, tumor size, lymphovascular invasion, mitotic index (Mib-1), estrogen and progesterone receptor status (ER/PR status), C-erb B-2 (HER-2/neu) expression and amplification, and p53 expression. Chi square analysis for statistical significance was applied. RESULTS: Of the original 690 patients, 296 showed some kind of metastases in the SLN; 238 patients had gross metastases in the SLN. After axillary lymph node dissection (ALND), 102 patients (43%) had NSLNs with metastases, and 136 (57%) had negative axillary non-sentinel nodes. Another 58 patients harbored solitary micrometastases in the SLN. After ALND, 8 (14%) patients had further NSLN involvement, and 50 (86%) had negative axillary nodes. CONCLUSIONS: Analysis of the primary breast lesion in patients with micrometastatic SLN and metastatic NSLNs revealed the presence of lymphovascular invasion, Mib-1 index > 10%, and tumor size > 2 cm. Patients without lymphovascular invasion, Mib-1 < 10% and T size < 2 cm could avoid further ALND.


Subject(s)
Breast Neoplasms/pathology , Sentinel Lymph Node Biopsy , Adult , Aged , Aged, 80 and over , Carcinoma, Ductal, Breast/pathology , Chi-Square Distribution , Female , Humans , Lymphatic Metastasis/pathology , Middle Aged , Mitotic Index , Neoplasm Invasiveness
2.
Surg Endosc ; 20(9): 1341-7, 2006 Sep.
Article in English | MEDLINE | ID: mdl-16703435

ABSTRACT

BACKGROUND: Several techniques for localizing pulmonary nodules have been described, but the advantages and disadvantages of each method remain unclear. We reviewed ultrasound, endofinger, finger palpation and wait and watch, radioguided, vital dye, fluoroscopic, agar marking, and needle wire methods for localizing pulmonary nodules. METHODS: Original, peer-reviewed, and full-length articles in English were searched with PubMed and ISI Web of Sciences. Case reports and case series with less than 10 patients were excluded. RESULTS: All localization techniques showed good reliability, but some carry a high rate of major or minor complications and drawbacks. CONCLUSION: No ideal localization technique is available; thus, the choice still depends on surgeon's preference and local availability of both specialists and instruments.


Subject(s)
Solitary Pulmonary Nodule/diagnosis , Thoracoscopy/methods , Humans
3.
Eur J Surg Oncol ; 31(7): 715-20, 2005 Sep.
Article in English | MEDLINE | ID: mdl-16005176

ABSTRACT

AIMS: To determine the axillary recurrence rate in breast cancer patients with negative sentinel lymph nodes (SLN) who did not undergo further axillary lymph node dissection (ALND), and to establish whether this conservative axillary approach leads to an increased recourse to diagnostic axillary biopsy during the follow-up period because of the clinical suspicion of nodal recurrence. METHODS: In 479 patients, operated on for early breast cancer between 1998 and 2002 in five institutions, SLN biopsy was negative and no further axillary surgery was performed. SLN was localized using subdermal injection with 30-50 MBq of 99m-Tc-colloidal albumin. Follow-up controls were performed at 6-monthly intervals. RESULTS: The mean number of SLNs removed was 1.4 per patient. Most patients (90.6%) were given adjuvant systemic therapy, based on the primary tumour characteristics. At a median follow-up of 35.8 months, no clinical axillary recurrence was found. No patient underwent surgical axillary biopsy for suspicious clinical or ultrasonographic findings. CONCLUSIONS: Our results confirm that SLN biopsy without ALND in SLN-negative patients with early breast cancer is not followed by clinically evident axillary recurrence in the short-term.


Subject(s)
Breast Neoplasms/pathology , Neoplasm Recurrence, Local , Sentinel Lymph Node Biopsy , Adult , Aged , Aged, 80 and over , Axilla , Case-Control Studies , Female , Follow-Up Studies , Humans , Lymph Node Excision , Middle Aged , Prognosis
SELECTION OF CITATIONS
SEARCH DETAIL