Background: Postoperative lymphedema in breast cancer survivors is a serious complication that develops from axillary lymph node dissection (ALND), chemotherapy, and radiation therapy. Axillary reverse mapping (ARM) was recently introduced to reduce lymphedema. This pilot study aimed to investigate the feasibility of preserving the ARM node using fluorescence imaging for patients at high risk of lymphedema.
Methods: We prospectively screened patients with breast cancer who had pathologic node-positive disease at diagnosis and were scheduled for neoadjuvant chemotherapy (NCT). The sentinel lymph node (SLN) was identified using blue dye and radioisotope, while the ARM node was traced using indocyanine green (ICG). In cases in which SLN was negative on the intraoperative frozen section examination, the ARM node and lymphatics were preserved.
Results: Of the 20 screened patients, six whose metastatic axillary lymph node (ALN) was converted to clinically node-negative disease after NCT were enrolled. No patients experienced recurrence at 24 months postoperative. Four patients who had a preserved ARM node did not develop lymphedema. One patient whose ARM node was not preserved due to SLN identification failure did not develop postoperative lymphedema. One patient who underwent ALND without ARM node conservation because of metastatic SLN on frozen section examination developed postoperative lymphedema.
Conclusions: ARM is oncologically safe, decreases the incidence of postoperative lymphedema, and allows for the early detection of postoperative lymphedema in patients who underwent ALND. Ultimately, ARM may help improve the quality of life of patients with pathologic node-positive breast cancer.
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http://dx.doi.org/10.21037/gs.2020.03.29 | DOI Listing |
Jt Dis Relat Surg
January 2025
Ankara Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, 06230 Altındağ, Ankara, Türkiye.
Objectives: This study aims to investigate the frequency of recurrence and prolonged postoperative symptoms in patients undergoing open A1 pulley release for trigger finger and to identify potential associated factors.
Patients And Methods: Between October 2021 and December 2023, a total of 72 patients (30 males, 42 females; mean age: 58.0±11.
Objectives: To report the first cases of surgical staging for apparently early-stage endometrial cancer performed using the Versius® next-generation robotic surgical system (Cambridge Medical Robots [CMR] Surgical, Cambridge, UK).
Design: Prospective case series. Participants/Materials: Women who underwent surgical staging, including total hysterectomy, bilateral adnexectomy, and sentinel lymph node (SLN) biopsy, for apparently early-stage endometrial cancer using the Versius® next-generation robotic surgical system (CMR Surgical, Cambridge, UK).
Am J Otolaryngol
December 2024
Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA. Electronic address:
Background/objectives: RAS mutations are common in thyroid cancer, but their impact on clinical outcomes remains controversial. This study aimed to evaluate the prevalence of RAS mutations in thyroid cancer and their association with various clinical and pathological features.
Methods: We conducted a systematic review and meta-analysis of studies reporting on RAS mutations in thyroid cancer.
J Neuroeng Rehabil
December 2024
Department of Kinesiology, University of Georgia, 330 River Road, Athens, GA, 30602, USA.
Background: The prefrontal cortex (PFC) is an important node for action planning in the frontoparietal reaching network but its role in reaching in children with cerebral palsy (CP) is unexplored. This case-control study combines a robotic task with functional near-infrared spectroscopy (fNIRS) to concurrently assess reaching accuracy and PFC activity during time-constrained, goal-directed reaching in children with CP. We hypothesized that reaching accuracy in children with CP would be lower than in typically developing children and would be related to PFC activity.
View Article and Find Full Text PDFInt J Radiat Oncol Biol Phys
December 2024
Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Purpose: This study reports on the clinical outcomes of the single arm phase-II STEAL trial investigating online adaptive stereotactic body radiotherapy (SBRT) for abdominal-pelvic lymph node (A-P LN) oligometastases.
Methods: Patients with oligometastatic A-P LN were enrolled and treated to a total dose of 45 Gy in five fractions on the CyberKnife. For each patient, a library of three plans was created using a pre-treatment diagnostic CT scan and the treatment planning CT scan.
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