| Autor: |
Barsoum, Kerolos A., Safwat, Yehia M., Elshayeb, Amr Y., Adel, Lamiaa, Ali, Emad H., Ameen, Mahmoud A. |
| Předmět: |
|
| Zdroj: |
Surgical Chronicles; Apr-Jun2024, Vol. 29 Issue 2, p229-235, 7p |
| Abstrakt: |
Background: In recent years, management of the axilla in breast cancer has been changing significantly. Axillary lymph node dissection (ALND) has been the standard care for axillary lymph node positive patients, however significant morbidity has been reported with the procedure. Hence, there was a need for a clinical trial to evaluate the optimal treatment for clinically node-positive breast cancer patients in terms of surgery and radiotherapy. Methods:We included thirty female patients with operable breast cancer with clinically/ultrasonographically positive axilla who were candidates for ALND. Intraoperative ultrasound guided axillary lymph node sampling is done followed by backup ALND and sent as separate specimens. Sensitivity, specificity, negative predictive value, positive predictive value, false negative rate, and overall accuracy were calculated. Results:We harvested 77 nodes guided by intraoperative ultrasound; 59 nodes found to have macroscopic metastasis (true positive) by paraffin sections. While 10 nodes had microscopic metastasis, 8 nodes had no metastasis by paraffin sections (false positive). We harvested a total number of 387 nodes as a backup axillary clearance (residual LNS); 1 node had a macroscopic metastasis (false negative) by paraffin sections. While 22 nodes had microscopic metastasis, 364 nodes had no metastasis by paraffin sections (true negative). Analysis of the previous data showed that sensitivity and specificity is 76.62% and 99.74% respectively with false negative rate (FNR) 1.6%. positive and negative predictive values are 98.33% and 95.54% respectively. The overall accuracy is 95.9%. Conclusion:The use of intraoperative ultrasound guided axillary lymph node sampling as a tailored procedure in clinically node positive patients in early breast cancer will avoid surgical overtreatment by selectively removing the lymph nodes that are affected by the cancer, thereby sparing many patients the unnecessary complications of a radical surgery, providing a better quality of life while keeping the same efficacy. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
|
