Selective Axillary Dissection after Neoadjuvant Chemotherapy in Patients with Lymph-Node-Positive Breast Cancer (CLYP Study): The Radio-Guided Occult Lesion Localization Technique for Biopsy-Proven Metastatic Lymph Nodes
(1) Background: To help to refine the accuracy of sentinel lymph node biopsy (SLNB) in breast cancer (BC) patients with biopsy-proven nodal disease prior to neoadjuvant chemotherapy (NACT), a method of marking the biopsy-proven positive LN at diagnosis to enable its removal during surgery was propos...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-03-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/15/7/2046 |
| _version_ | 1797608238669103104 |
|---|---|
| author | Rossella Rella Marco Conti Enida Bufi Charlotte Marguerite Lucille Trombadori Alba Di Leone Daniela Terribile Riccardo Masetti Luca Zagaria Antonino Mulè Francesca Morciano Gianluca Franceschini Paolo Belli |
| author_facet | Rossella Rella Marco Conti Enida Bufi Charlotte Marguerite Lucille Trombadori Alba Di Leone Daniela Terribile Riccardo Masetti Luca Zagaria Antonino Mulè Francesca Morciano Gianluca Franceschini Paolo Belli |
| author_sort | Rossella Rella |
| collection | DOAJ |
| description | (1) Background: To help to refine the accuracy of sentinel lymph node biopsy (SLNB) in breast cancer (BC) patients with biopsy-proven nodal disease prior to neoadjuvant chemotherapy (NACT), a method of marking the biopsy-proven positive LN at diagnosis to enable its removal during surgery was proposed. The aim of this study was to evaluate the accuracy of the Radio-Guided Occult Lesion Localization (ROLL) technique of biopsy-proven metastatic LN in nodal staging after NACT among node-positive BC patients. (2) Methods: Patients with invasive BC and biopsy-proven axillary metastases receiving NACT were enrolled. A clip marker was placed on the sampled LN (clipped lymph node, CLN) before NACT. Before surgery, the ROLL procedure (radioactive tracer injection into CLN under ultrasound guidance) was performed, and the CLN was surgically resected. The correspondence between the CLNs and SLNs was evaluated. The pathologic findings of the CLNs and SLN(s) were compared with remaining axillary nodes at ALND to determine false negative rates (FNRs). (3) Results: Seventy-two patients were analyzed. Surgery successfully identified the CLN in 70/72 procedures (97.2%). For 60/72 patients who underwent ALND, the FNRs dropped from 19.35% for SLNB to 3.13% for CLN biopsy. (4) Conclusions: The ROLL procedure got CLNs is accurate in axillary nodal staging after NACT in node-positive BC patients at diagnosis. |
| first_indexed | 2024-03-11T05:40:38Z |
| format | Article |
| id | doaj.art-441bcec8ef674b63b4502dd1dcbc27fb |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T05:40:38Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-441bcec8ef674b63b4502dd1dcbc27fb2023-11-17T16:25:18ZengMDPI AGCancers2072-66942023-03-01157204610.3390/cancers15072046Selective Axillary Dissection after Neoadjuvant Chemotherapy in Patients with Lymph-Node-Positive Breast Cancer (CLYP Study): The Radio-Guided Occult Lesion Localization Technique for Biopsy-Proven Metastatic Lymph NodesRossella Rella0Marco Conti1Enida Bufi2Charlotte Marguerite Lucille Trombadori3Alba Di Leone4Daniela Terribile5Riccardo Masetti6Luca Zagaria7Antonino Mulè8Francesca Morciano9Gianluca Franceschini10Paolo Belli11UOC di Radiologia Toracica e Cardiovascolare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyUOC di Radiologia Toracica e Cardiovascolare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyUOC di Radiologia Toracica e Cardiovascolare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyUOC di Radiologia Toracica e Cardiovascolare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyCentro Integrato di Senologia, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyCentro Integrato di Senologia, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyCentro Integrato di Senologia, Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyUOC di Medicina Nucleare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyDipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Unità di Gineco-Patologia e Patologia Mammaria, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyFacoltà di Medicina e Chirurgia, Università Cattolica Sacro Cuore, Largo F. Vito 1, 00168 Rome, ItalyDipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Unità di Gineco-Patologia e Patologia Mammaria, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyUOC di Radiologia Toracica e Cardiovascolare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy(1) Background: To help to refine the accuracy of sentinel lymph node biopsy (SLNB) in breast cancer (BC) patients with biopsy-proven nodal disease prior to neoadjuvant chemotherapy (NACT), a method of marking the biopsy-proven positive LN at diagnosis to enable its removal during surgery was proposed. The aim of this study was to evaluate the accuracy of the Radio-Guided Occult Lesion Localization (ROLL) technique of biopsy-proven metastatic LN in nodal staging after NACT among node-positive BC patients. (2) Methods: Patients with invasive BC and biopsy-proven axillary metastases receiving NACT were enrolled. A clip marker was placed on the sampled LN (clipped lymph node, CLN) before NACT. Before surgery, the ROLL procedure (radioactive tracer injection into CLN under ultrasound guidance) was performed, and the CLN was surgically resected. The correspondence between the CLNs and SLNs was evaluated. The pathologic findings of the CLNs and SLN(s) were compared with remaining axillary nodes at ALND to determine false negative rates (FNRs). (3) Results: Seventy-two patients were analyzed. Surgery successfully identified the CLN in 70/72 procedures (97.2%). For 60/72 patients who underwent ALND, the FNRs dropped from 19.35% for SLNB to 3.13% for CLN biopsy. (4) Conclusions: The ROLL procedure got CLNs is accurate in axillary nodal staging after NACT in node-positive BC patients at diagnosis.https://www.mdpi.com/2072-6694/15/7/2046clipped lymph nodeneoadjuvant systemic therapynode-positive breast cancer patientsRadio-Guided Occult Lesion Localization (ROLL) techniquesentinel lymph node biopsy |
| spellingShingle | Rossella Rella Marco Conti Enida Bufi Charlotte Marguerite Lucille Trombadori Alba Di Leone Daniela Terribile Riccardo Masetti Luca Zagaria Antonino Mulè Francesca Morciano Gianluca Franceschini Paolo Belli Selective Axillary Dissection after Neoadjuvant Chemotherapy in Patients with Lymph-Node-Positive Breast Cancer (CLYP Study): The Radio-Guided Occult Lesion Localization Technique for Biopsy-Proven Metastatic Lymph Nodes Cancers clipped lymph node neoadjuvant systemic therapy node-positive breast cancer patients Radio-Guided Occult Lesion Localization (ROLL) technique sentinel lymph node biopsy |
| title | Selective Axillary Dissection after Neoadjuvant Chemotherapy in Patients with Lymph-Node-Positive Breast Cancer (CLYP Study): The Radio-Guided Occult Lesion Localization Technique for Biopsy-Proven Metastatic Lymph Nodes |
| title_full | Selective Axillary Dissection after Neoadjuvant Chemotherapy in Patients with Lymph-Node-Positive Breast Cancer (CLYP Study): The Radio-Guided Occult Lesion Localization Technique for Biopsy-Proven Metastatic Lymph Nodes |
| title_fullStr | Selective Axillary Dissection after Neoadjuvant Chemotherapy in Patients with Lymph-Node-Positive Breast Cancer (CLYP Study): The Radio-Guided Occult Lesion Localization Technique for Biopsy-Proven Metastatic Lymph Nodes |
| title_full_unstemmed | Selective Axillary Dissection after Neoadjuvant Chemotherapy in Patients with Lymph-Node-Positive Breast Cancer (CLYP Study): The Radio-Guided Occult Lesion Localization Technique for Biopsy-Proven Metastatic Lymph Nodes |
| title_short | Selective Axillary Dissection after Neoadjuvant Chemotherapy in Patients with Lymph-Node-Positive Breast Cancer (CLYP Study): The Radio-Guided Occult Lesion Localization Technique for Biopsy-Proven Metastatic Lymph Nodes |
| title_sort | selective axillary dissection after neoadjuvant chemotherapy in patients with lymph node positive breast cancer clyp study the radio guided occult lesion localization technique for biopsy proven metastatic lymph nodes |
| topic | clipped lymph node neoadjuvant systemic therapy node-positive breast cancer patients Radio-Guided Occult Lesion Localization (ROLL) technique sentinel lymph node biopsy |
| url | https://www.mdpi.com/2072-6694/15/7/2046 |
| work_keys_str_mv | AT rossellarella selectiveaxillarydissectionafterneoadjuvantchemotherapyinpatientswithlymphnodepositivebreastcancerclypstudytheradioguidedoccultlesionlocalizationtechniqueforbiopsyprovenmetastaticlymphnodes AT marcoconti selectiveaxillarydissectionafterneoadjuvantchemotherapyinpatientswithlymphnodepositivebreastcancerclypstudytheradioguidedoccultlesionlocalizationtechniqueforbiopsyprovenmetastaticlymphnodes AT enidabufi selectiveaxillarydissectionafterneoadjuvantchemotherapyinpatientswithlymphnodepositivebreastcancerclypstudytheradioguidedoccultlesionlocalizationtechniqueforbiopsyprovenmetastaticlymphnodes AT charlottemargueritelucilletrombadori selectiveaxillarydissectionafterneoadjuvantchemotherapyinpatientswithlymphnodepositivebreastcancerclypstudytheradioguidedoccultlesionlocalizationtechniqueforbiopsyprovenmetastaticlymphnodes AT albadileone selectiveaxillarydissectionafterneoadjuvantchemotherapyinpatientswithlymphnodepositivebreastcancerclypstudytheradioguidedoccultlesionlocalizationtechniqueforbiopsyprovenmetastaticlymphnodes AT danielaterribile selectiveaxillarydissectionafterneoadjuvantchemotherapyinpatientswithlymphnodepositivebreastcancerclypstudytheradioguidedoccultlesionlocalizationtechniqueforbiopsyprovenmetastaticlymphnodes AT riccardomasetti selectiveaxillarydissectionafterneoadjuvantchemotherapyinpatientswithlymphnodepositivebreastcancerclypstudytheradioguidedoccultlesionlocalizationtechniqueforbiopsyprovenmetastaticlymphnodes AT lucazagaria selectiveaxillarydissectionafterneoadjuvantchemotherapyinpatientswithlymphnodepositivebreastcancerclypstudytheradioguidedoccultlesionlocalizationtechniqueforbiopsyprovenmetastaticlymphnodes AT antoninomule selectiveaxillarydissectionafterneoadjuvantchemotherapyinpatientswithlymphnodepositivebreastcancerclypstudytheradioguidedoccultlesionlocalizationtechniqueforbiopsyprovenmetastaticlymphnodes AT francescamorciano selectiveaxillarydissectionafterneoadjuvantchemotherapyinpatientswithlymphnodepositivebreastcancerclypstudytheradioguidedoccultlesionlocalizationtechniqueforbiopsyprovenmetastaticlymphnodes AT gianlucafranceschini selectiveaxillarydissectionafterneoadjuvantchemotherapyinpatientswithlymphnodepositivebreastcancerclypstudytheradioguidedoccultlesionlocalizationtechniqueforbiopsyprovenmetastaticlymphnodes AT paolobelli selectiveaxillarydissectionafterneoadjuvantchemotherapyinpatientswithlymphnodepositivebreastcancerclypstudytheradioguidedoccultlesionlocalizationtechniqueforbiopsyprovenmetastaticlymphnodes |