The Number of Removed Lymph Nodes for an Acceptable False Negative Rate in Sentinel Lymph Node Biopsy for Breast Cancer / 한국유방암학회지

PURPOSE: This study was performed to find the adequate number of removed lymph nodes to achieve an acceptable false-negative rate when performing sentinel lymph node biopsy for breast cancer. METHODS: A total of 179 sentinel node biopsies combined with conventional axillary lymph node dissection for breast cancer were performed between November 2003 and June 2007. RESULTS: The overall identification rate of sentinel lymph node and the false negative rate of the biopsy were 95.0% and 8.1%, respectively. Yet the false negative rate of the biopsy was lowered as the number of the removed nodes was increased. Especially, the false negative rate was 0% when more than 4 lymph nodes were removed. CONCLUSION: We recommend that four lymph nodes should be removed to obtain accurate results in sentinel node biopsy for breast cancer.

The Use of a Corrective Procedure with Vicryl Mesh for Oncoplastic Surgery of the Breast / 한국유방암학회지

PURPOSE: In addition to the oncological results, cosmetic results are very important to cancer patients. Currently, the use of oncoplastic surgery is an emerging approach. In this study, we examined the clinical outcomes of the use of a corrective procedure with an absorbable implant, a Vicryl mesh(R), as compared with the use of conventional breast conserving surgery (BCS). METHODS: Fifty six patients who completed questionnaire were enrolled in the study. For 33 cases, BCS was performed concurrently with the use of a Vicryl mesh and for the other 23 cases, conventional BCS alone was performed. Contraindications of the use of corrective procedure were a patient age over 60 year, diabetes, neoadjuvant chemotherapy and a previous excisional biopsy performed on the same breast. Patients rated their cosmetic outcomes by use of a four point scale. RESULTS: For one of 34 cases, the Vicryl mesh was removed due to infection and this patient was excluded from the study. Twenty seven of the remaining 33 patients (82%) who underwent the corrective procedure with Vicryl mesh were satisfied with their outcome. For patients that received conventional BCS only ten of 23 patients (43%) were satisfied with their outcome (p=0.05). Patient age, body mass index (BMI) and tumor location did not affect the cosmetic outcomes of the corrective procedure. When the resection area of the breast was 40-70 cm2, 88% of the patients were satisfied with their outcome. CONCLUSION: This study suggested that the use of Vicryl mesh correction was superior to the use of conventional BCS alone for cosmesis. This method appears to provide a satisfactory outcome for oncoplastic surgery of the breast.

Diagnostic Feasibility of Galectin-3 for Suspicious Malignant Thyroid Nodule in Preoperative Fine-Needle Aspiration Cytology

PURPOSE: Fine Needle Aspiration Cytology (FNAC) is considered as the most feasible preoperative diagnostic tool for thyroid lesions. However, the false results of FNAC are not uncommon, and so we need a development of novel supportive preoperative diagnostic modality. In previous studies, galectin-3, a beta-galactosidase-binding protein, was expressed preferentially in thyroid malignancies. In this study, we analyzed whether the galectin-3 immunohistochemistry (IHC) is useful as a preoperative diagnostic tool. METHODS: 79 patients who underwent a definite surgery for thyroid nodule were analyzed. The preoperative routine stained cytology and galectin-3 IHC for fine-needle aspirates and the galectin-3 IHC for postoperative specimen were performed. Individual results were compared with the final diagnoses. RESULTS: Of 79 specimens, 28 (35.4%) were malignant. The false negative rate (FNR) of galectin-3 IHC in the surgical specimen was 10.0%. The FNR of galectin-3 IHC for the fine-needle aspirates was 50.0% and the FNR of routine cytology was 20.5%. However, the FNR of galectin-3 IHC in the fine-needle aspirates was lowered up to 20.0% in thyroid lesions obtained by using ultrasound-guided aspiration. Among the 14 cases reported as suspicious in routine cytology, 13 cases were revealed the accurate correlations in galectn-3 IHC. CONCLUSION: It appears that galectin-3 IHC in preoperative FNAC alone had a little accuracy. However, preoperative galectin-3 IHC in thyroid lesions obtained under the ultrasound guidance could be diagnostic. Especially in suspicious group in FNAC, galectin-3 IHC could be critical method in differentiating malignant lesions from benign lesions of thyroid.