Immunomodulation by imiquimod in patients with high-risk primary melanoma.

Imiquimod is a synthetic Toll-like receptor 7 (TLR7) agonist approved for the topical treatment of actinic keratoses, superficial basal cell carcinoma, and genital warts. Imiquimod leads to an 80-100% cure rate of lentigo maligna; however, studies of invasive melanoma are lacking. We conducted a pilot study to characterize the local, regional, and systemic immune responses induced by imiquimod in patients with high-risk melanoma.

Axillary recurrence after sentinel lymph node biopsy for breast cancer.

Sentinel lymph node biopsy (SLNB) is routinely performed as an axillary staging procedure for breast cancer. Although the reported false-negative rate approaches 10 per cent, this does not always lead to axillary recurrence. We previously reported an axillary recurrence rate of 1 per cent at a median follow-up of 2 years.

Focused microwave thermotherapy for preoperative treatment of invasive breast cancer: a review of clinical studies.

Background: Preoperative focused microwave thermotherapy (FMT) is a promising method for targeted treatment of breast cancer cells. Results of four multi-institutional clinical studies of preoperative FMT for treating invasive carcinomas in the intact breast are reviewed.

Methods: Externally applied wide-field adaptive phased-array FMT has been investigated both as a preoperative heat-alone ablation treatment and as a combination treatment with preoperative anthracycline-based chemotherapy for breast tumors ranging in ultrasound-measured size from 0.

Outcomes following sentinel lymph node biopsy for breast cancer.

Evaluation of axillary lymph nodes for metastatic involvement is the most significant factor in gauging prognosis in breast cancer patients. Complete axillary dissection can be associated with significant morbidity. Therefore, sentinel node biopsy was developed to sample nodes and avoid dissection in patients without clinical evidence of nodal involvement.

Evaluation of three scoring systems predicting non sentinel node metastasis in breast cancer patients with a positive sentinel node biopsy.

Background: Completion axillary lymph node dissection (cALND), performed after a positive sentinel lymph node biopsy (SLNB) in breast cancer patients, often results in no additional positive nodes. Scoring systems have been published to aid in the prediction of nonsentinel node metastasis. Our purpose was to assess the validity of these scoring systems in our patient population.

Axillary regional recurrence after sentinel lymph node biopsy for breast cancer.

The accuracy of sentinel lymph node biopsy (SLNB) staging in breast cancer has been demonstrated in studies comparing it with axillary dissection. There is a 5 per cent false-negative rate, but this does not always correlate with axillary recurrence. Our purpose was to determine the rate of axillary lymphatic recurrence in breast cancer patients who had a negative SLNB.

Success of neoadjuvant chemotherapy in conversion of mastectomy to breast conservation surgery.

Neoadjuvant chemotherapy (NC) in patients with breast cancer results in high response rates and has been used with the purpose of reducing tumor size and achieving breast conservation (BC) in individuals who initially require mastectomy. Our objective is to determine the success of NC in achieving BC in women who initially were not candidates for BC. We conducted a cohort study of women with invasive breast cancer who required mastectomy but desired BC surgery.

Intraoperative injection of technetium-99m sulfur colloid is effective in the detection of sentinel lymph nodes in breast cancer.

Background: Our objective was to determine if intraoperative injection of technetium-99m-labeled sulfur colloid is as effective as preoperative injection in the detection of sentinel lymph nodes (SLNs).

Methods: Two hundred consecutive patients with breast cancer underwent SLN biopsy examination. Radiocolloid was injected in the preoperative area (group A) or immediately after induction of anesthesia in the operating room (group B).

Percutaneous excisional biopsy of palpable breast masses under ultrasound visualization.

A palpable breast mass is a common reason for surgical consultation. Our goal was to determine whether ultrasound-guided vacuum-assisted core biopsy (US-VACB) is safe and effective in completely removing presumed benign palpable breast masses. We conducted a cohort study of 201 consecutive patients with presumed benign palpable masses who underwent removal with US-VACB.

Outcomes of surgical and sonographic assessment of breast masses in women younger than 30.

Assessment of breast masses in young women is challenging due to normal glandular variance. Our purpose is to define the outcomes of specialized physical exam, selective breast sonography (BUS), and biopsy in women younger than 30. Five hundred forty-two patients younger than 30 referred with a palpable breast mass were studied.

Outcomes of sonography-based management of breast cysts.

Background: Ultrasound is commonly used during diagnosis of breast lesions. Our purpose was to study the role of sonography for risk stratification of malignancy in the diagnosis and management of palpable breast cysts.

Methods: This was a cohort study of 176 patients with palpable breast cysts.

Use of preoperative breast ultrasonography for mapping of breast cancer extent improves resection margins during breast conservation surgery.

Background: Positive margins after breast conservation surgery occur frequently and negatively influence local control rates.

Hypothesis: Preoperative breast ultrasonography reduces the incidence of positive margins during breast conservation surgery.

Design: Case-control analysis.

Focused microwave phased array thermotherapy for ablation of early-stage breast cancer: results of thermal dose escalation.

Background: Tumor ablation as a means of treating breast cancer is being investigated. Microwave energy is promising because it can preferentially heat high-water-content breast carcinomas, compared to adipose and glandular tissues.

Methods: This is a prospective, multicenter, nonrandomized dose-escalation study of microwave treatment.

Overview of breast health care guidelines for countries with limited resources.

Among women around the globe, breast cancer is both the most common cancer and the leading cause of cancer-related death. Women in economically disadvantaged countries have a lower incidence of breast cancer, but poorer survival rates for the disease relative to women in affluent countries. Evidence suggests that breast cancer mortality can be reduced if resources are applied to the problem in a systematic way.

Immediate preoperative injection of 99m-Tc sulfur colloid is effective in the detection of breast sentinel lymph nodes.

Sentinel lymph node (SLN) biopsy is an accurate technique to determine the metastatic status of lymph nodes. Radionuclide guidance makes the procedure easier and improves the success rate. Coordinating the operating room and nuclear medicine schedules causes delays when same-day radionuclide injection is used.

The role of nuclear medicine in breast cancer detection: a focus on Technetium-99 Sestamibi scintimammography.

Screening mammography in women aged over 50 years reduces breast cancer death by 30%. However, because mammography cannot accurately differentiate benign from malignant lesions, many mammography-directed breast biopsies are benign. In the past decade, methods of "functional breast imaging," including magnetic resonance imaging, scintimammography using single photon emission tomography, and positron emission tomography, have improved the sensitivity and specificity rates of conventional mammography for the detection of breast cancer.