The effect of sentinel node tumor burden on non-sentinel node status and recurrence rates in breast cancer.
ABSTRACT Routine axillary lymph node dissection (ALND) after selective sentinel lymphadenectomy (SSL) in the treatment of breast cancer remains controversial. We sought to determine the need for routine ALND by exploring the relationship between sentinel lymph node (SLN) and non-SLN (NSLN) status. We also report our experience with disease relapse in the era of SSL and attempt to correlate this with SLN tumor burden.
This was a retrospective study of 390 patients with invasive breast cancer treated at a single institution who underwent successful SSL from November 1997 to November 2002.
Of the 390 patients, 115 received both SSL and ALND. The percentage of additional positive NSLNs in the SLN-positive group (34.2%) was significantly higher than in the SLN-negative group (5.1%; P = .0004). The SLN macrometastasis group had a significantly higher rate of positive NSLNs (39.7%) compared with the SLN-negative group (5.1%; P = .0001). Sixteen patients developed recurrences during follow-up, including 6.1% of SLN-positive and 3.3% of SLN-negative patients. Among the SLN macrometastasis group, 8.7% had recurrence, compared with 2.2% of SLN micrometastases over a median follow-up period of 31.1 months. One regional failure developed out of 38 SLN-positive patients who did not undergo ALND.
ALND is recommended for patients with SLN macrometastasis because of a significantly higher incidence of positive NSLNs. Higher recurrence rates are also seen in these patients. However, the role of routine ALND in patients with a low SLN tumor burden remains to be further determined by prospective randomized trials.
Conference Paper: Application of SVD to 2-D spectral estimation[Show abstract] [Hide abstract]
ABSTRACT: In this paper, a new method by which some modern techniques of one dimension (1-D) spectral estimation can be extended to two dimension (2-D) cases is presented. The main point of the new method is to find the optimum separable approximation of a given autocorrelation matrix in the least square sense, so that 2-D spectral estimation can be reduced to 1-D problem. It is proved in this paper that finding the optimum separable approximation of a matrix in the least square sense is equivalent to finding separable representation of the matrix by singular value decomposition (SVD). Finally, some results of experiments are shown to illustrate the performance of the new method and to compare with other 2-D spectral estimation methods.Acoustics, Speech, and Signal Processing, IEEE International Conference on ICASSP '84.; 04/1984
Conference Paper: A poly-phase structure for system identification and adaptive filtering[Show abstract] [Hide abstract]
ABSTRACT: An alias free parallel structure for system identification is proposed. The method utilizes the properties of a DFT filter bank in conjunction with accumulators which form a zooming mechanism on alias free points in the frequency domain. This method is very ideal for identifying long impulse responses under very adverse input coloringAcoustics, Speech, and Signal Processing, 1994. ICASSP-94., 1994 IEEE International Conference on; 05/1994