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Feasibility of Charcoal Tattooing of Cytology-Proven Metastatic Axillary Lymph Node at Diagnosis and Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy in Breast Cancer Patients

Authors
 Seho Park  ;  Ja Seung Koo  ;  Gun Min Kim  ;  Joohyuk Sohn  ;  Seung Il Kim  ;  Young Up Cho  ;  Byeong-Woo Park  ;  Vivian Youngjean Park  ;  Jung Hyun Yoon  ;  Hee Jung Moon  ;  Min Jung Kim  ;  Eun-Kyung Kim 
Citation
 CANCER RESEARCH AND TREATMENT, Vol.50(3) : 801-812, 2018 
Journal Title
CANCER RESEARCH AND TREATMENT
ISSN
 1598-2998 
Issue Date
2018
Keywords
Charcoal ; Neoadjuvant therapy ; Sentinel lymph node biopsy ; Tattoo ; Breast neoplasms
Abstract
Purpose: Sentinel lymph node biopsy (SLNB) can be performed when node-positive disease is converted to node-negative status after neoadjuvant chemotherapy (NCT). Tattooing nodes might improve accuracy but supportive data are limited. This study aimed to investigate the feasibility of charcoal tattooing metastatic axillary lymph node (ALN) at presentation followed by SLNB after NCT in breast cancers.

Materials and Methods: Twenty patientswith cytology-proven node metastases prospectively underwent charcoal tattooing at diagnosis. SLNB using dual tracers and axillary surgery after NCT were then performed. The detection rate of tattooed node and diagnostic performance of SLNB were analyzed.

Results: All patients underwent charcoal tattooingwithout significant morbidity. Sentinel and tattooed nodes could be detected during surgery after NCT. Nodal pathologic complete response was achieved in 10 patients. Overall sensitivity, false-negative rate (FNR), negative predictive value, and accuracy of hot/blue SLNB were 80.0%, 20.0%, 83.3%, and 90.0%, respectively. Retrieving more nodes and favorable nodal response were associated with improved performance. The best accuracy was observed when excised tattooed node was calculated together (FNR, 0.0%). Cold/non-blue tattooed nodes of five patients were removed during non-sentinel axillary surgery but clinicopathological parameters did not differ compared to patients with hot/blue tattooed node detected during SLNB, suggesting the importance of the tattooing procedure itself to improve performance.

Conclusion: Charcoal tattooing of cytology-confirmed metastatic ALN at presentation is technically feasible and does not limit SLNB after NCT. The tattooing procedure without additional preoperative localization is advantageous for improving the diagnostic performance of SLNB in this setting.
Files in This Item:
T201802476.pdf Download
DOI
10.4143/crt.2017.210
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Koo, Ja Seung(구자승) ORCID logo https://orcid.org/0000-0003-4546-4709
Kim, Gun Min(김건민) ORCID logo https://orcid.org/0000-0001-9167-8682
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0003-4949-1237
Kim, Seung Il(김승일)
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
Park, Byeong Woo(박병우) ORCID logo https://orcid.org/0000-0003-1353-2607
Park, Se Ho(박세호) ORCID logo https://orcid.org/0000-0001-8089-2755
Park, Vivian Youngjean(박영진) ORCID logo https://orcid.org/0000-0002-5135-4058
Sohn, Joo Hyuk(손주혁) ORCID logo https://orcid.org/0000-0002-2303-2764
Yoon, Jung Hyun(윤정현) ORCID logo https://orcid.org/0000-0002-2100-3513
Cho, Young Up(조영업) ORCID logo https://orcid.org/0000-0003-2936-410X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163193
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