A consensus conference on the role of sentinel node biopsy in breast cancer was held in Philadelphia in April 2001. The participants included many highly respected American and European investigators in this area. This report summarizes the deliberations of the group and promotes its current guidelines for the integration of this new technique into contemporary clinical practice.
"Other antigens for micrometastases detection of breast cancer are anti-human epidermal growth factor receptors (HER)2, anti-epithelial cell adhesion molecule (anti-EpCAM), and anti-MUC1 . Although IHC staining for cytokeratin is not routinely advocated by any consensus recommendation, it is commonly used in routine practice in the United States and in many European countries [24-27]. SLN cytokeratin and epithelial membrane antigen IHC screening reported micrometastases in 9% to 30% of those cases, in which the lymph nodes were earlier declared negative on histopathology [28-30]. "
[Show abstract][Hide abstract] ABSTRACT: Breast cancer cure aims at complete elimination of malignant cells and essentially requires detection and treatment of any micrometastases. Here, we present a review of the current methods in use and the potential role of the quantum dots (QDs) in detection and visualization of sentinel lymph node and micrometastases in breast cancer patients. The traditional histopathological, immunohistochemical, and reverse transcriptase polymerase chain reaction procedures being used for micrometastases detection had serious drawbacks of high false negativity, specificity variations and false positivity of the results. Photon emission fluorescence multiplexing characteristics of the quantum dots make them potentially ideal probes for studying the dynamics of cellular processes over time such as continuous tracking of cell migration, differentiation, and metastases. In breast cancer, QDs based molecular and genomic detections had an unparallel high sensitivity and specificity.
Journal of Breast Cancer 03/2013; 16(1):1-11. DOI:10.4048/jbc.2013.16.1.1 · 1.58 Impact Factor
"Sentinel lymph node (SN) biopsy can accurately stage the axilla in early breast cancer, and it causes less morbidity than axillary lymph node dissection (ALND) , , . It remains to be determined whether ALND is always required for women with positive SNs on final histology, given that 40% to 70% of these patients have no metastatic non-sentinel lymph nodes (non-SNs) , , , . "
[Show abstract][Hide abstract] ABSTRACT: To decipher the interaction between the molecular subtype classification and the probability of a non-sentinel node metastasis in breast cancer patients with a metastatic sentinel lymph-node, we applied two validated predictors (Tenon Score and MSKCC Nomogram) on two large independent datasets.
Our datasets consisted of 656 and 574 early-stage breast cancer patients with a metastatic sentinel lymph-node biopsy treated at first by surgery. We applied both predictors on the whole dataset and on each molecular immune-phenotype subgroups. The performances of the two predictors were analyzed in terms of discrimination and calibration. Probability of non-sentinel lymph node metastasis was detailed for each molecular subtype.
Similar results were obtained with both predictors. We showed that the performance in terms of discrimination was as expected in ER Positive HER2 negative subgroup in both datasets (MSKCC AUC Dataset 1 = 0.73 [0.69-0.78], MSKCC AUC Dataset 2 = 0.71 (0.65-0.76), Tenon Score AUC Dataset 1 = 0.7 (0.65-0.75), Tenon Score AUC Dataset 2 = 0.72 (0.66-0.76)). Probability of non-sentinel node metastatic involvement was slightly under-estimated. Contradictory results were obtained in other subgroups (ER negative HER2 negative, HER2 positive subgroups) in both datasets probably due to a small sample size issue. We showed that merging the two datasets shifted the performance close to the ER positive HER2 negative subgroup.
We showed that validated predictors like the Tenon Score or the MSKCC nomogram built on heterogeneous population of breast cancer performed equally on the different subgroups analyzed. Our present study re-enforce the idea that performing subgroup analysis of such predictors within less than 200 samples subgroup is at major risk of misleading conclusions.
PLoS ONE 10/2012; 7(10):e47390. DOI:10.1371/journal.pone.0047390 · 3.23 Impact Factor
"In contrast to melanoma and breast cancer, there is an absence of universal agreement on the definition of lymph node metastases in cervical cancer. Following the Philadelphia Consensus Conference on sentinel nodes in breast cancer , definitions have been proposed: macrometastases as a single focus of metastatic disease per node measuring more than 2 mm, micrometastases as a focus of metastatic disease ranging from 0.2 mm to no more than 2 mm and, in accordance with Marchiolé et al, submicrometastases as metastases measuring no more than 0.2 mm (including the presence of a single non-cohesive tumor cell) . SLN and pelvic lymph nodes are considered positive when they contain macrometastases, micrometastases or submicrometastases. "
[Show abstract][Hide abstract] ABSTRACT: Lymph node status is an important prognostic factor and a criterion for adjuvant therapy in uterine cancers. While detection of micrometastases by ultrastaging techniques is correlated to prognosis in several other cancers, this remains a matter of debate for uterine cancers. The objective of this review on sentinel nodes (SN) in uterine cancers was to determine the contribution of ultrastaging to detect micrometastases.
Review of the English literature on SN procedure in cervical and endometrial cancers and histological techniques including hematoxylin and eosin (H&E) staining, serial sectioning, immunohistochemistry (IHC) and molecular techniques to detect micrometastases.
In both cervical and endometrial cancers, H&E and IHC appeared insufficient to detect micrometastases. In cervical cancer, using H&E, serial sectioning and IHC, the rate of macrometastases varied between 7.1% and 36.3% with a mean value of 25.8%. The percentage of women with micrometastases ranged from 0% and 47.4% with a mean value of 28.3%. In endometrial cancer, the rate of macrometastases varied from 0% to 22%. Using H&E, serial sectioning and IHC, the rate of micrometastases varied from 0% to 15% with a mean value of 5.8%. In both cervical and endometrial cancers, data on the contribution of molecular techniques to detect micrometastases are insufficient to clarify their role in SN ultrastaging.
In uterine cancers, H&E, serial sectioning and IHC appears the best histological combined technique to detect micrometastases. Although accumulating data have proved the relation between the risk of recurrence and the presence of micrometastases, their clinical implications on indications for adjuvant therapy has to be clarified.
Journal of Experimental & Clinical Cancer Research 01/2010; 29(1):5. DOI:10.1186/1756-9966-29-5 · 4.43 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.