Probe-Assisted Axillary Lymph Node Biopsy Compared with Axillary Dissection in Breast Cancer: A Retrospective Study from the West of Iran
Authors: Morteza Alizadeh Foroutan, Hassan Moayeri, Keivan Sabooni, Motahareh Rouhi Ardeshiri
Abstract:
Breast cancer incidence is annually increasing in various parts of the world, and sentinel lymph node biopsy (SLNB) has turned into a new standard for care as a staging process in this regard. In the present study, the gamma probe technique was used for SLNB as a safe method with more accuracy and less complications. The study sought to compare the results of two surgical techniques, namely, axillary lymph node dissection (ALND) and SLNB, including epidemiological results and clinicopathological features of BC patients from the western provinces of Iran. In general, 420 BC women were identified who referred to the breast clinic in Sanandaj, Kurdistan province during 2017-2021. Of whom, 318 patients underwent breast surgery, and from these patients, 277 cases participated in the current study. Patients were divided into those undergoing ALND and SLNB. The criteria for complete dissection or axillary biopsy using the gamma probe were based on the results of clinical examinations and the presence of palpable lymph nodes. Overall complications after surgery belonged to 58 (18.9%) cases, including 15 (25.9%) and 43 (74.1%) patients in the SLNB and ALND groups, respectively (P = 0.74). Based on the findings, Seroma (60.3%) was the most reported complication in each group. Most patients had tumors in the upper-outer quadrant of their left breast. The mean of the tumor dimension in the SLNB and ALND groups was 2.1 ± 1.3 cm and 3.2 ± 1.8 cm, respectively, (P = 0.003). The benefits of breast-conserving surgery (BCS) with the SLNB technique are clearly undeniable and can be considered a method with less complications and a better prognosis. Accordingly, SLNB and BCS are favorable methods that can be performed, along with gamma probe technique, which is safe and accurate.
Keywords: Breast cancer, Sentinel lymph node biopsy, Axillary lymph node dissection, Gamma probe.
Procedia APA BibTeX Chicago EndNote Harvard JSON MLA RIS XML ISO 690 PDF Downloads 55References:
[1] Barthelmes L, Goyal A, Newcombe RG, McNeill F, Mansel RE, New S, groups As (2010) Adverse reactions to patent blue V dye - The NEW START and ALMANAC experience. Eur J Surg Oncol 36:399-403. doi: 10.1016/j.ejso.2009.10.007
[2] Bilimoria KY, Bentrem DJ, Hansen NM, Bethke KP, Rademaker AW, Ko CY, Winchester DP, Winchester DJ (2009) Comparison of sentinel lymph node biopsy alone and completion axillary lymph node dissection for node-positive breast cancer. J Clin Oncol 27:2946-2953. doi: 10.1200/JCO.2008.19.5750
[3] Bray F, McCarron P, Parkin DM (2004) The changing global patterns of female breast cancer incidence and mortality. Breast cancer research 6:1-11.
[4] Bromham N, Schmidt-Hansen M, Astin M, Hasler E, Reed MW (2017) Axillary treatment for operable primary breast cancer. Cochrane Database Syst Rev 1:CD004561. doi: 10.1002/14651858.CD004561.pub3
[5] Charalampoudis P, Markopoulos C, Kovacs T (2018) Controversies and recommendations regarding sentinel lymph node biopsy in primary breast cancer: a comprehensive review of current data. European Journal of Surgical Oncology 44:5-14.
[6] Chehade HEH, Headon H, El Tokhy O, Heeney J, Kasem A, Mokbel K (2016) Is sentinel lymph node biopsy a viable alternative to complete axillary dissection following neoadjuvant chemotherapy in women with node-positive breast cancer at diagnosis? An updated meta-analysis involving 3,398 patients. The American Journal of Surgery 212:969-981.
[7] Chu KU, Turner RR, Hansen NM, Brennan MB, Bilchik A, Giuliano AE (1999) Do all patients with sentinel node metastasis from breast carcinoma need complete axillary node dissection? Annals of surgery 229:536.
[8] Dabakuyo TS, Fraisse J, Causeret S, Gouy S, Padeano MM, Loustalot C, Cuisenier J, Sauzedde JM, Smail M, Combier JP, Chevillote P, Rosburger C, Boulet S, Arveux P, Bonnetain F (2009) A multicenter cohort study to compare quality of life in breast cancer patients according to sentinel lymph node biopsy or axillary lymph node dissection. Ann Oncol 20:1352-1361. doi: 10.1093/annonc/mdp016
[9] Ersoy YE, Kadioglu H (2018) Review of Novel Sentinel Lymph Node Biopsy Techniques in Breast Cancer Patients Treated with Neoadjuvant Chemotherapy. Clin Breast Cancer 18:e555-e559. doi: 10.1016/j.clbc.2018.01.004
[10] Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM (2010) Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 127:2893-2917. doi: 10.1002/ijc.25516
[11] Gherghe M, Bordea C, Blidaru A (2015) Sentinel lymph node biopsy (SLNB) vs. axillary lymph node dissection (ALND) in the current surgical treatment of early stage breast cancer. J Med Life 8:176-180.
[12] Goldhirsch A, Ingle JN, Gelber RD, Coates AS, Thurlimann B, Senn HJ, Panel m (2009) Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2009. Ann Oncol 20:1319-1329. doi: 10.1093/annonc/mdp322
[13] Hack TF, Cohen L, Katz J, Robson LS, Goss P (1999) Physical and psychological morbidity after axillary lymph node dissection for breast cancer. J Clin Oncol 17:143-149. doi: 10.1200/JCO.1999.17.1.143
[14] Hwang RF, Gonzalez‐Angulo AM, Yi M, Buchholz TA, Meric‐Bernstam F, Kuerer HM, Babiera GV, Tereffe W, Liu DD, Hunt KK (2007) Low locoregional failure rates in selected breast cancer patients with tumor‐positive sentinel lymph nodes who do not undergo completion axillary dissection. Cancer: Interdisciplinary International Journal of the American Cancer Society 110:723-730.
[15] Jazayeri SB, Saadat S, Ramezani R, Kaviani A (2015) Incidence of primary breast cancer in Iran: Ten-year national cancer registry data report. Cancer Epidemiol 39:519-527. doi: 10.1016/j.canep.2015.04.016
[16] Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Ashikaga T, Weaver DL, Miller BJ, Jalovec LM, Frazier TG, Noyes RD, Robidoux A, Scarth HM, Mammolito DM, McCready DR, Mamounas EP, Costantino JP, Wolmark N, National Surgical Adjuvant B, Bowel P (2007) Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial. Lancet Oncol 8:881-888. doi: 10.1016/S1470-2045(07)70278-4
[17] Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Costantino JP, Ashikaga T, Weaver DL, Mamounas EP, Jalovec LM (2010) Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. The lancet oncology 11:927-933.
[18] Langer I, Guller U, Berclaz G, Koechli OR, Schaer G, Fehr MK, Hess T, Oertli D, Bronz L, Schnarwyler B, Wight E, Uehlinger U, Infanger E, Burger D, Zuber M (2007) Morbidity of sentinel lymph node biopsy (SLN) alone versus SLN and completion axillary lymph node dissection after breast cancer surgery: a prospective Swiss multicenter study on 659 patients. Ann Surg 245:452-461. doi: 10.1097/01.sla.0000245472.47748.ec
[19] Li CZ, Zhang P, Li RW, Wu CT, Zhang XP, Zhu HC (2015) Axillary lymph node dissection versus sentinel lymph node biopsy alone for early breast cancer with sentinel node metastasis: A meta-analysis. Eur J Surg Oncol 41:958-966. doi: 10.1016/j.ejso.2015.05.007
[20] Lucci A, McCall LM, Beitsch PD, Whitworth PW, Reintgen DS, Blumencranz PW, Leitch AM, Saha S, Hunt KK, Giuliano AE, American College of Surgeons Oncology G (2007) Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011. J Clin Oncol 25:3657-3663. doi: 10.1200/JCO.2006.07.4062
[21] Mansel RE, Fallowfield L, Kissin M, Goyal A, Newcombe RG, Dixon JM, Yiangou C, Horgan K, Bundred N, Monypenny I, England D, Sibbering M, Abdullah TI, Barr L, Chetty U, Sinnett DH, Fleissig A, Clarke D, Ell PJ (2006) Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst 98:599-609. doi: 10.1093/jnci/djj158
[22] Petrek JA, Pressman PI, Smith RA (2000) Lymphedema: current issues in research and management. CA Cancer J Clin 50:292-307; quiz 308-211. doi: 10.3322/canjclin.50.5.292
[23] Ram R, Singh J, McCaig E (2014) Sentinel Node Biopsy Alone versus Completion Axillary Node Dissection in Node Positive Breast Cancer: Systematic Review and Meta-Analysis. Int J Breast Cancer 2014:513780. doi: 10.1155/2014/513780
[24] Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, Intra M, Veronesi P, Robertson C, Maisonneuve P, Renne G, De Cicco C, De Lucia F, Gennari R (2003) A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med 349:546-553. doi: 10.1056/NEJMoa012782
[25] Veronesi U, Viale G, Paganelli G, Zurrida S, Luini A, Galimberti V, Veronesi P, Intra M, Maisonneuve P, Zucca F, Gatti G, Mazzarol G, De Cicco C, Vezzoli D (2010) Sentinel lymph node biopsy in breast cancer: ten-year results of a randomized controlled study. Ann Surg 251:595-600. doi: 10.1097/SLA.0b013e3181c0e92a
[26] Wang Z, Wu LC, Chen JQ (2011) Sentinel lymph node biopsy compared with axillary lymph node dissection in early breast cancer: a meta-analysis. Breast Cancer Res Treat 129:675-689. doi: 10.1007/s10549-011-1665-1
[27] Zahoor S, Haji A, Battoo A, Qurieshi M, Mir W, Shah M (2017) Sentinel Lymph Node Biopsy in Breast Cancer: A Clinical Review and Update. J Breast Cancer 20:217-227. doi: 10.4048/jbc.2017.20.3.217