Twenty-year experience of examining biopsies of signal lymph nodes in breast cancer

V. F. Semiglazov; Семиглазов В. Ф.; P. V. Krivorotko; Криворотько П. В.; E. K. Zhiltsova; Жильцова Е. К.; S. V. Kanaev; Канаев С. В.; E. S. Trufanova; Труфанова Е. С.; P. I. Krzhivitskiy; Крживицкий П. И.; A. V. Komyakhov; Комяхов А. В.; T. T. Tabagua; Табагуа Т. Т.; K. S. Nikolaev; Николаев К. С.; A. A. Bessonov; Бессонов А. А.; V. G. Ivanov; Иванов В. Г.; L. P. Gigolaeva; Гиголаева Л. П.; O. A. Ivanova; Иванова О. А.; K. Yu. Zernov; Зернов К. Ю.; G. A. Dashyan; Дашян Г. А.; V. V. Semiglazov; Семиглазов В. В.; A. S. Emelyanov; Емельянов А. С.; E. A. Busko; Бусько Е. А.; A. V. Chernaya; Чёрная А. В.; A. S. Artemyeva; Артемьева А. С.; S. N. Novikov; Новиков С. Н.

doi:10.17650/1994-4098-2020-16-1-12-20

Twenty-year experience of examining biopsies of signal lymph nodes in breast cancer

Authors: Semiglazov V.F.¹, Krivorotko P.V.¹^,2, Zhiltsova E.K.¹, Kanaev S.V.¹, Trufanova E.S.¹, Krzhivitskiy P.I.¹, Komyakhov A.V.¹, Tabagua T.T.¹, Nikolaev K.S.¹, Bessonov A.A.¹, Ivanov V.G.¹, Gigolaeva L.P.¹, Ivanova O.A.¹, Zernov K.Y.¹, Dashyan G.A.¹, Semiglazov V.V.¹, Emelyanov A.S.¹, Busko E.A.¹, Chernaya A.V.¹, Artemyeva A.S.¹, Novikov S.N.¹
Affiliations:
1. N.N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia
2. I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia
Issue: Vol 16, No 1 (2020)
Pages: 12-20
Section: MAMMOLOGY. ORIGINAL REPORTS
Published: 08.06.2020
URL: https://ojrs.abvpress.ru/ojrs/article/view/698
DOI: https://doi.org/10.17650/1994-4098-2020-16-1-12-20
ID: 698

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Abstract

Biopsy of signal (sentinel) lymph nodes (LN) has been performed at the N.N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia, for almost 20 years. In the first few years, contrast-visual method (1 % blue isosulfan and triphenyl methane control) was used in 640 patients with early (T1–2N0M0) breast cancer. In 150 patients from this cohort, standard axillary dissection was performed irrespectively of the results of signal (sentinel) biopsy. The rate of false positive responses varied between 4.6 and 6.6 %. Since 2012, radioisotope method of visualization of signal LN with intratumor administration of ^99mТс-technephyte colloid particles has been used (in 708 patients with T1–3N0M0 breast cancer). This type of signal LN biopsy had the following diagnostic characteristics: sensitivity was 58.9 %, specificity was 96.2 %, diagnostic accuracy was 87.1 %.

In parallel with this study, in 2016 a study of diagnostic accuracy and safety of biopsy of axillary LN after neoadjuvant systemic therapy was started. The study included 263 patients with T1N1–3M0, T2–3N0–3M0, T4N0–1M0 breast cancer. To evaluate clinical status of axillary LN, ultrasound, single-photon emission computed tomography, mammography at baseline and after completion of neoadjuvant chemotherapy ± targeted therapy (trastuzumab) were performed. In some patients, in the recent years a double method of signal LN labeling (radioisotope and fluorescent methods) was used.

In patients with baseline cN⁺-status, the rate of false positive signal LN biopsy conclusions was 13.6 %, in patients with baseline cN0-status it was 7.7 %.

The study of double contrast of axillary LN and targeted label of metastatic LN prior to neoadjuvant systemic therapy continues. In total, various modifications of biopsy of signal LN were performed in 2,000 patients with breast cancer.

The study protocol was approved by the biomedical ethics committee of N.N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia.

All patients gave written informed consent to participate in the study.

Keywords

breast cancer, axillary lymph node biopsy, adjuvant and neoadjuvant treatment, contrast biopsy, radioisotope biopsy, fluorescent labeling

References

Krivorotko P.V., Tabagua T.T., Komyakhov A.V. et al. Sentinel lymph node biopsy in early breast cancer: the experience of the N.N. Petrov Research Institute of Oncology. Voprosy Onkologii = Problems in Oncology 2017;63(2):267–73. (In Russ.).
Semiglazov V.V., Krivorotko P.V., Semiglazov V.F. et al. International recommendations on breast cancer treatment: Guidelines for doctors. Ed. by V.F. Semiglazov. Moscow: MK, 2020. 232 p. (In Russ.).
Kanaev S.V., Novikov S.N., Krivorotko P.V. et al. Combination of scintigraphy with 99mTc-MIBI and ultrasonography in diagnosis of axillary lymph node metastases in patients with breast cancer. Voprosy Onkologii = Problems in Oncology 2013;59(1):52–8. (In Russ.).
Alvarez S., Anorbe E., Alcorta P. et al. Role of sonography in the diagnosis of axillary lymph node metastases in breast cancer: a systematic review. Am J Roentgenol 2006;186(5):1342–8. doi: 10.2214/AJR.05.0936.
Lumachi F., Tregnaghi A., Ferretti G. et al. Accuracy of ultrasonography and 99mTc-sestamibi scintimammography for assessing axillary lymph node status in breast cancer patients. A prospective study. Eur J Surg Oncol 2006;32(9):933–6. doi: 10.1016/j.ejso.2006.05.007.
Mathijssen I.M., Strijdhorst H., Kiestra S.K. et al. Added value of ultrasound in screening the clinically negative axilla in breast cancer. J Surg Oncol 2006;94:364–7.
Zgajnar J., Hocevar M., Podkrajsek M. et al. Patients with preoperatively ultrasonically uninvolved axillary lymph nodes: a distinct subgroup of early breast cancer patients. Breast Cancer Res Treat 2006;97(3):293–9. doi: 10.1007/s10549-005-9123-6.
Buscombe J.R., Holloway B., Roche N. et al. Position of nuclear medicine in the diagnostic work-up of breast cancer. Q J Nucl Med Mol Imaging 2004;48(2):109–18.
Eberl M.M., Fox C.H., Edge S.B. et al. BI-RADS classification for management of abnormal mammograms. J Am Board Fam Med 2006;19(2):161–4. doi: 10.3122/jabfm.19.2.161.
Kanaev S.V., Novikov S.N., Krzhivitskiy P.I. et al. Possibilities of SPECT-CT in the diagnosis of tumor lesion of axillary lymph nodes in patients with breast cancer. Voprosy Onkologii = Problems in Oncology 2014;60(2):51–6. (In Russ.).
Schulz-Wendtland R. Neoadjuvant chemotherapy-monitoring: clinical examination, ultrasound, mammography, MRI, elastography: only one, only few or all? Eur J Radiol 2012;81:147–8. doi: 10.1016/S0720-048X(12)70061-X.

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Twenty-year experience of examining biopsies of signal lymph nodes in breast cancer

Full Text

Abstract

Keywords

About the authors

References

Supplementary files