Is pleomorphic lobular carcinoma really a distinct clinical entity?

Background: Attempts to define the clinical behavior of pleomorphic lobular carcinoma (PLC) have been limited to small series, and clinical management strategies have yet to be established. We describe our experience with PLC as compared to classic ILC and invasive ductal carcinoma (IDC).

Methods: From 9/1996 to 5/2003, clinical and histopathologic data for 5,635 patients undergoing primary surgical treatment and sentinel lymph node biopsy for breast cancer were collected.

Breast cancer recurrence following prosthetic, postmastectomy reconstruction: incidence, detection, and treatment.

Background: The purpose of this study was to evaluate the influence of prosthetic reconstruction on the incidence, detection, and management of locoregional recurrence following mastectomy for invasive breast cancer.

Methods: A matched retrospective cohort study was performed. Only patients with invasive breast cancer who had 2 years or more of follow-up and/or patients who had recurrence within 2 years of their primary cancer were included.

Does the benefit of sentinel node frozen section vary between patients with invasive duct, invasive lobular, and favorable histologic subtypes of breast cancer?

Background: Although many questions regarding sentinel lymph node (SLN) biopsy in breast cancer have been answered by observational studies and, increasingly, by prospective trials, the role of intraoperative SLN assessment remains a matter of debate. Here we report in detail the results of intraoperative SLN assessment by frozen section (FS), with particular attention to variations in sensitivity and yield by histologic subtype, by tumor size, and by other clinicopathologic parameters.

Methods: Five thousand two hundred ninety-eight consecutive patients with clinical stage T1-3N0 invasive breast carcinoma had SLN biopsy with intraoperative FS at Memorial Sloan Kettering Cancer Center between 1996 and 2004.

Doctor, what are my chances of having a positive sentinel node? A validated nomogram for risk estimation.

Purpose: Lymph node metastasis is a multifactorial event. Several variables have been described as predictors of lymph node metastasis in breast cancer. However, it is difficult to apply these data-usually expressed as odds ratios-to calculate the probability of sentinel lymph node (SLN) metastasis for a specific patient.

A declining rate of completion axillary dissection in sentinel lymph node-positive breast cancer patients is associated with the use of a multivariate nomogram.

Objective: To compare sentinel lymph node (SLN)-positive breast cancer patients who had completion axillary dissection (ALND) with those who did not, with particular attention to clinicopathologic features, nomogram scores, rates of axillary local recurrence (LR), and changes in treatment pattern over time.

Background: While conventional treatment of SLN-positive patients is to perform ALND, there may be a low-risk subgroup of SLN-positive patients in whom ALND is not required. A multivariate nomogram that predicts the likelihood of residual axillary disease may assist in identifying this group.

Perpendicular inked versus tangential shaved margins in breast-conserving surgery: does the method matter?

Background: In breast-conserving surgery (BCS), the method of margin assessment and the definition of a negative margin vary widely. The purpose of this study was to compare the incidence of positive margins and rates of reexcision between two methods of margin assessment at a single institution.

Study Design: In July 2004, our protocol for margin evaluation changed from perpendicular inked margins (Group A, n=263) to tangential shaved margins (Group B, n=261).

Eighteen sensations after breast cancer surgery: a 5-year comparison of sentinel lymph node biopsy and axillary lymph node dissection.

Background: The aim of this study is to evaluate prevalence, severity, and level of distress of 18 sensations at baseline (3-15 days) and 5 years after breast cancer surgery, and compare sensations after sentinel lymph node biopsy (SLNB) with those after SLNB plus immediate or delayed axillary lymph node dissection (ALND).

Methods: A total of 187 patients with breast cancer completed the Breast Sensation Assessment Scale at baseline and at 3, 6, 12, 24, and 60 months after surgery to assess prevalence, severity, and level of distress of sensations. Of these, 133 had SLNB, and 54 had SLNB and ALND.

Can sentinel lymph node biopsy be omitted in patients with favorable breast cancer histology?

Background: The widespread use of sentinel lymph node biopsy (SLNB) to replace axillary dissection has broadened the indications for axillary staging in breast cancer. Recent studies have demonstrated a finite risk of lymphedema and sensory morbidity associated with SLNB. We undertook this study to determine whether SLNB could be omitted in clinically node-negative patients with favorable-histology breast cancer.

Is the clinically positive axilla in breast cancer really a contraindication to sentinel lymph node biopsy?

Background: Clinically positive axillary nodes are widely considered a contraindication to sentinel lymph node (SLN) biopsy in breast cancer, yet no data support this mandate. In fact, data from the era of axillary lymph node dissection (ALND) suggest that clinical examination of the axilla is falsely positive in as many as 30% of cases. Here we report the results of SLN biopsy in a selected group of breast cancer patients with palpable axillary nodes classified as either moderately or highly suspicious for metastasis.

Cytokeratin-positive cells in sentinel lymph nodes in breast cancer are not random events: experience in patients undergoing prophylactic mastectomy.

Background: The incidence of immunohistochemistry (IHC)-detected epithelial cell displacement in sentinel lymph node (SLN) biopsy is unknown. In the current study, we address this question by examining the pattern of SLN involvement in patients undergoing prophylactic mastectomy (PM) at Memorial Sloan-Kettering Cancer Center (New York, NY).

Methods: Between January 1999 and January 2003, 5275 patients underwent SLN biopsy.

Eighteen sensations after breast cancer surgery: a two-year comparison of sentinel lymph node biopsy and axillary lymph node dissection.

Purpose/objectives: To evaluate the prevalence, severity, and level of distress of 18 sensations at baseline (3-15 days) and 24 months after breast cancer surgery and to compare sensations after sentinel lymph node biopsy (SLNB) with those after SLNB plus immediate or delayed axillary lymph node dissection (ALND).

Design: Prospective, descriptive.

Setting: Evelyn H.

A prospective analysis of the effect of blue-dye volume on sentinel lymph node mapping success and incidence of allergic reaction in patients with breast cancer.

Background: This study examined whether the volume of isosulfan blue dye used in sentinel lymph node (SLN) mapping in breast cancer is related to the SLN identification rate or to the incidence of allergic reactions.

Methods: From January 2001 to November 2002, 1728 breast cancer patients underwent 1832 SLN mapping procedures with the combined technique of intraparenchymal blue dye and intradermal radioisotope. Details of each procedure and all allergic reactions were prospectively recorded.

A nomogram for predicting the likelihood of additional nodal metastases in breast cancer patients with a positive sentinel node biopsy.

Background: The standard of care for breast cancer patients with sentinel lymph node (SLN) metastases includes complete axillary lymph node dissection (ALND). However, many question the need for complete ALND in every patient with detectable SLN metastases, particularly those perceived to have a low risk of non-SLN metastases. Accurate estimates of the likelihood of additional disease in the axilla could assist greatly in decision-making regarding further treatment.

Obesity influences outcome of sentinel lymph node biopsy in early-stage breast cancer.

Background: Sentinel lymph node biopsy is a rapidly emerging standard of care for staging the axilla in invasive breast cancer. Factors influencing success must be identified to understand the procedure's limitations and challenges. Increasing body mass with age has an inverse relationship to success.

The accuracy of sentinel lymph node biopsy in multicentric and multifocal invasive breast cancers.

Background: Sentinel lymph node biopsy (SLNB) has proved to be an accurate alternative to complete axillary lymph node dissection (ALND) in clinically node-negative breast cancer patients. Multicentric (MC) and multifocal (MF) invasive breast cancers are considered to be relative contraindications to SLNB. We examine the accuracy of SLNB in patients with MC and MF invasive breast cancers.

Sensory morbidity after sentinel lymph node biopsy and axillary dissection: a prospective study of 233 women.

Background: We prospectively compared the sensory morbidity and lymphedema experienced after sentinel node biopsy (SLNB) and axillary dissection (ALND) over a 12-month period by using a validated instrument.

Methods: Patients undergoing breast-conserving therapy completed the Breast Sensation Assessment Scale (BSAS) at baseline and 3, 6, and 12 months after surgery. Repeated-measures analysis of variance was used to compare ALND and SLNB over the 12-month period.

Eighteen sensations after breast cancer surgery: a comparison of sentinel lymph node biopsy and axillary lymph node dissection.

Purpose/objectives: To evaluate prevalence, severity, and level of distress of 18 sensations at 3-15 days (baseline), 3 months, and 6 months after breast cancer surgery; to compare sentinel lymph node biopsy (SLNB) to SLNB with immediate or delayed axillary lymph node dissection; to evaluate the Breast Sensation Assessment Scale(c) (BSAS(c)) for reliability and validity.

Design: Prospective, descriptive.

Setting: Evelyn H.