Intermediary clip placement to assist accurate axillary lymph node localization
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Axillary lymph nodes
Neoadjuvant Therapy
Axilla
Objective To explore the ultrasonographic characteristics of metastatic lymph nodes of the breast cancer. Methods With two dimensional and color Doppler ultrasonography, the shape, size, internal echo and hemodynamic indices of axillary metastatic lymph nodes in 45 preoperative patients with breast cancer were observed. Results Pathological examination revealed that the shape of 39 metastatic lymph nodes was close to round. Conjunctive lymph nodes were the main characeristic of nodal metastases. With the increase of the lymph nodes in size, more color signals were displayed and most of signals were around the nodes. Multiple lymph nodes showed more color signals than single ones. Conclusion The diagnostic accuracy of metastasis lymph nodes could be increased with the combination of two dimensional and color Doppler ultrasonography.
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Color doppler
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Mesenteric, bifurcational, axillary and popliteal lymph nodes have been studied in 22 healthy mature male dogs. Amount of blast cells, small lymphocytes, plasma cells and macrophages has been taken into account in the paracortical zone, in the germinative centers and in the medullary cords. For two weeks to one group of the animals every day imuran in turn with aurantin (10 mg/kg and 25 mg/kg) are injected, or antilymphocytic serum (ALS) intraperitoneally every other day (0.1 ml/kg). The combined injection of imuran and aurantin produces a more pronounced toxic effect to the hemopoietic organs than ALS. ALS is more specific for T-dependent zones of the lymph nodes. In the dose and interval mentioned ALS is an immunostimulating preparation for the immunocompetent cells of the germinative centers of the lymph nodes. The reaction of the lymph nodes depends on their regional belonging.
Axillary lymph nodes
Mesenteric lymph nodes
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Palpation as a preoperative test, which is routinely performed in the majority of cases to examine lymph nodes in the breast, appears insufficient. Particularly, preoperative state of the lymph nodes is important in decisionmaking process for restricted surgery. This report describes a detailed investigation of CT obtained from the axillary region (AX. CT); CT scanner (3mm in width) takes several views of the affected breast and lymph nodes, and a map of the regional lymph nodes isdrawn. Comparison of the map with the extirpated specimens resulted in the following findings: 1) AX. CT could determine 16.6±3.7 lymph nodes per case. Successful drawing rate was 68.0% (n=21) when compared to extirpated ones (24.4±7.8). 2) Regional determination of drawn lymph modes could be attained from distances from the axirally vein. 3) In lymph nodes 3mm or more in diamete, various findings including shape, internal structure, adhesion between lymph nodes each other, and spiculation were shown. 4) The above findings and CT values could successfully estimate the metastasized lymph nodes.
Axillary lymph nodes
Palpation
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The presence of bilaterally palpable axillary lymph nodes was previously found to be a prognostically favorable clinical sign. This study has sought to determine whether patients having bilaterally palpable lymph nodes are characterized by distinctive features in their homolateral nodes and primary tumors. The authors collected groups of cases according to the presence or absence of metastases to axillary lymph nodes and the palpability of their homolateral and heterolateral nodes. The superior survival of patients with bilaterally palpable lymph nodes was most closely correlated with superior sinus histiocytosis reactivity of the homolateral lymph nodes. The findings are discussed in relation to the concept of tumor-host interactions and the therapeutic implications.
Axillary lymph nodes
Axilla
Axillary nodes
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A variety of pathological changes with clinical and prognostic significance is described in axillary lymph nodes removed at mastectomy. We studied 572 lymph nodes removed from 43 women and 1 man during a radical or modified radical mastectomy performed for carcinoma of the breast. We found that in about one-third of the specimens some degree of fat infiltration, or changes, was present; metastases were found in either fatty or nonfatty lymph nodes. We conclude that the presence of fat in axillary lymph nodes does not influence implantation of tumor cells from a primary carcinoma of the breast and has to be reported as an anatomic variant.
Axillary lymph nodes
Radical mastectomy
Modified Radical Mastectomy
Breast carcinoma
Infiltration (HVAC)
Axilla
Axillary nodes
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Axillary lymph nodes
Axilla
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Axilla
Axillary lymph nodes
Neoadjuvant Therapy
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All breast cancer patients are examined to check for the presence of malignant tumour cells that may have spread to the axillary lymph nodes. Following an ultrasound of the axilla, one or more lymph nodes are surgically removed for this purpose. This dissertation shows, among other things, that a contrast-enhanced MRI scan of the axilla could provide a promising alternative to surgical removal of the lymph nodes. If the validation study confirms this, surgery could be avoided in 70% of new breast cancer patients, because they do not have metastases in the lymph nodes. They would also be less exposed to the potential effects of axillary surgery, such as problems with shoulder movement, arm swelling due to a build-up of lymph fluid, or changes in arm sensitivity.
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Axillary lymph nodes
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Objective To evaluate the effect of tiny axillary lymph nodes in breast cancer staging. Methods Axillary specimens from 127 breast cancer patients were included. After excising the lymph nodes by palpation and visualization, the remaining axillary tissue was immersed into Carnoy's solution for 6-12 hours. Then the left axillary tissue was placed in the Pyrex tray and transilluminated from the below. The tiny lymph nodes were easily recognized as white chalky nodules standing out of the background with semitransparent fat. The lymph nodes were identified by pathologic examined. Results 2 483 lymph nodes were found by the traditional methods and 878 more lymph nodes were found by immersed into Carnoy's solution. Among them 781 lymph nodes were smaller than 3 mm. The average number of lymph nodes founded by the new way was 26.47 ±9.69 compared to 19.55 ±7.95 by the routine method. Four cases considered previously to be pNO became pN1, two cases previously graded as pN1 became pN2, and another case was upstaged from pN2 to pN3. Conclusions The new method is an easy and effective way for detecting tiny lymph nodes in axillary, and it helps to accurate staging and possibility change the method of therapy.
Axillary lymph nodes
Palpation
Axilla
Axillary nodes
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