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Intraoperative palpation of sentinel lymph nodes can accurately predict axilla in early breast cancer

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Date
2019-01-01
Author
Dinccag, Ahmet Sait
Kulle, Cemil Burak
Onder, Semen
Igci, Abdullah
Ozmen, Vahit
Ersoy, YELİZ EMİNE
Yardimci, ERKAN
Gucin, ZÜHAL
Malya, FATMA ÜMİT
Muslumanoglu, Mahmut
Ozkurt, Enver
Tukenmez, Mustafa
Yilmaz, Ravza
Cabioglu, Neslihan
Karanlik, Hasan
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Type
Article
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Abstract
Recent randomized trials have shown that completion axillary lymph node dissection (ALND) is not required in all patients with a positive sentinel lymph node (SLN) who will receive radiation therapy. Although routine intraoperative pathologic assessment (IPA) becomes unnecessary and less indicated by breast surgeons in the United States and some European countries, it is still widely used all around the world. In this prospective study, the feasibility of intraoperative nodal palpation (INP) as opposed to IPA of the SLN has been analyzed. Between March 2014 and June 2015, 305 patients with clinical T1-2/N0 breast cancer from two different breast clinics (cohort A; [n = 225] and cohort B; [n = 80]) who underwent any breast surgery with sentinel lymph node biopsy (SLNB) were included in this study. Surgeons evaluated the SLNs by manual palpation before sending for IPA, and findings compared with the final pathology. The positive predictive values (PPV) of INP and IPA were 81.8% and 97.9%, respectively, whereas the negative predictive values (NPV) of INP and IPA were 83% and 92.4%. The accuracies of INP and IPA were 82.6% and 94.1%, respectively. If patients with SLNB including micrometastasis were also considered in the final pathologic assessment (FPA) (-) group that would not require a further axillary dissection, the revised NPV of INP and FPA were found to be 92.6% and 98.1%, respectively. The revised accuracy of INP also found to be increase to 86.9%. Our study, which is the only prospective one about palpation of dissected SLNs in the literature, suggests that INP can help to identify patients who do not need ALND, which encourages omitting IPA in cT1-2 N0 breast cancer.
Subject
Ozkurt E., Yardimci E., Tukenmez M., Ersoy Y. E. , Yilmaz R., Cabioglu N., Karanlik H., Kulle C. B. , Malya F. Ü. , Onder S., et al., -Intraoperative palpation of sentinel lymph nodes can accurately predict axilla in early breast cancer-, BREAST JOURNAL, cilt.25, ss.96-102, 2019
URI
https://hdl.handle.net/20.500.12645/6366
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BEZMIALEM VAKIF UNIVERSITY

About us |Policies | Library | Contact us | Send Feedback | Sitemap | Admin

Bezmialem Vakıf Üniversitesi, Adnan Menderes Bulvarı Vatan Caddesi 34093 Fatih, İstanbul / TURKEY
Copyright © Bezmialem Vakıf Üniversitesi

Creative Commons Lisansı
Bezmialem Institutional Repository, Creative Commons Alıntı-GayriTicari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.

OpenAccess@BVU

Support by  UNIREPOS