Does increased tumor burden of sentinel nodes in breast cancer affect detection procedure?
Abstract Numerous studies have shown that sentinel lymph node biopsy (SLN) has a high level of detection sensitivity. Successful detection procedure depends on the amount of radioactivity and accumulation of blue dye in the SN. Our aim was to relate the differences observed in intraoperative SN pres...
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| Veröffentlicht in: | European journal of surgical oncology 2013-03, Vol.39 (3), p.266-272 |
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| creator | Kohl Schwartz, A.S Leo, C Rufibach, K Varga, Z Fink, D Gabriel, N |
| description | Abstract Numerous studies have shown that sentinel lymph node biopsy (SLN) has a high level of detection sensitivity. Successful detection procedure depends on the amount of radioactivity and accumulation of blue dye in the SN. Our aim was to relate the differences observed in intraoperative SN presentation to tumor burden, characteristics of the primary tumor and patient attributes. Our retrospective analysis included 369 patients undergoing SLN in the Department of Gynecology of the University Hospital of Zurich within five years. Data was collected from the patients (age, BMI), the primary tumor (size, grading, hormone receptors, HER2 status) and the SNs removed (counts per second [cps], blue dye, size of nodular metastasis, extracapsular involvement, number of SNs excised). Because patients typically had more than one SN, a linear mixed-effects model was used to account for the clustering within one patient. SNs presented with significantly lower radioactivity in elderly (−1.8%/year, p |
| doi_str_mv | 10.1016/j.ejso.2012.12.016 |
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Successful detection procedure depends on the amount of radioactivity and accumulation of blue dye in the SN. Our aim was to relate the differences observed in intraoperative SN presentation to tumor burden, characteristics of the primary tumor and patient attributes. Our retrospective analysis included 369 patients undergoing SLN in the Department of Gynecology of the University Hospital of Zurich within five years. Data was collected from the patients (age, BMI), the primary tumor (size, grading, hormone receptors, HER2 status) and the SNs removed (counts per second [cps], blue dye, size of nodular metastasis, extracapsular involvement, number of SNs excised). Because patients typically had more than one SN, a linear mixed-effects model was used to account for the clustering within one patient. SNs presented with significantly lower radioactivity in elderly (−1.8%/year, p < 0.001) and obese patients (−3.9%/kg/m2, p = 0.006) as well as in G3 primary tumors ( p = 0.002). Radiocolloid accumulation decreased with increasing metastasis size (−6.1%/mm, p = 0.006). In conclusion the detection procedure of SNs is mainly affected by the patient's age and BMI and by nodular metastasis' size. Phagocytotic activity in the lymph node may increase radiotracer accumulation, showing the highest tracer signals in micrometastatic SNs. In large SN metastasis the lymph flow appears obstructed, reducing the axillary drainage and therefore making detection procedure difficult.</description><identifier>ISSN: 0748-7983</identifier><identifier>EISSN: 1532-2157</identifier><identifier>DOI: 10.1016/j.ejso.2012.12.016</identifier><identifier>PMID: 23321392</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Axilla ; Breast cancer ; Breast Neoplasms - metabolism ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; Colloids - pharmacokinetics ; Contrast Media - pharmacokinetics ; Failed localization ; Female ; Hematology, Oncology and Palliative Medicine ; Humans ; Lymph Nodes - metabolism ; Lymph Nodes - pathology ; Lymph Nodes - surgery ; Middle Aged ; Neoplasm Grading ; Retrospective Studies ; Sentinel Lymph Node Biopsy ; Surgery ; Switzerland ; Tumor Burden</subject><ispartof>European journal of surgical oncology, 2013-03, Vol.39 (3), p.266-272</ispartof><rights>Elsevier Ltd</rights><rights>2012 Elsevier Ltd</rights><rights>Copyright © 2012 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-78f593f8267c9e1a559392a7f7a6e6677ffa480f372eebb3aa850dacf5453c553</citedby><cites>FETCH-LOGICAL-c455t-78f593f8267c9e1a559392a7f7a6e6677ffa480f372eebb3aa850dacf5453c553</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ejso.2012.12.016$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23321392$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kohl Schwartz, A.S</creatorcontrib><creatorcontrib>Leo, C</creatorcontrib><creatorcontrib>Rufibach, K</creatorcontrib><creatorcontrib>Varga, Z</creatorcontrib><creatorcontrib>Fink, D</creatorcontrib><creatorcontrib>Gabriel, N</creatorcontrib><title>Does increased tumor burden of sentinel nodes in breast cancer affect detection procedure?</title><title>European journal of surgical oncology</title><addtitle>Eur J Surg Oncol</addtitle><description>Abstract Numerous studies have shown that sentinel lymph node biopsy (SLN) has a high level of detection sensitivity. Successful detection procedure depends on the amount of radioactivity and accumulation of blue dye in the SN. Our aim was to relate the differences observed in intraoperative SN presentation to tumor burden, characteristics of the primary tumor and patient attributes. Our retrospective analysis included 369 patients undergoing SLN in the Department of Gynecology of the University Hospital of Zurich within five years. Data was collected from the patients (age, BMI), the primary tumor (size, grading, hormone receptors, HER2 status) and the SNs removed (counts per second [cps], blue dye, size of nodular metastasis, extracapsular involvement, number of SNs excised). Because patients typically had more than one SN, a linear mixed-effects model was used to account for the clustering within one patient. SNs presented with significantly lower radioactivity in elderly (−1.8%/year, p < 0.001) and obese patients (−3.9%/kg/m2, p = 0.006) as well as in G3 primary tumors ( p = 0.002). Radiocolloid accumulation decreased with increasing metastasis size (−6.1%/mm, p = 0.006). In conclusion the detection procedure of SNs is mainly affected by the patient's age and BMI and by nodular metastasis' size. Phagocytotic activity in the lymph node may increase radiotracer accumulation, showing the highest tracer signals in micrometastatic SNs. In large SN metastasis the lymph flow appears obstructed, reducing the axillary drainage and therefore making detection procedure difficult.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Axilla</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - metabolism</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>Colloids - pharmacokinetics</subject><subject>Contrast Media - pharmacokinetics</subject><subject>Failed localization</subject><subject>Female</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Lymph Nodes - metabolism</subject><subject>Lymph Nodes - pathology</subject><subject>Lymph Nodes - surgery</subject><subject>Middle Aged</subject><subject>Neoplasm Grading</subject><subject>Retrospective Studies</subject><subject>Sentinel Lymph Node Biopsy</subject><subject>Surgery</subject><subject>Switzerland</subject><subject>Tumor Burden</subject><issn>0748-7983</issn><issn>1532-2157</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU-LFDEQxYMo7uzqF_AgOXrpMX8mnQ6IsqyuCgse1IuXkE4qkLYnWZNuYb-91c7qwYMQKFK894r6FSHPONtzxvuX0x6mVvaCcbHHh60HZMeVFJ3gSj8kO6YPQ6fNIM_IeWsTY8xIbR6TMyGl4NKIHfn2tkCjKfsKrkGgy3oslY5rDZBpibRBXlKGmeYSfgvpuCkX6l32UKmLEfxCAyxYUsn0thYPYa3w5gl5FN3c4Ol9vSBfr999ufrQ3Xx6__Hq8qbzB6WWTg9RGRkH0WtvgDuFPyOcjtr10Pdax-gOA4tSC4BxlM4NigXnozoo6ZWSF-TFKRdH_1ihLfaYmod5dhnK2iwXw2AMxhqUipPU19JahWhvazq6emc5sxtTO9mNqd2YotFiC03P7_PX8Qjhr-UPRBS8OgkAt_yZoNrmEyCekCpSsaGk_-e__sfu55STd_N3uIM2lbVm5Ge5bWiwn7erbkflGCK1kvIXdUOdbg</recordid><startdate>20130301</startdate><enddate>20130301</enddate><creator>Kohl Schwartz, A.S</creator><creator>Leo, C</creator><creator>Rufibach, K</creator><creator>Varga, Z</creator><creator>Fink, D</creator><creator>Gabriel, N</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130301</creationdate><title>Does increased tumor burden of sentinel nodes in breast cancer affect detection procedure?</title><author>Kohl Schwartz, A.S ; Leo, C ; Rufibach, K ; Varga, Z ; Fink, D ; Gabriel, N</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-78f593f8267c9e1a559392a7f7a6e6677ffa480f372eebb3aa850dacf5453c553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Axilla</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - metabolism</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - surgery</topic><topic>Colloids - pharmacokinetics</topic><topic>Contrast Media - pharmacokinetics</topic><topic>Failed localization</topic><topic>Female</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Lymph Nodes - metabolism</topic><topic>Lymph Nodes - pathology</topic><topic>Lymph Nodes - surgery</topic><topic>Middle Aged</topic><topic>Neoplasm Grading</topic><topic>Retrospective Studies</topic><topic>Sentinel Lymph Node Biopsy</topic><topic>Surgery</topic><topic>Switzerland</topic><topic>Tumor Burden</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kohl Schwartz, A.S</creatorcontrib><creatorcontrib>Leo, C</creatorcontrib><creatorcontrib>Rufibach, K</creatorcontrib><creatorcontrib>Varga, Z</creatorcontrib><creatorcontrib>Fink, D</creatorcontrib><creatorcontrib>Gabriel, N</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kohl Schwartz, A.S</au><au>Leo, C</au><au>Rufibach, K</au><au>Varga, Z</au><au>Fink, D</au><au>Gabriel, N</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does increased tumor burden of sentinel nodes in breast cancer affect detection procedure?</atitle><jtitle>European journal of surgical oncology</jtitle><addtitle>Eur J Surg Oncol</addtitle><date>2013-03-01</date><risdate>2013</risdate><volume>39</volume><issue>3</issue><spage>266</spage><epage>272</epage><pages>266-272</pages><issn>0748-7983</issn><eissn>1532-2157</eissn><abstract>Abstract Numerous studies have shown that sentinel lymph node biopsy (SLN) has a high level of detection sensitivity. Successful detection procedure depends on the amount of radioactivity and accumulation of blue dye in the SN. Our aim was to relate the differences observed in intraoperative SN presentation to tumor burden, characteristics of the primary tumor and patient attributes. Our retrospective analysis included 369 patients undergoing SLN in the Department of Gynecology of the University Hospital of Zurich within five years. Data was collected from the patients (age, BMI), the primary tumor (size, grading, hormone receptors, HER2 status) and the SNs removed (counts per second [cps], blue dye, size of nodular metastasis, extracapsular involvement, number of SNs excised). Because patients typically had more than one SN, a linear mixed-effects model was used to account for the clustering within one patient. SNs presented with significantly lower radioactivity in elderly (−1.8%/year, p < 0.001) and obese patients (−3.9%/kg/m2, p = 0.006) as well as in G3 primary tumors ( p = 0.002). Radiocolloid accumulation decreased with increasing metastasis size (−6.1%/mm, p = 0.006). In conclusion the detection procedure of SNs is mainly affected by the patient's age and BMI and by nodular metastasis' size. Phagocytotic activity in the lymph node may increase radiotracer accumulation, showing the highest tracer signals in micrometastatic SNs. In large SN metastasis the lymph flow appears obstructed, reducing the axillary drainage and therefore making detection procedure difficult.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>23321392</pmid><doi>10.1016/j.ejso.2012.12.016</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Axilla Breast cancer Breast Neoplasms - metabolism Breast Neoplasms - pathology Breast Neoplasms - surgery Colloids - pharmacokinetics Contrast Media - pharmacokinetics Failed localization Female Hematology, Oncology and Palliative Medicine Humans Lymph Nodes - metabolism Lymph Nodes - pathology Lymph Nodes - surgery Middle Aged Neoplasm Grading Retrospective Studies Sentinel Lymph Node Biopsy Surgery Switzerland Tumor Burden |
| title | Does increased tumor burden of sentinel nodes in breast cancer affect detection procedure? |
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