The Role of Sentinel Lymph Node Biopsy in Patients With B5c Breast Cancer Diagnosis.


Journal

In vivo (Athens, Greece)
ISSN: 1791-7549
Titre abrégé: In Vivo
Pays: Greece
ID NLM: 8806809

Informations de publication

Date de publication:
Historique:
received: 25 10 2019
revised: 04 11 2019
accepted: 15 11 2019
entrez: 29 12 2019
pubmed: 29 12 2019
medline: 10 6 2020
Statut: ppublish

Résumé

The histopathological assessment of the B5c category may sometimes be hampered by simple artifacts that may lead to over- or underestimation of that particular breast cancer so that its management is still controversial, especially with regard to the decision to proceed immediately to sentinel lymph node (SLN) biopsy. Hence, a retrospective study was performed in 174 patients undergoing breast-conserving surgery with a preoperative diagnosis of B5c in order to assess the usefulness of axillary node staging by means of SLN biopsy. Pre- and post-operative parameters including imaging data, histology of the primary tumor and SLN biopsy, biological prognostic factors, type of operation, and adjuvant regimens were computed. Invasive carcinoma and carcinoma in situ were diagnosed in 46 (26.5%) and 128 patients (73.5%), respectively. Preoperative tumor size was significantly related to post-operative diagnosis of invasive carcinoma (p=0.020), retaining its predictive value at logistic regression analysis (p=0.046). Post-operative predictive factors of invasion were represented by tumor stage (p=0.008) and grading (p=0.008). B5c preoperative diagnosis in patients undergoing breast conservative surgery would suggest an immediate wide local excision avoiding any further preoperative histologic assessment. Conversely, one-stage SLN biopsy might be suggested for patients eligible to mastectomy, similar to patients with carcinoma in situ, although its impact on the therapeutic and prognostic assessment seems negligible.

Sections du résumé

BACKGROUND/AIM OBJECTIVE
The histopathological assessment of the B5c category may sometimes be hampered by simple artifacts that may lead to over- or underestimation of that particular breast cancer so that its management is still controversial, especially with regard to the decision to proceed immediately to sentinel lymph node (SLN) biopsy. Hence, a retrospective study was performed in 174 patients undergoing breast-conserving surgery with a preoperative diagnosis of B5c in order to assess the usefulness of axillary node staging by means of SLN biopsy.
PATIENTS AND METHODS METHODS
Pre- and post-operative parameters including imaging data, histology of the primary tumor and SLN biopsy, biological prognostic factors, type of operation, and adjuvant regimens were computed.
RESULTS RESULTS
Invasive carcinoma and carcinoma in situ were diagnosed in 46 (26.5%) and 128 patients (73.5%), respectively. Preoperative tumor size was significantly related to post-operative diagnosis of invasive carcinoma (p=0.020), retaining its predictive value at logistic regression analysis (p=0.046). Post-operative predictive factors of invasion were represented by tumor stage (p=0.008) and grading (p=0.008).
CONCLUSION CONCLUSIONS
B5c preoperative diagnosis in patients undergoing breast conservative surgery would suggest an immediate wide local excision avoiding any further preoperative histologic assessment. Conversely, one-stage SLN biopsy might be suggested for patients eligible to mastectomy, similar to patients with carcinoma in situ, although its impact on the therapeutic and prognostic assessment seems negligible.

Identifiants

pubmed: 31882499
pii: 34/1/355
doi: 10.21873/invivo.11781
pmc: PMC6984094
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

355-359

Informations de copyright

Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Références

Breast Care (Basel). 2018 Oct;13(5):324-330
pubmed: 30498416
Eur J Surg Oncol. 2019 Feb;45(2):147-152
pubmed: 30482543
Radiology. 1996 Feb;198(2):323-5
pubmed: 8596825
Adv Anat Pathol. 1998 Nov;5(6):367-72
pubmed: 10095878
Eur J Surg Oncol. 2015 Jan;41(1):86-93
pubmed: 25441934
J Clin Oncol. 2005 Oct 20;23(30):7703-20
pubmed: 16157938
Curr Oncol Rep. 2015 Nov;17(11):48
pubmed: 26373411
Semin Oncol. 2004 Jun;31(3):324-32
pubmed: 15190489
Cancer. 2003 Nov 15;98(10):2105-13
pubmed: 14601079
Breast Cancer. 2016 Jul;23(4):640-8
pubmed: 25981971
Eur J Cancer. 2017 Nov;86:59-81
pubmed: 28963914

Auteurs

Piero Fregatti (P)

School of Medicine, University of Genoa, Genoa, Italy.
Breast Surgery Clinic, San Martino Policlinic Hospital, Genoa, Italy.

Marco Gipponi (M)

Breast Surgery Clinic, San Martino Policlinic Hospital, Genoa, Italy marco.gipponi@hsanmartino.it.

Raquel Diaz (R)

Breast Surgery Clinic, San Martino Policlinic Hospital, Genoa, Italy.

Raffaele DE Rosa (R)

School of Medicine, University of Genoa, Genoa, Italy.

Federica Murelli (F)

School of Medicine, University of Genoa, Genoa, Italy.
Breast Surgery Clinic, San Martino Policlinic Hospital, Genoa, Italy.

Francesca Depaoli (F)

Breast Unit, ASL3, Genoa, Italy.

Francesca Pitto (F)

Pathology Unit, San Martino Policlinic Hospital, Genoa, Italy.

Ilaria Baldelli (I)

School of Medicine, University of Genoa, Genoa, Italy.
Plastic Surgery, San Martino Policlinic Hospital, Genoa, Italy.

Gabriele Zoppoli (G)

School of Medicine, University of Genoa, Genoa, Italy.
Department of Internal Medicine, San Martino Policlinic Hospital, Genoa, Italy.

Marcello Ceppi (M)

Biostatistics Unit, San Martino Policlinic Hospital, Genoa, Italy.

Daniele Friedman (D)

School of Medicine, University of Genoa, Genoa, Italy.
Breast Surgery Clinic, San Martino Policlinic Hospital, Genoa, Italy.

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