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Original Articles
- Risk Factors for a False-Negative Result of Sentinel Node Biopsy in Patients with Clinically Node-Negative Breast Cancer
- Seung Ah Lee, Hak Min Lee, Hak Woo Lee, Ban Seok Yang, Jong Tae Park, Sung Gwe Ahn, Joon Jeong, Seung Il Kim
- Cancer Res Treat. 2018;50(3):625-633. Published online July 31, 2017
- DOI: https://doi.org/10.4143/crt.2017.089
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Abstract
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Supplementary Material
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ePub - Purpose
Although sentinel lymph node biopsy (SLNB) can accurately represent the axillary lymph node (ALN) status, the false-negative rate (FNR) of SLNB is the main concern in the patients who receive SLNB alone instead of ALN dissection (ALND).
Materials and Methods
We analyzed 1,886 patientswho underwent ALNDafter negative results of SLNB,retrospectively. A logistic regression analysis was used to identify risk factors associated with a falsenegative (FN) result. Cox regression model was used to estimate the hazard ratio of factors affecting disease-free survival (DFS).
Results
Tumor located in the upper outer portion of the breast, lymphovascular invasion, suspicious node in imaging assessment and less than three sentinel lymph nodes (SLNs) were significant independent risk factors for FN in SLNB conferring an adjusted odds ratio of 2.10 (95% confidence interval [CI], 1.30 to 3.39), 2.69 (95% CI, 1.47 to 4.91), 2.59 (95% CI, 1.62 to 4.14), and 2.39 (95% CI, 1.45 to 3.95), respectively. The prognostic factors affecting DFS were tumor size larger than 2 cm (hazard ratio [HR], 1.86; 95% CI, 1.17 to 2.96) and FN of SLNB (HR, 2.51; 95% CI, 1.42 to 4.42) in SLN-negative group (FN and true-negative), but in ALN-positive group (FN and true-positive), FN of SLNB (HR, 0.64; 95% CI, 0.33 to 1.25) did not affect DFS.
Conclusion
In patients with risk factors for a FN such as suspicious node in imaging assessment, upper outer breast cancer, less than three harvested nodes, we need attention to find another metastatic focus in non-SLNs during the operation. It may contribute to provide an exact prognosis and optimizing adjuvant treatments. -
Citations
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- Axillary staging with 18F-FDG PET/CT in early breast cancer: impact of tumor subtypes
Abdullah Gunes, Nuray Colapkulu-Akgul, Caner Akgul, Ibrahim Unlu, Saffet Cinar
Annals of Saudi Medicine.2025; 45(3): 145. CrossRef - Detection of presence or absence of metastasis in WSI patches of breast cancer using the dual-enhanced convolutional ensemble neural network
Ruigang Ge, Guoyue Chen, Kazuki Saruta, Yuki Terata
Machine Learning with Applications.2024; 17: 100579. CrossRef - Ultrasound radiomics based on axillary lymph nodes images for predicting lymph node metastasis in breast cancer
Yu-Long Tang, Bin Wang, Tao Ou-Yang, Wen-Zhi Lv, Shi-Chu Tang, An Wei, Xin-Wu Cui, Jiang-Sheng Huang
Frontiers in Oncology.2023;[Epub] CrossRef - Future Directions in the Assessment of Axillary Lymph Nodes in Patients with Breast Cancer
Filippo Pesapane, Luciano Mariano, Francesca Magnoni, Anna Rotili, Davide Pupo, Luca Nicosia, Anna Carla Bozzini, Silvia Penco, Antuono Latronico, Maria Pizzamiglio, Giovanni Corso, Enrico Cassano
Medicina.2023; 59(9): 1544. CrossRef - Axillary Lymph Node Dissection Can Be Omitted in Breast Cancer Patients With Mastectomy and False-Negative Frozen Section in Sentinel Lymph Node Biopsy
Jing Si, Rong Guo, Huan Pan, Xiang Lu, Zhiqin Guo, Chao Han, Li Xue, Dan Xing, Wanxin Wu, Caiping Chen
Frontiers in Oncology.2022;[Epub] CrossRef - False-negative frozen section of sentinel nodes in early breast cancer (cT1-2N0) patients
Zhu-Jun Loh, Kuo-Ting Lee, Ya-Ping Chen, Yao-Lung Kuo, Wei-Pang Chung, Ya-Ting Hsu, Chien-Chang Huang, Hui-Ping Hsu
World Journal of Surgical Oncology.2021;[Epub] CrossRef - What Is High-risk Breast Cancer With Pathologically Negative Lymph Nodes for Regional Recurrence?
Sang-Won Kim, Won Kyung Cho, Doo Ho Choi, Haeyoung Kim, Oyeon Cho, Won Park, Mison Chun
International Journal of Radiation Oncology*Biology*Physics.2021; 111(4): 992. CrossRef - Validating the ACOSOG Z0011 Trial Result: A Population-Based Study Using the SEER Database
Jiwoong Jung, Byoung Hyuck Kim, Jongjin Kim, Sohee Oh, Su-jin Kim, Chang-Sup Lim, In Sil Choi, Ki-Tae Hwang
Cancers.2020; 12(4): 950. CrossRef - Retrospectively validating the results of the ACOSOG Z0011 trial in a large Asian Z0011-eligible cohort
Jiwoong Jung, Wonshik Han, Eun Sook Lee, So-Youn Jung, Jai Hong Han, Dong-Young Noh, Yumi Kim, Hee Jun Choi, Jeong Eon Lee, Seok Jin Nam, Jong Won Lee, Hee Jeong Kim, Eunhae Um, Joo Heung Kim, Seho Park, Young Up Cho
Breast Cancer Research and Treatment.2019; 175(1): 203. CrossRef - Preliminary study of contrast-enhanced ultrasound in combination with blue dye vs. indocyanine green fluorescence, in combination with blue dye for sentinel lymph node biopsy in breast cancer
Yidong Zhou, Yan Li, Feng Mao, Jing Zhang, Qingli Zhu, Songjie Shen, Yan Lin, Xiaohui Zhang, He Liu, Mengsu Xiao, Yuxin Jiang, Qiang Sun
BMC Cancer.2019;[Epub] CrossRef
- Axillary staging with 18F-FDG PET/CT in early breast cancer: impact of tumor subtypes
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- Genetic Polymorphism of Epoxide Hydrolase and GSTM1 in Lung Cancer Susceptibility of Korean Population
- Jun Hwa Hwang, Kyu Sik Kim, Yu Il Kim, Eun Joung Kim, Kyung Hwa Park, Gye Jung Cho, Jin Young Ju, Sung Chul Lim, Young Chul Kim, Kyung Ok Park, Jong Tae Park, Sung Ja Ahn
- Cancer Res Treat. 2003;35(6):483-488. Published online December 31, 2003
- DOI: https://doi.org/10.4143/crt.2003.35.6.483
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Abstract
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- PURPOSE
Although 80~90% of patients with lung cancer are smokers, only 11% of smokers develop lung cancer. Genetic susceptibility according to the polymorphism of the epoxide hydrolase (mEPHX) gene and homozygous deletion of GSTM1 (M1 subunit of Glutathione S transferase) was studied in this case control study. MATERIALS AND METHODS: Genomic DNA from 76 subjects with lung cancer (40 squamous cell carcinoma, 13 adenocarcinoma, 10 subtype undetermined non-small cell lung cancer, and 13 small cell lung carcinoma) and 62 age- matched controls were extracted from peripheral white blood cells. PCR and RFLP (restriction fragments length polymorphism) with restriction enzyme (RsaI) and automatic sequencing were used for mEPHX genotyping (T-->C, Tyr113His) in exon 3 and (A-->G, His139Arg) in exon 4. Looking for homozygous deletions of GSTM1, multiplex PCR with primers for the GSTM1 gene and coagulation factor V gene (as positive control) were performed. RESULTS: The age distribution between the cancer and control groups were similar (63.6 7.2 vs. 61.1 7.9 years). The lung cancer group, however, had more smokers (73.3%, 44/60) than the control group (21/54, 38.9%, p<0.001). The rate of homozygous deletion of the GSTM1 gene was significantly higher in the lung cancer group (65.8%, 50/76) than in the control group (46.8%, 29/62, p<0.05), causing the relative risk of GSTM1 deletion for lung cancer as 2.19 (95% CI: 1.10~4.35, p=0.02). Among 118 subjects whose mEPHX gene polymorphisms were studied, 62 (52.5%) subjects showed genotypes with slow enzyme activity while 45 (38.1%) showed normal enzyme activity and 11 (9.3%) showed fast enzyme activity. There was no significant difference in the distribution of mEPHX gene polymorphisms between the two groups. CONCLUSION: The homozygous deletion of the GSTM1 gene was associated with high lung cancer susceptibility, whereas the mEPHX genotype showed no significant connection with risk of lung cancer in a sample Korean population.
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