지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2017.1
- 수록면
- 1,088 - 1,096 (9page)
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초록· 키워드
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PURPOSE: The American College of Surgeons Oncology Group Z0011 trial reported that complete dissection of axillary lymph nodes (ALNs) may not be warranted in women with clinical T1-T2 tumors and one or two involved ALNs who were undergoing lumpectomy plus radiation followed by systemic therapy. The present study was conducted to identify preoperative imaging predictors of ≥ 3 ALNs.
MATERIALS AND METHODS: The training set consisted of 1,917 patients with clinical T1-T2 and node negative invasive breast cancer. Factors associated with ≥ 3 involved ALNs were evaluated by logistic regression analysis. The validation set consisted of 378 independent patients. The nomogram was applied prospectively to 512 patients who met the Z0011 criteria.
RESULTS: Of the 1,917 patients, 204 (10.6%) had ≥ 3 positive nodes. Multivariate analysis showed that involvement of ≥ 3 nodes was significantly associated with ultrasonographic and chest computed tomography findings of suspicious ALNs (p < 0.001 each). These two imaging criteria, plus patient age, were used to develop a nomogram calculating the probability of involvement of ≥ 3 ALNs. The areas under the receiver operating characteristic curve of the nomogram were 0.852 (95% confidence interval [CI], 0.820 to 0.883) for the training set and 0.896 (95% CI, 0.836 to 0.957) for the validation set. Prospective application of the nomogram showed that 60 of 512 patients (11.7%) had scores above the cut-off. Application of the nomogram reduced operation time and cost, with a very low re-operation rate (1.6%).
CONCLUSION: Patients likely to have ≥ 3 positive ALNs could be identified by preoperative imaging. The nomogram was helpful in selective intraoperative examination of sentinel lymph nodes.
목차
등록된 정보가 없습니다.
참고문헌 (30)
참고문헌 신청
McLaughlin SA / 2008 / Influence of frozen-section analysis of sentinel lymph node and lumpectomy margin status on reoperation rates in patients undergoing breast-conservation therapy / J Am Coll Surg 206:76~82
Pamilo M / 1989 / Real-time ultrasound, axillary mammography, and clinical examination in the detection of axillary lymph node metastases in breast cancer patients / J Ultrasound Med 8:115~120
Nori J / 2007 / Role of axillary ultrasound examination in the selection of breast cancer patients for sentinel node biopsy / Am J Surg 193:16~20
Lee MC / 2011 / Consequences of axillary ultrasound in patients with T2 or greater invasive breast cancers / Ann Surg Oncol 18:72~77
March DE / 1991 / CT-pathologic correlation of axillary lymph nodes in breast carcinoma / J Comput Assist Tomogr 15:440~444
Pamilo M / 1989 / Real-time ultrasound, axillary mammography, and clinical examination in the detection of axillary lymph node metastases in breast cancer patients / J Ultrasound Med 8:115~120
Nori J / 2007 / Role of axillary ultrasound examination in the selection of breast cancer patients for sentinel node biopsy / Am J Surg 193:16~20
Lee MC / 2011 / Consequences of axillary ultrasound in patients with T2 or greater invasive breast cancers / Ann Surg Oncol 18:72~77
March DE / 1991 / CT-pathologic correlation of axillary lymph nodes in breast carcinoma / J Comput Assist Tomogr 15:440~444
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