Write your message
Volume 18, Issue 3 (Iranian Journal of Breast Diseases 2025)                   ijbd 2025, 18(3): 132-0 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Raei N, Abdolahad M, Kaviani A. Intraoperative Assessment of Breast Lymph Nodes using Cancer Diagnostic Probe in Impedimetric Mode. ijbd 2025; 18 (3) :132-0
URL: http://ijbd.ir/article-1-1099-en.html
Intraoperative Assessment of Breast Lymph Nodes using Cancer Diagnostic Probe in Impedimetric Mode
Nahid Raei1 , Mohammad Abdolahad2 , Ahmad Kaviani *3
1- Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran
2- Nano Bioelectronics Devices Lab, Cancer Electronics Research Group, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Iran
3- Department of Surgical Oncology, University of Montreal, Montreal, Canada , akaviani@archbreastcancer.com
Abstract:   (454 Views)
Axillary lymph node dissection (ALND) was a standard component of breast cancer surgery for decades until the 1990s, when sentinel lymph node biopsy (SLNB) emerged as a less invasive and more precise alternative. SLNB revolutionized axillary staging by reducing complications and unnecessary dissections. Today, it is the preferred method in most breast cancer surgeries, rendering ALND nearly obsolete in many clinical scenarios (1). Initially, intraoperative assessment of sentinel lymph nodes was pivotal in determining the need for immediate ALND. This reduced the need for reoperations in patients with positive nodes. However, as the role of ALND declined, so did the emphasis on intraoperative node evaluation (2). Currently, ALND is reserved for select cases, such as clinically node-positive patients receiving neoadjuvant chemotherapy (NAC) (3) or luminal breast cancer patients with three or more involved nodes. In patients with only one or two positive nodes, ALND is generally avoided, and radiation therapy is often employed. However, current diagnostic techniques sometimes struggle to accurately quantify involved nodes, especially in cases involving small or confluent metastases (4). With the increased use of NAC, particularly in countries where patients present at more advanced stages, accurate lymph node evaluation remains essential. Traditional intraoperative diagnostic techniques, such as frozen section (FS) and touch preparation, although generally effective in luminal ductal carcinoma, have limited value post-NAC and in invasive lobular carcinoma (ILC). Moreover, FS prolongs surgery by 45 minutes to an hour, thereby increasing anesthesia duration and straining hospital resources (5). Thus, a critical clinical gap remains: current intraoperative methods are time-intensive, exhibit reduced sensitivity in post-NAC and ILC patients, and may be impractical in resource-limited settings.
Keywords: CDP, Breast Cancer, Lymph node, intraoperative assessment
Full-Text [PDF 500 kb]   (189 Downloads)    
Type of Study: Letter to Editor | Subject: Diagnosis, treatment, rehabilitation
Received: 2025/02/19 | Accepted: 2025/07/9 | Published: 2025/10/2
References
1. Nieweg OE, Uren RF, Thompson JF. The history of sentinel lymph node biopsy. Cancer J. 2015;21(1):3-6. doi: 10.1097/PPO.0000000000000091. [DOI:10.1097/PPO.0000000000000091] [PMID]
2. Ortega Expósito C, Falo C, Pernas S, Pérez Carton S, Gil Gil M, Ortega R, et al. The effect of omitting axillary dissection and the impact of radiotherapy on patients with breast cancer sentinel node macrometastases: a cohort study following the ACOSOG Z0011 and AMAROS trials. Breast Cancer Res Treat. 2021;189(1):111-20. doi: 10.1007/s10549-021-06274-9. [DOI:10.1007/s10549-021-06274-9] [PMID]
3. Peterko A, Avirović M, Valković Zujić P, Grebić D, Juranić D, Lovasić F. The Type of Surgical Axillary Staging Following Neoadjuvant Systemic Treatment Has No Impact on Breast Cancer Patients' Oncological Outcomes : SLNB; safe staging post-NA setting. Arch Breast Cancer. 2023;10(4):377-8. doi: 10.32768/abc.2023104377-387. [DOI:10.32768/abc.2023104377-387]
4. Barbieri E, Gentile D, Bottini A, Sagona A, Gatzemeier W, Losurdo A, et al. Neo-Adjuvant Chemotherapy in Luminal, Node Positive Breast Cancer: Characteristics, Treatment and Oncological Outcomes: A Single Center's Experience. Eur J Breast Health. 2021;17(4):356-62. doi: 10.4274/ejbh.galenos.2021.2021-4-8. [DOI:10.4274/ejbh.galenos.2021.2021-4-8] []
5. Banerjee SM, El-Sheikh S, Keshtgar MRS. Intra-Operative Assessment of Sentinel Lymph Nodes in Breast Cancer. Arch Breast Cancer. 2014;1(2):44-52. doi: 10.19187/abc.20141244-52.
6. Abdolahad M, Kaviani A. Real-time Detection of Cellular Metabolism: a New Trend for Intra-Operative Diagnosis of Cavity Margins: Intraoperative CDP. Arch Breast Cancer. 2022;10(1):1-3. doi: 10.32768/abc.20231011-3. [DOI:10.32768/abc.20231011-3]
7. Garcia-Etienne CA, Ferrari A, Della Valle A, Lucioni M, Ferraris E, Di Giulio G, et al. Management of the axilla in patients with breast cancer and positive sentinel lymph node biopsy: An evidence-based update in a European breast center. Eur J Surg Oncol. 2020;46(1):15-23. doi: 10.1016/j.ejso.2019.08.013. [DOI:10.1016/j.ejso.2019.08.013] [PMID]
8. Mathelin C, Lodi M. Narrative review of sentinel lymph node biopsy in breast cancer: a technique in constant evolution with still numerous unresolved questions. Chin Clin Oncol. 2021;10(2):20. doi: 10.21037/cco-20-207. [DOI:10.21037/cco-20-207] [PMID]
Add your comments about this article : Your username or Email:
CAPTCHA
Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2025 CC BY-NC 4.0 | Iranian Journal of Breast Diseases

Designed & Developed by: Yektaweb