• Humans
• Sentinel Lymph Node Biopsy/standards
• Sentinel Lymph Node Biopsy/methods
• Breast Neoplasms/pathology
• Breast Neoplasms/surgery
• Breast Neoplasms/therapy
• Female
• Neoplasm Staging

• ACOSOG Z0011
• Breast cancer
• Sentinel lymph node

• Humans
• Breast Neoplasms/pathology
• Breast Neoplasms/surgery
• Breast Neoplasms/mortality
• Breast Neoplasms/therapy
• Female
• Sentinel Lymph Node Biopsy
• Middle Aged
• Mastectomy, Segmental/methods
• Retrospective Studies
• Axilla
• Lymph Node Excision/methods
• Adult
• Aged
• Neoplasm Recurrence, Local/pathology
• Disease-Free Survival
• Lymphatic Metastasis
• Neoplasm Staging
• Chemotherapy, Adjuvant

• Bone marrow invasion
• Diagnosis
• FDP/FIB
• Gastric cancer
• Prognosis

• Humans
• Stomach Neoplasms/pathology
• Stomach Neoplasms/mortality
• Stomach Neoplasms/blood
• Stomach Neoplasms/diagnosis
• Male
• Female
• Middle Aged
• Prognosis
• Biomarkers, Tumor/blood
• Retrospective Studies
• Bone Marrow/pathology
• Aged
• Neoplasm Invasiveness
• Adult
• ROC Curve
• Kaplan-Meier Estimate
• Neoplasm Staging

• 20241554 Hebei Province Medical Science Research Key Project
• H2020206292 The National Natural Science Foundation of China of Hebei Province
• H2024206074 The National Natural Science Foundation of China of Hebei Province

• Breast cancer
• axillary lymph nodes
• neoadjuvant
• radiotherapy
• surgery

• Disseminated cancer cells
• Dormancy
• EMT
• Early dissemination
• Metastasis

• Humans
• Animals
• Neoplasm Metastasis
• Neoplasms/pathology
• Neoplastic Cells, Circulating/pathology
• Disease Progression

• 1R01CA266443-01A1 NIH HHS
• R01 CA266443 NCI NIH HHS
• ASP231044859 Susan G. Komen
• Scholar Program in Solid Tumors grant Gilead Research Scholars
• Sohn Prize-PSSCRA Pershing Square Foundation
• CCR22899137 Susan G. Komen

• Female
• Humans
• Pathologists
• Lymphatic Metastasis
• Neoplasm Staging
• Gynecology
• Endometrial Neoplasms/pathology
• Genital Neoplasms, Female/pathology

• 2022, Pathological diagnosis
• Breast cancer
• Guideline

• Female
• Humans
• Breast Neoplasms/diagnosis
• Breast Neoplasms/pathology
• Decision Support Techniques
• Japan
• Medical Oncology

• Female
• Humans
• Biomarkers, Tumor/metabolism
• Immunohistochemistry
• Receptor, ErbB-2/metabolism
• Breast
• Prognosis
• Breast Neoplasms/diagnosis
• Receptors, Progesterone/metabolism

• Breast cancer
• Clinical utility
• External validation
• PREDICT Breast
• Prognosis prediction

• Humans
• Female
• Adult
• Prognosis
• Breast Neoplasms/pathology
• Chemotherapy, Adjuvant
• Registries
• Netherlands

• HER2-positive
• breast cancer
• micro-metastases
• sentinel node
• survival

• Breast cancer
• Fluorescence imaging
• Meta-analysis
• Sentinel lymph node
• Tracing method

• Humans
• Female
• Sentinel Lymph Node Biopsy/methods
• Indocyanine Green
• Breast Neoplasms/diagnostic imaging
• Breast Neoplasms/pathology
• Sentinel Lymph Node/diagnostic imaging
• Sentinel Lymph Node/pathology
• Coloring Agents
• Photochemotherapy/methods
• Photosensitizing Agents
• Optical Imaging/methods
• Fluorescence
• Multicenter Studies as Topic

• Female
• Humans
• Endometrial Neoplasms/pathology
• Lymph Node Excision
• Lymph Nodes/pathology
• Lymphatic Metastasis/pathology
• Neoplasm Staging
• Prognosis
• Retrospective Studies

• Axillary surgery
• Breast cancer
• MARI
• Sentinel lymph node biopsy
• Targeted axillary dissection

• Axillary reverse mapping
• lymphedema
• sentinel lymph node biopsy

• ACOSOG Z0011
• ACOSOG Z1071
• AMAROS
• Artificial intelligence
• Breast cancer
• Extranodal extension
• Intraoperative evaluation
• NSABP B-32
• OSNA
• Sentinel lymph node

Lymph nodes (LNs) metastasis is one of the most important factors affecting the outcome of non-small cell lung. The aim of this study is to explore whether presence of oncogenic alterations in histologically-negative lymph nodes (LNs) can be of prognostic significance in stage I lung adenocarcinoma (LUAD). We confirmed that presence of oncogenic alterations in regional LN may be associated with higher risks of postsurgical recurrence of Stage I LUAD, particularly for certain molecular subgroups. These results warranted future studies on larger cohort of NSCLC patients using more comprehensive cancer gene panels to establish the clinical impact of molecular LN occult metastasis for localized NSCLC and identify Stage I patients at high risks for recurrence for appropriate adjuvant therapy.

Background: Survival of patients with stage I non-small cell lung cancer (NSCLC) varies greatly. We sought to explore whether presence of oncogenic alterations in histologically-negative lymph nodes (LNs) can be of prognostic significance in stage I lung adenocarcinoma (LUAD). Methods: Genomic analysis of oncogenic alterations was applied to 123 stage I LUAD tumors. The same genomic variants identified in primary tumors were examined in corresponding histologically-negative LNs. Results: A total of 102 (82.9%) patients had at least one canonical oncogenic alteration detected in primary tumors, and 57 LNs from 12 patients (11.8%) were found to carry the identical oncogenic alterations detected in the corresponding primary tumor tissues, including EGFR mutations (six cases), KRAS mutations (three cases), ALK fusion (one case), BRAF mutation (one case) and HER2 & NRAS co-mutations (one case). None of these LNs was found to have occult tumor cells by routine pathological assessment or immunohistochemistry staining using antibodies against pan-cytokeratins (AE1/AE3) and the epithelial marker Ber-EP4. The detection rate of oncogenenic alterations in LN was significantly higher in RAS-mutant tumors than EGFR mutant tumors (36.36% verse 7.41%, p = 0.017). Patients with oncogenic alterations in LN showed inferior disease-free survival (DFS, p = 0.025) and overall survival (OS, p = 0.027). Furthermore, patients with RAS-mutations detected in LN had the worst DFS and OS (p = 0.001). Among the 11 patients with RAS mutation in primary tumors, DFS and OS in the four patients with mutations detected in LN were significantly shorter than the remaining seven patients without mutations LN (DFS, p = 0.001, OS, p = 0.002). Conclusions: Genomic analysis has the potential to detect oncogenic alterations in regional LNs for localized LUAD and presence of oncogenic alterations in regional LN may be associated with inferior clinical outcome of stage I LUAD, particularly for certain molecular subgroups. ClinicalTrials.gov ID NCT04266691

• Disseminated tumor cell dormancy
• Dormant niche
• Metastasis
• Microenvironment
• Quiescence

• Animals
• Disease Management
• Disease Susceptibility
• Humans
• Neoplasms/etiology
• Neoplasms/pathology
• Recurrence
• Tumor Microenvironment

• F99 CA234840 NCI NIH HHS
• R01 CA249528 NCI NIH HHS
• R01 CA252874 NCI NIH HHS
• U54 CA193461 NCI NIH HHS

• Axilla
• Breast cancer
• Chemotherapy
• Contralateral prophylactic mastectomy
• Endocrine therapy
• Neoadjuvant

• Antineoplastic Agents/therapeutic use
• Antineoplastic Agents, Hormonal/therapeutic use
• Axilla
• Breast Neoplasms/drug therapy
• Breast Neoplasms/surgery
• Breast Neoplasms/therapy
• Combined Modality Therapy
• Female
• Humans
• Lymph Node Excision
• Mammaplasty
• Mastectomy
• Neoadjuvant Therapy
• Neoplasm Staging
• Prophylactic Mastectomy

• K08 CA241390 NCI NIH HHS

Axillary sentinel lymph node biopsy (SLNB) is standard treatment for patients with clinically and pathological negative lymph nodes. However, the role of completion axillary lymph node dissection (cALND) following positive sentinel lymph node biopsy (SLNB) is debated.

To identify a subgroup of women with high axillary tumor burden undergoing SLNB in whom cALND can be safely omitted in order to reduce the risk of long-term complications and create a Preoperative Clinical Risk Index (PCRI) that helps us in our clinical practice to optimize the selection of these patients.

Patients with positive SLNB who underwent a cALND were included in this study. Univariate and multivariate analysis of prognostic and predictive factors were used to create a PCRI for safely omitting cALND.

From May 2007 to April 2014, we performed 1140 SLN biopsies, of which 125 were positive for tumor and justified to practice a posterior cALND. Pathologic findings at SLNB were micrometastases (mic) in 29 cases (23.4%) and macrometastasis (MAC) in 95 cases (76.6%). On univariate analysis of the 95 patients with MAC, statistically significant factors included: age, grade, phenotype, histology, lymphovascular invasion, lymph-node tumor size, and number of positive SLN. On multivariate analysis, only lymph-node tumor size (≤ 20 mm) and number of positive SLN (> 1) retained significance. A numerical tool was created giving each of the parameters a value to predict preoperatively which patients would not benefit from cALND. Patients with a PCRI ≤ 15 has low probability (< 10%) of having additional lymph node involvement, a PRCI between 15-17.6 has a probability of 43%, and the probability increases to 69% in patients with a PCRI > 17.6.

The PCRI seems to be a useful tool to prospectively estimate the risk of nodal involvement after positive SLN and to identify those patients who could omit cALND. Further prospective studies are necessary to validate PCRI clinical generalization.

• Sentinel lymph node biopsy
• Complete axillary lymph node dissection
• Preoperative clinical risk index
• Macrometastasis

Occult metastases in axillary lymph nodes have been reported to be associated with poor prognosis in patients with breast cancer. However, studies on the prognostic value of occult metastases have shown controversial results. This meta-analysis aimed to evaluate the prognostic significance of occult lymph node metastases in breast cancer.

Studies published until May, 2020, which retrospectively examined negative lymph nodes by stepsectioning and/or immunohistochemistry, were retrieved from MEDLINE, EMBASE, CNKI, and Cochrane Library databases. The pooled Relative Risk (RR) with 95% confidence interval (95% CI) for overall survival (OS) and disease-free survival (DFS) were calculated to examine the associations between occult metastases and prognosis.

Patients with occult metastases in axillary lymph nodes had poorer five-year DFS (RR = 0.930; 95% CI = 0.907–0.954) and OS (RR = 0.972; 95% CI = 0.954–0.990). Furthermore, the DFS (RR = 0.887; 95% CI = 0.810–0.972) and OS (RR = 0.896; 95% CI = 0.856–0.939) of patients with occult metastases were significantly lower after a ten-year follow-up.

Occult metastases in the axillary lymph nodes are associated with poorer DFS andOS of patients with breast cancer. Occult metastases might serve as a predictive factor of survival outcomes in patients with breast cancer.

• Axillary lymph nodes
• Breast cancer
• Occult metastases
• Recurrence
• Survival

• Bone marrow
• Disseminated tumour cells
• Early breast cancer
• Micrometastases
• Prognosis
• Tumour staging

• Breast cancer
• Lymph nodes
• Neoadjuvant treatment
• Questionnaire
• Sentinel lymph nodes

• Breast cancer
• Dormancy
• EMT
• Gene expression
• Quiescence
• Recurrence
• Residual disease
• Stem cells
• Targeted therapy

• Animals
• Breast Neoplasms/drug therapy
• Breast Neoplasms/genetics
• Breast Neoplasms/pathology
• Disease-Free Survival
• Epithelial-Mesenchymal Transition/genetics
• Female
• Humans
• Mice
• Mice, Transgenic
• Molecular Targeted Therapy/adverse effects
• Neoplasm Metastasis
• Neoplasm Recurrence, Local
• Neoplasm, Residual/blood supply
• Neoplasm, Residual/etiology
• Neoplasm, Residual/genetics
• Neoplasm, Residual/pathology
• Neoplastic Stem Cells/metabolism
• Neoplastic Stem Cells/pathology
• Neovascularization, Pathologic/pathology
• Receptor, ErbB-2/antagonists & inhibitors
• Receptor, ErbB-2/genetics
• Wnt1 Protein/antagonists & inhibitors
• Wnt1 Protein/genetics

• R01 CA098371 NCI NIH HHS
• R01 CA143296 NCI NIH HHS
• R01 CA148774 NCI NIH HHS
• R01 CA208273 NCI NIH HHS
• National Cancer Institute
• U.S. Department of Defense
• Susan G. Komen
• Breast Cancer Research Foundation

Prognostic impact of lymph node micro-metastases (pN1mi) has been discordantly reported in the literature. The need to clarify this point for decision-making regarding adjuvant therapy, particularly for patients with endocrine receptor (ER)-positive status and HER2-negative tumors, is further reinforced by the generalization of gene expression signatures using pN status in their recommendation algorithm.

We retrospectively analyzed 13 773 patients treated for ER-positive breast cancer in 13 French cancer centers from 1999 to 2014. Five categories of axillary lymph node (LN) status were defined: negative LN (pN0i−), isolated tumor cells [pN0(i+)], pN1mi, and pN1 divided into single (pN1 = 1) and multiple (pN1 > 1) macro-metastases (>2 mm). The effect of LN micro-metastases on outcomes was investigated both in the entire cohort of patients and in clinically relevant subgroups according to tumor subtypes. Propensity-score-based matching was used to balance differences in known prognostic variables associated with pN status.

As determined by sentinel LN biopsy, 9427 patients were pN0 (68.4%), 546 pN0(i+) (4.0%), 1446 pN1mi (10.5%) and 2354 pN1 with macro-metastases (17.1%). With a median follow-up of 61.25 months, pN1 status, but not pN1mi, significantly impacted overall survival (OS), disease-free survival (DFS), metastasis-free survival (MFS), and breast-cancer-specific survival. In the subgroup of patients with known tumor subtype, pN1 = 1, as pN1 > 1, but not pN1mi, had a significant prognostic impact on OS. DFS and MFS were only impacted by pN1 > 1. Similar results were observed in the subgroup of patients with luminal A-like tumors (n = 7101). In the matched population analysis, pN1macro, but not pN1mi, had a statistically significant negative impact on MFS and OS.

LN micro-metastases have no detectable prognostic impact and should not be considered as a determining factor in indicating adjuvant chemotherapy. The evaluation of the risk of recurrence using second-generation signatures should be calculated considering micro-metastases as pN0.

•

LN micro-metastases have no detectable prognostic impact.

• breast cancer
• micro-metastases
• sentinel node
• survival

• Acoustic liposome
• Chemotherapy
• Drug delivery
• Lymph node metastasis
• Lymphatic vessel
• Ultrasound

Oncotype Dx is used to predict the long-term recurrence risk in patients with estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative invasive breast cancer (BC). This study aimed at establishing a correlation between clinicopathological parameters and recurrence score (RS), subsequently improving predictability and ultimately justifying the use of the multigene assay.

A retrospective analysis of the pathology and clinical data of 114 female patients with BC who had Oncotype Dx testing between 2012 and 2019. The pathological parameters included are tumor cell type, tumor grade, pathological stage, and mitotic index (MI). The expression of ER, progesterone receptor (PR), HER2, and Ki67 was assessed by immunohistochemistry. A univariate and multivariate linear regression analysis was performed to assess the correlation between these parameters and the RS.

In univariate analysis, age (˂40 years), higher tumor grade, and low PR expression were significantly associated with higher RS (P = .02; ˂.001; and ˂.001, respectively). Both MI and Ki67 were also strongly correlated with an increase in the RS with a P value of .01 (Spearman correlation 0.34 and 0.33). In multivariate linear regression analysis, age, MI, and Ki67 lost their significance, but both higher grade and PR remained significantly associated with a higher RS along with the tumor stage (P ˂ .001; ˂.001; and .04, respectively).

Tumor grade and PR immunohistochemical expression are the main predictors of RS in our study population. Other clinicopathological features were not significant predictors of change in RS in multivariate analysis.

• Breast cancer
• Oncotype DX
• clinicopathological parameters
• immunohistochemical expression
• recurrence risk
• risk score

• Breast cancer
• distant metastasis
• locoregional relapse
• molecular type
• prognostic indicator
• sentinel lymph node

Knowledge of the association between isolated tumor cells (ITCs) in breast cancer patients and the outcome is very limited. We aimed to determine the prognostic value of axillary lymph node ITCs for T1N0M0 female breast cancer (FBC) patients.

Data for T1N0M0 FBC patients staged ITCs negative [pN0(i−)] and positive [pN0(i+)] were extracted from the Surveillance, Epidemiology, and End Results database from 2004 to 2015. Prognostic predictors were identified by Kaplan–Meier analysis, competing risk model, and Fine–Gray multivariable regression model.

A total of 94,599 subjects were included, 88,632 of whom were staged at pN0(i−) and 5,967 were pN0(i+). Patients staged pN0(i+) had worse breast cancer-specific survival (BCSS) [hazard ratio (HR): 1.298, 95% CI = 1.069–1.576, P = 0.003] and higher breast cancer-specific death (BCSD) rate (Gray’s test, P = 0.002) than pN0(i−) group. In the Fine–Gray multivariable regression analysis, the pN0(i+) group had higher BCSD rate (HR: 1.321, 95% CI = 1.109–1.575, P = 0.002) than pN0(i−) group. In subgroup analyses, no significant difference in BCSD was shown between the chemotherapy and non-chemotherapy subgroup (Gray’s test, P = 0.069) or radiotherapy and non-radiotherapy subgroup (Gray’s test, P = 0.096).

ITC was independently related to the increase of the BCSD rate and could be identified as a reliable survival predictor for T1N0M0 FBC patients.

• SEER database
• competing risk model
• female breast cancer
• isolated tumor cells
• survival analysis

Although lobectomy is considered the standard surgery for any non‐small cell lung cancer (NSCLC), recent evidence indicates that for early NSCLCs segmentectomy may be equally effective. For segmentectomy to be oncologically safe, however, adequate intraoperative lymph node staging is essential. The aim of this study was to compare the results of a new rapid‐IHC system to the HE analysis for intraoperative nodal diagnosis in lung cancer patients considered for segmentectomy.

This retrospective study analyzed the pathological reports from NSCLC resections over a six‐year period between 2014 and 2020. Using a new device for rapid‐IHC, we applied a high‐voltage, low‐frequency alternating current (AC) field, which mixes the antipancytokeratin antibody as the voltage is switched on/off. Rapid‐IHC can provide a nodal diagnosis within 20 minutes.

Frozen sections from 106 resected lymph nodes from 70 patients were intraoperatively evaluated for metastasis. Of those, five nodes were deemed positive based on both HE staining and rapid‐IHC. In addition, rapid‐IHC alone detected isolated tumor cells in one hilar lymph node. Three cStage IA patients with nodal metastasis detected with HE staining and rapid‐IHC received complete lobectomies. Five‐year relapse‐free survival and overall survival among patients receiving segmentectomy with rapid‐IHC were 88.77% and 88.79%, respectively.

Rapid‐IHC driven by AC mixing is simple, highly accurate, and preserves nodal tissue for subsequent tests. This system can be used effectively for intraoperative nodal diagnosis.

Rapid immunohistochemistry based on alternating‐current field mixing (completed within 20 minutes) is simple and highly accurate. This system will assist clinicians when making intraoperative diagnoses of lymph node metastasis and deciding upon the appropriate surgical procedure in segmentectomy for lung cancer.

Rapid immunohistochemistry driven by alternating‐current field mixing (completed within 20 minutes intraoperatively) is simple, highly accurate, and preserves lymph node tissue for subsequent pathological examination, including molecular assessments.

Segmentectomy for lung cancer is oncologically safe, but only when there is adequate intraoperative node staging. Rapid immunohistochemistry will assist clinicians when making intraoperative nodal diagnoses.

• Intraoperative diagnosis
• lung cancer
• lymph node metastasis
• rapid immunohistochemistry
• segmentectomy

• Breast cancer

• diagnosis
• early breast cancer
• follow-up
• treatment

• Cancer
• Immunotherapy
• Minimal residual disease

• Breast cancer
• Early stages
• Local control
• Overall survival
• Postmastectomy radiotherapy

• Biomarkers
• Breast cancer
• CTCs
• Circulating tumor cells
• Liquid biopsy
• Micrometastases
• Prognostic factors

• breast cancer
• sentinel node

• angular domain
• fluorescence
• lymph node
• mesoscopic
• metastases
• optical projection tomography

• Animals
• Biopsy
• Breast Neoplasms/diagnostic imaging
• Breast Neoplasms/pathology
• Cell Culture Techniques
• Cell Line, Tumor
• Female
• Green Fluorescent Proteins/metabolism
• Humans
• Lymph Nodes/pathology
• Lymphatic Metastasis/diagnostic imaging
• Scattering, Radiation
• Spheroids, Cellular
• Swine
• Tomography, Optical/methods

• R01 EB023969 NIBIB NIH HHS

• intramammary
• lymph node
• prognosis
• sentinel