Brittany Z Dashevsky1, Ashley Altman2, Hiroyuki Abe3, Nora Jaskowiak4, Jean Bao5, David V Schacht6, Deepa Sheth7, Kirti Kulkarni8. 1. University of Chicago Medical Center, Department of Radiology, Chicago, IL 60637, United States. Electronic address: Brittany.Dashevsky@ucsf.edu. 2. University of Chicago Medical Center, Department of Radiology, Chicago, IL 60637, United States. Electronic address: Ashley.Altman@uchospitals.edu. 3. University of Chicago Medical Center, Department of Radiology, Chicago, IL 60637, United States. Electronic address: habe@radiology.bsd.uchicago.edu. 4. University of Chicago Medical Center, Department of Surgery, Chicago, IL 60637, United States. Electronic address: njaskowi@surgery.bsd.uchicago.edu. 5. University of Chicago Medical Center, Department of Surgery, Chicago, IL 60637, United States. Electronic address: jbao@surgery.bsd.uchicago.edu. 6. University of Chicago Medical Center, Department of Radiology, Chicago, IL 60637, United States. Electronic address: dschacht@radiology.bsd.uchicago.edu. 7. University of Chicago Medical Center, Department of Radiology, Chicago, IL 60637, United States. Electronic address: DSheth@radiology.bsd.uchicago.edu. 8. University of Chicago Medical Center, Department of Radiology, Chicago, IL 60637, United States. Electronic address: kkulkarni@radiology.bsd.uchicago.edu.
Abstract
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.
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 cancerpatients (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.
Authors: Sabine R de Wild; Janine M Simons; Marie-Jeanne T F D Vrancken Peeters; Marjolein L Smidt; Linetta B Koppert Journal: Breast Care (Basel) Date: 2021-08-17 Impact factor: 2.860
Authors: Janine M Simons; Thiemo J A van Nijnatten; Carmen C van der Pol; Ernest J T Luiten; Linetta B Koppert; Marjolein L Smidt Journal: Ann Surg Date: 2019-03 Impact factor: 12.969
Authors: Daan Hellingman; Maarten L Donswijk; Gonneke A O Winter-Warnars; Petra de Koekkoek-Doll; Marilyn Pinas; Yvonne Budde-van Namen; Johan Westerga; Marie-Jeanne T F D Vrancken Peeters; Nikola Kimmings; Marcel P M Stokkel Journal: EJNMMI Res Date: 2019-10-24 Impact factor: 3.138