Clinical breast cancer
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Clinical breast cancer · Jun 2013
A new technique that complements sentinel lymph node biopsy: lymph node dissection under the intercostobrachial nerves in early-stage breast cancer.
Arm lymphedema is a common complication after axillary lymph node dissection (ALND), and there is no effective treatment. The clinical significance of sentinel lymph node biopsy (SLNB) is to avoid the risk of arm lymphedema caused by ALND in cases in which the nodes are negative for cancer cells. In developed countries, sentinel lymph node (SLN) localization methods by using combined dye and radioactive tracer techniques predict the lymph node status in early-stage breast cancer with comparable success rates, accuracy, and false-negative rates. In fact, most researchers agree that the combined technique has significantly higher accuracy than marking the sentinel nodes with dye alone. In China, the radioactive tracer technique is mostly used in research but not in clinical surgery, where it is not permitted. The necessity of intercostobrachial nerves (ICBN) preservation is now accepted by the surgeons and has become the standard procedure in such dissections, which reduces postoperative skin numbness and loss of feeling in the upper arm. ⋯ ALND under the ICBN could be considered a procedure complementary to SLNB in early-stage breast cancer in China, where the radioactive tracer technique is not widely applied.
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Clinical breast cancer · Jun 2013
Five-year outcomes and toxicities using 3-dimensional conformal external beam radiation therapy to deliver accelerated partial breast irradiation.
Limited 5-year data exist on clinical outcomes and toxicities for patients undergoing 3-dimensional conformal radiation therapy (3D-CRT) APBI. ⋯ In the largest group of patients published to date using 3D-CRT to deliver APBI, no local recurrences were noted at 5 years. More than 80% of patients had excellent or good cosmesis.
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Clinical breast cancer · Apr 2013
The role of immunohistochemistry in breast cancer patients treated with neoadjuvant chemotherapy: an old tool with an enduring prognostic value.
To assess the molecular subtypes determined by hormonal receptors (HR) and human epidermal growth factor receptor 2 (HER2) status and the role of proliferation measured by the Ki-67 marker as predictive and prognostic factors in breast cancer patients treated with neoadjuvant chemotherapy. ⋯ Molecular subtypes and Ki-67 index were independent prognostic factors for disease-free survival and overall survival in breast cancer patients treated with neoadjuvant chemotherapy. A high rate of Ki-67 and HR(-) expression were predictors of pCR.
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Clinical breast cancer · Feb 2013
Outcomes of clinically node-negative breast cancer without axillary dissection: can preserved axilla be safely treated with radiation after a positive sentinel node biopsy?
We analyzed whether axillary nodal irradiation could control clinically node-negative disease, including those patients with a positive sentinel lymph node biopsy (SLNB), most of whom received regional nodal irradiation. We also evaluated toxicity profiles that resulted from nodal irradiation. ⋯ Treatment without axillary dissection showed excellent outcomes with negligible toxicity for patients with clinically node negative, including those with a positive SLNB. Regional nodal irradiation after a positive SLNB is a reasonable alternative to axillary dissection.
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Clinical breast cancer · Feb 2013
Comparative StudyInfluence of neoadjuvant chemotherapy on HER2/neu status in invasive breast cancer.
Reliably estimating HER2/neu expression in breast cancer is important for predicting patient prognosis and optimizing adjuvant therapeutic strategies. In this retrospective cohort study, effects of NAC on HER2/neu status in invasive breast cancer were evaluated, and the related factors were analyzed. ⋯ Neoadjuvant chemotherapy for breast carcinoma resulted in the HER2/neu status alteration by IHC, but they have stable gene amplification status by FISH. HER2/neu protein overexpression indicated greater sensitivity to neoadjuvant anthracycline- and taxane-based chemotherapy. Thus, retesting HER2/neu IHC status in residual tumors after NAC should be considered in order to optimize adjuvant systemic therapy.