Sentinel node biopsy after neoadjuvant chemotherapy for node-positive breast cancer: Does axillary ultrasound improve performance? Journal Article
| Authors: | Mautner, S. K.; Cody, H. S. 3rd |
| Article Title: | Sentinel node biopsy after neoadjuvant chemotherapy for node-positive breast cancer: Does axillary ultrasound improve performance? |
| Abstract: | A 66-year-old otherwise healthy woman palpates a lump in the lower inner quadrant of her left breast; she has no family history of breast or ovarian cancer and is not of Ashkenazi heritage. Clinical examination confirms a mobile 2-cm mass at 8:00 in her left breast; the axilla is clinically negative. Mammography is negative, but ultrasound (US) shows a 2.2-cm irregular hypoechoic nodule corresponding to the palpable mass, and US-guided core biopsy shows poorly differentiated invasive ductal carcinoma, triple negative (estrogen receptor, 0; progesterone receptor, 0; and human epidermal growth factor receptor 2, 0). US also notes a single suspicious 1-cm node in the left axilla, which US-guided core biopsy shows to be metastatic carcinoma (Fig 1). Clips placed to mark the sites of the breast and axillary biopsies are in appropriate position. She receives dose-dense neoadjuvant chemotherapy (NAC) with doxorubicin, cyclophosphamide, and paclitaxel, with completeresolution of her physical findings but with persistence of an abnormal left axillary node on US. She then has a left partial mastectomy with I-125 seed localization of the clip marking the core biopsy site and a left sentinel lymph node (SLN) biopsy using combined dye-isotope mapping. Final pathology confirms no cancer in the breast or in four SLNs; treatment effect is present in the breast and in the single SLN containing the clip placed at the time of biopsy. Copyright © 2015 American Society of Clinical Oncology. All rights reserved. |
| Keywords: | epidermal growth factor; cancer survival; aged; cancer surgery; case report; doxorubicin; cancer combination chemotherapy; paclitaxel; adjuvant therapy; cancer adjuvant therapy; disease free survival; cancer staging; lymph node metastasis; cancer diagnosis; sentinel lymph node biopsy; cyclophosphamide; axillary lymph node; iodine 125; mammography; family history; breast carcinoma; echography; partial mastectomy; estrogen receptor; progesterone receptor; clinical examination; isotope tracing; clip; image guided biopsy; dose densification; human; female; priority journal; article |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 33 |
| Issue: | 30 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2015-10-20 |
| Start Page: | 3375 |
| End Page: | 3378 |
| Language: | English |
| DOI: | 10.1200/jco.2014.60.3316 |
| PROVIDER: | scopus |
| PUBMED: | 26371144 |
| DOI/URL: | |
| Notes: | Export Date: 2 December 2015 -- Source: Scopus |
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