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204 records – page 1 of 21.

Adjuvant high dose rate vaginal brachytherapy as treatment of stage I and II endometrial carcinoma.

https://arctichealth.org/en/permalink/ahliterature19333
Source
Obstet Gynecol. 2002 Feb;99(2):235-40
Publication Type
Article
Date
Feb-2002
Author
Neil S Horowitz
William A Peters
Michael R Smith
Charles W Drescher
Mary Atwood
Timothy P Mate
Author Affiliation
The Swedish Medical Center, Seattle, Washington, USA. horowitzn@msnotes.wustl.edu
Source
Obstet Gynecol. 2002 Feb;99(2):235-40
Date
Feb-2002
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - mortality - radiotherapy - secondary - surgery
Administration, Intravaginal
Aged
Brachytherapy - methods
Carcinoma, Adenosquamous - mortality - radiotherapy - secondary - surgery
Disease-Free Survival
Endometrial Neoplasms - mortality - pathology - radiotherapy - surgery
Female
Humans
Lymph Node Excision
Medical Records
Middle Aged
Neoplasm Recurrence, Local - mortality
Neoplasm Staging
Radiation Dosage
Radiotherapy, Adjuvant
Registries
Retrospective Studies
Survival Analysis
Sweden
Treatment Outcome
Abstract
OBJECTIVE: To evaluate the efficacy of high dose rate vaginal brachytherapy in the treatment of International Federation of Gynecology and Obstetrics stage IB, IC, and II endometrial carcinoma after surgical staging and complete lymphadenectomy. METHODS: All patients with stage IB, IC, or II adenocarcinoma or adenosquamous carcinoma of the endometrium who received postoperative high dose rate vaginal brachytherapy at our institution between June 1, 1989, and June 1, 1999, were eligible. High dose rate vaginal brachytherapy was delivered in three fractions of 700 cGy. Retrospective chart review was performed. Kaplan-Meier estimates were calculated for disease-free and overall survival. RESULTS: One hundred sixty-four women were identified. Fifty-six percent had stage IB disease, 30% had stage IC disease, and 14% had stage II disease. Approximately one third of patients had high-grade lesions and nearly 40% had deep myometrial invasion. Median follow-up was 65 months (range 6-142 months). To date, 14 patients have had recurrence; 2 at the vaginal apex, 9 at distant sites, 1 at the pelvic sidewall, 1 simultaneously in the pelvis and at a distant site, and 1 at an unknown site. Both patients with vaginal apex recurrences had salvage therapy and are now free of disease. The overall 5-year survival and disease-free survival rates were 87% and 90%, respectively. There were no Radiation Therapy Oncology Group grade 3 or 4 toxicities. High dose rate vaginal brachytherapy was approximately $1,000 less expensive than external-beam whole-pelvic radiation. CONCLUSIONS: Adjuvant high dose rate vaginal brachytherapy in thoroughly staged patients with intermediate-risk endometrial carcinoma provides excellent overall and disease-free survival with less toxicity and at less cost compared with whole-pelvic radiation.
PubMed ID
11814503 View in PubMed
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Adjuvant radiation trials for high-risk breast cancer patients: adequacy of lymphadenectomy.

https://arctichealth.org/en/permalink/ahliterature20381
Source
Ann Surg Oncol. 2000 Jun;7(5):357-60
Publication Type
Article
Date
Jun-2000
Author
A W Silberman
G P Sarna
D. Palmer
Author Affiliation
Division of Surgical Oncology, Cedars-Sinai Medical Center, Los Angeles, California, USA. aws222@aol.com
Source
Ann Surg Oncol. 2000 Jun;7(5):357-60
Date
Jun-2000
Language
English
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - pathology - radiotherapy - surgery
Clinical Trials
Female
Humans
Lymph Node Excision
Lymphatic Metastasis
Middle Aged
Neoplasm Recurrence, Local
Neoplasm, Residual
Radiotherapy, Adjuvant
Reproducibility of Results
Retrospective Studies
Risk factors
Abstract
BACKGROUND: The recently published, widely publicized adjuvant radiation trials from Denmark and Canada concluded that the addition of postoperative radiotherapy (XRT) to modified radical mastectomy (MRM) and adjuvant chemotherapy reduces locoregional recurrences and prolongs survival in high-risk premenopausal patients with breast cancer. Our thesis is that adequate lymphadenectomies were not performed in either study. Consequently, the conclusion to these studies is not applicable to those patients who have undergone adequate surgery. METHODS: To better assess adequate lymph node yield from an MRM, a retrospective review was performed on 215 consecutive patients treated surgically for invasive breast cancer. Data from this review were compared with the surgical data from the above-mentioned radiotherapy trials. RESULTS: In a group of 131 patients who had MRM, the average number of nodes removed was 26 (median, 25), and 75.5% of the specimens had 20 or more lymph nodes. In 73 patients who underwent segmental mastectomy with axillary lymph node dissection, both the average and the median number of lymph nodes removed were 24, and 68.9% had 20 or more nodes. These data compare to the Danish radiation trial in which a median of 7 lymph nodes were removed (with 76% of the patients having 9 or fewer lymph nodes in the specimen) and to the Canadian radiation trial in which a median of 11 lymph nodes were removed. In addition, in our breast cancer patients with positive nodes (84 of 204; 41.2%), 45.2.% (38 of 84) had more than three positive nodes compared with 29.8% in the Danish study and 35% in the Canadian study. CONCLUSIONS: Our surgical data are sufficiently different from those of the Danish and Canadian studies to indicate that, in those studies, incomplete lymph node dissections were performed and that residual disease was left behind in the axilla in some or all of the patients. The addition of XRT in the setting of residual axillary disease may compensate for an inadequate operation and yield an acceptable oncological result; however, these studies did not provide an adequate comparison with a well-performed MRM without XRT. In the absence of documented benefit, XRT should not be routinely added if a complete lymph node dissection has been performed.
PubMed ID
10864343 View in PubMed
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Age-related variations in the use of axillary dissection.

https://arctichealth.org/en/permalink/ahliterature188208
Source
Int J Radiat Oncol Biol Phys. 2002 Nov 1;54(3):637-9
Publication Type
Article
Date
Nov-1-2002
Author
Nancy Price Mendenhall
Source
Int J Radiat Oncol Biol Phys. 2002 Nov 1;54(3):637-9
Date
Nov-1-2002
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Axilla
Breast Neoplasms - mortality - pathology - surgery
British Columbia
Female
Humans
Lymph Node Excision
Middle Aged
Sample Size
Survival Rate
Notes
Comment On: Int J Radiat Oncol Biol Phys. 2002 Nov 1;54(3):794-80312377331
PubMed ID
12377311 View in PubMed
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Age-related variations in the use of axillary dissection: a survival analysis of 8038 women with T1-ST2 breast cancer.

https://arctichealth.org/en/permalink/ahliterature188206
Source
Int J Radiat Oncol Biol Phys. 2002 Nov 1;54(3):794-803
Publication Type
Article
Date
Nov-1-2002
Author
Pauline T Truong
Vanessa Bernstein
Elaine Wai
Boon Chua
Caroline Speers
Ivo A Olivotto
Author Affiliation
Radiation Therapy Program, British Columbia Cancer Agency, Vancouver Island Cancer Centre, University of British Columbia, Victoria, British Columbia, Canada. ptruong@bccancer.bc.ca
Source
Int J Radiat Oncol Biol Phys. 2002 Nov 1;54(3):794-803
Date
Nov-1-2002
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Axilla
Breast Neoplasms - mortality - pathology - surgery - therapy
British Columbia - epidemiology
Carcinoma, Lobular - mortality - pathology - surgery - therapy
Cohort Studies
Databases, Factual
Female
Humans
Lymph Node Excision - mortality - utilization
Mastectomy, Segmental - utilization
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Radiotherapy, Adjuvant - utilization
Survival Analysis
Abstract
The use of axillary dissection (AD) in women with invasive breast cancer is increasingly questioned. This study analyzes the survival in women with T1-2 breast cancer according to age and AD use.
Data from the Breast Cancer Outcomes Unit Database were analyzed for 8038 women aged 50-89 years referred to the British Columbia Cancer Agency between 1989 and 1998 with invasive T1-2,M0 breast cancer. Tumor and treatment characteristics were compared between women treated with and without AD (AD+ vs. AD-) according to three age groups: 50-64, 65-74 and 75+ years. Regional relapse and actuarial 5-year overall and breast cancer-specific survival were compared between AD+ and AD- women. Multivariate analysis of age, tumor and treatment factors, and adjusted hazard ratios with AD omission were performed.
AD was omitted more frequently with advancing age (4% vs. 8% vs. 22% in women aged 50-64, 65-74, and 75+ years, respectively, p
Notes
Comment In: Int J Radiat Oncol Biol Phys. 2002 Nov 1;54(3):637-912377311
PubMed ID
12377331 View in PubMed
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Analysis of clinical applicability of the breast cancer nomogram for positive sentinel lymph node: the canadian experience.

https://arctichealth.org/en/permalink/ahliterature156220
Source
Ann Surg Oncol. 2008 Sep;15(9):2562-7
Publication Type
Article
Date
Sep-2008
Author
Eric Poirier
Lucas Sideris
Pierre Dubé
Pierre Drolet
Sarkis H Meterissian
Author Affiliation
Surgical Oncology, McGill University Health Center, Montreal, QC, Canada. ricpoirier@sympatico.ca
Source
Ann Surg Oncol. 2008 Sep;15(9):2562-7
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - pathology - surgery
Canada
Carcinoma, Ductal, Breast - secondary - surgery
Carcinoma, Lobular - secondary - surgery
Female
Humans
Lymph Node Excision
Lymphatic Metastasis
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Nomograms
Predictive value of tests
Prospective Studies
ROC Curve
Sensitivity and specificity
Sentinel Lymph Node Biopsy
Abstract
A Breast Cancer Nomogram (BCN) for predicting nonsentinel lymph node (NSLN) involvement has been developed and prospectively tested in several series. However, its clinical applicability has never been tested among surgeons.
The BCN was applied to 209 SLN-positive patients. Its performance was assessed by the area under the receiver-operating characteristic (ROC) curve. Surgeons in Quebec were surveyed to determine the predicted NSLN positivity below which they would not dissect the axilla. The accuracy of the BCN was determined in this clinically relevant range.
The predictive accuracy of the BCN had an area under the ROC curve of 0.687. Almost half of interviewed surgeons treat over 20 breast cancer per year. Fourteen out of 82 surgeons questioned would never leave the patient without a completion axillary dissection after a positive SLN, regardless of the BCN result. Seventy one percent of them would not complete axillary dissection if the prediction of a positive NSLN was
PubMed ID
18618183 View in PubMed
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Analysis of surgical and diagnostic quality at a specialist breast unit.

https://arctichealth.org/en/permalink/ahliterature83024
Source
Breast. 2006 Aug;15(4):490-7
Publication Type
Article
Date
Aug-2006
Author
Hoffmann J.
Author Affiliation
Breast Surgery Clinic, Horsholm Hospital, Horsholm, Denmark. jaho@fa.dk
Source
Breast. 2006 Aug;15(4):490-7
Date
Aug-2006
Language
English
Publication Type
Article
Keywords
Adult
Breast Neoplasms - diagnosis - surgery
Centralized Hospital Services
Denmark - epidemiology
Female
Humans
Lymph Node Excision - standards - utilization
Mastectomy - utilization
Middle Aged
Oncology Service, Hospital - standards - utilization
Prospective Studies
Quality of Health Care
Referral and Consultation
Reoperation - utilization
Sentinel Lymph Node Biopsy - standards - utilization
Abstract
The quality of a specialist breast unit was analysed prospectively, comparing data from 1998, with data from 2003. The analysis is based on 5451 new referrals and 632 major breast cancer operations. The period was characterized by an increasing number of surgical specialists and improvements in diagnostic resources. There was statistically significant improvement in the following parameters: frequency of excision biopsies fell from 17.3% to 10.4%; preoperative cancer diagnosis without excision biopsy rose from 67.4% to 95.1%; percentage of women receiving breast conserving surgery rose from 24.4% to 44.7%. Cases where less than 10 lymph nodes were removed at axillary dissection fell from 5.8% to 0.5%. Severe postoperative bleeding fell from 4.1% to 0.8%, severe wound infection from 4.7% to 1.1% and severe skin necrosis from 3.7% to 0.2%. It is concluded that centralization of surgical and diagnostic expertise at a high volume institution contributes positively to the quality of care.
PubMed ID
16343904 View in PubMed
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Applicability of the new ITKA GSD Basic 250 electrosurgical unit to urologic endoscopic surgery, laparoscopic surgery and urologic open surgery.

https://arctichealth.org/en/permalink/ahliterature21300
Source
J Med Eng Technol. 1998 Nov-Dec;22(6):270-3
Publication Type
Article
Author
O. Lukkarinen
P. Tuuttila
Author Affiliation
Department of Surgery, University of Oulu, Finland.
Source
J Med Eng Technol. 1998 Nov-Dec;22(6):270-3
Language
English
Publication Type
Article
Keywords
Abdominal Muscles - surgery
Animals
Bladder - surgery
Bladder Diseases - surgery
Bladder Neoplasms - surgery
Comparative Study
Cystoscopy
Electrocoagulation - instrumentation
Electrosurgery - instrumentation
Endoscopes
Equipment Design
Female
Humans
Kidney Neoplasms - surgery
Laparoscopes
Lymph Node Excision
Male
Nephrectomy
Prostatectomy
Prostatic Neoplasms - surgery
Safety
Swine
Urologic Surgical Procedures - instrumentation
Videotape Recording - instrumentation
Wound Healing
Abstract
The purpose of the study was to assess the applicability of a new ITKA GSD Basic 250 electrosurgical unit (ESU) to urologic endoscopic surgery, laparoscopic surgery and open urologic surgery, its possible interference with videorecording and stray currents in healthy tissues. A new ITKA GSD Basic 250 ESU (test ESU) was used and compared to conventional ESU (Berchtold Elektrotom 390 as reference ESU). Experimental surgery was carried out on three female pigs, which underwent endoscopic, laparoscopic and open surgery. Altogether 29 patients underwent either endoscopic or open surgery with the test ESU. In experimental surgery, the ideal cutting and coagulation settings of the test ESU were in the range 15-25% for endoscopic surgery. In laparoscopic surgery, tissues were ideally resected and removed at 10-15% power settings. In open experimental surgery, the ideal power settings were 25-30%. In human surgery, the test ESU operated well at 25-35% power settings in endoscopic surgery, while in open surgery on humans the ideal settings were 25-35% in monopolar use and 20-25% in bipolar use. When used for endoscopic operations, the test ESU did not interfere with videorecording. Nor were any adverse effects seen in the surrounding tissues. The patients had neither early nor late complications. Histopathological findings revealed no differences in healing between the test ESU and reference ESU. Experimental and patient surgery showed the test ESU to be both safe and effective. It is suitable to be used in urologic endoscopic surgery, laparoscopic surgery and open urologic surgery. It does not interfere with videorecording or cause harmful stray currents in surrounding tissues. Power can be adjusted linearly and precisely. Low-power operation is also possible.
PubMed ID
9884930 View in PubMed
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Application of fine-needle aspiration to the demonstration of ERBB2 and MYC expression by in situ hybridization in breast carcinoma.

https://arctichealth.org/en/permalink/ahliterature23646
Source
J Histochem Cytochem. 1994 Jun;42(6):795-803
Publication Type
Article
Date
Jun-1994
Author
Y. Soini
A. Mannermaa
R. Winqvist
D. Kamel
K. Poikonen
H. Kiviniemi
P. Pääkkö
Author Affiliation
Department of Pathology, University of Oulu, Finland.
Source
J Histochem Cytochem. 1994 Jun;42(6):795-803
Date
Jun-1994
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Biopsy, Needle - methods
Breast Neoplasms - genetics - pathology - surgery
Cell Line
DNA, Neoplasm - analysis
Female
Gene Expression
Genes, myc
Humans
In Situ Hybridization
Leukemia, Promyelocytic, Acute
Lymph Node Excision
Lymph Nodes - pathology
Lymphocytes - pathology
Metaphase
Middle Aged
Proto-Oncogene Proteins - analysis - biosynthesis
Proto-Oncogene Proteins c-myc - analysis - biosynthesis
Proto-Oncogenes
RNA, Messenger - analysis - biosynthesis
Receptor, Epidermal Growth Factor - analysis - biosynthesis
Receptor, erbB-2
Research Support, Non-U.S. Gov't
Tumor Cells, Cultured
Tumor Markers, Biological - analysis
Abstract
Thirteen consecutive fine-needle aspirates of breast carcinoma and five selected breast tumor cell lines were analyzed for ERBB2 and MYC mRNA expression by in situ hybridization. To compare the level of mRNA synthesis with those of gene amplification and oncoprotein synthesis, all tumors were also analyzed by Southern blot analysis, and for ERBB2 also by immunohistochemistry. Expression of ERBB2 mRNA was observed in eight tumors. MYC expression was observed in all tumors studied. Three tumor cell lines expressed both ERBB2 and MYC (SK-BR-3, HeLa, HT-29) and two only MYC (SK-LU-1, HL-60). Only one tumor showed amplification of ERBB2 and two of MYC. In all three cases there was a considerable increase in corresponding mRNA synthesis as detected by in situ hybridization. By immunohistochemistry, four cases showed either patchy areas or uniformly distributed, membrane-bound ERBB2 immunoreactivity. All except one case showed increased ERBB2 mRNA synthesis. There was a clear association between the quantity of ERBB2 mRNA and oncoprotein expression. The results show that in situ hybridization of fine-needle aspiration material is a sensitive method to detect increased expression of the ERBB2 and MYC oncogenes in breast carcinoma. Furthermore, this study indicates that in a majority of cases some other mechanism that gene amplification appears responsible for the increased gene expression. It is also possible that Southern blot analysis is not a sensitive enough method to detect gene amplifications in the heterogeneous breast tumors, which usually also contain stromal tissue. The fact that not all cases with elevated ERBB2 mRNA synthesis were immunohistochemically positive suggests that either immunohistochemistry (after fixation with 10% formalin) is a less sensitive method than in situ hybridization to detect abnormal gene expression or that there are cases in which the oncoprotein synthesis is for some reason depressed, even though there is an increase in gene transcription.
PubMed ID
7910618 View in PubMed
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Arm morbidity and disability after breast cancer: new directions for care.

https://arctichealth.org/en/permalink/ahliterature159371
Source
Oncol Nurs Forum. 2008 Jan;35(1):65-71
Publication Type
Article
Date
Jan-2008
Author
Roanne L Thomas-Maclean
Thomas Hack
Winkle Kwan
Anna Towers
Baukje Miedema
Andrea Tilley
Author Affiliation
Department of Sociology, University of Saskatchewan, Saskatoon, Canada. roanne.thomas@usask.ca
Source
Oncol Nurs Forum. 2008 Jan;35(1):65-71
Date
Jan-2008
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adaptation, Psychological
Adult
Aged
Aged, 80 and over
Arm
Breast Neoplasms - surgery
Canada - epidemiology
Female
Humans
Incidence
Longitudinal Studies
Lymph Node Excision - adverse effects
Lymphedema - epidemiology - etiology - psychology
Middle Aged
Musculoskeletal Diseases - epidemiology - etiology - psychology
Pain - epidemiology - etiology - psychology
Quality of Life
Range of Motion, Articular
Sentinel Lymph Node Biopsy - adverse effects
Abstract
To chart the incidence and course of three types of arm morbidity (lymphedema, pain, and range of motion [ROM] restrictions) in women with breast cancer 6-12 months after surgery and the relationship between arm morbidity and disability.
Longitudinal mixed methods approach.
Four sites across Canada.
347 patients with breast cancer 6-12 months after surgery at first point of data collection.
Incidence rates were calculated for three types of arm morbidity, correlations between arm morbidity and disability were computed, and open-ended survey responses were compiled and reviewed.
Lymphedema, pain, ROM, and arm, shoulder, and hand disabilities.
Almost 12% of participants experienced lymphedema, 39% reported pain, and about 50% had ROM restrictions. Little overlap in the three types of arm morbidity was observed. Pain and ROM restrictions correlated significantly with disability, but most women did not discuss arm morbidity with healthcare professionals.
Pain and ROM restrictions are prevalent 6-12 months after surgery, but lymphedema is not. Pain and ROM restrictions are associated with disability.
Screening for pain and ROM restrictions should be part of breast cancer follow-up care. Left untreated, arm morbidity could have a long-term effect on quality of life. Additional research into the longevity of various arm morbidity symptoms and possible interrelationships also is required.
PubMed ID
18192154 View in PubMed
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Arm morbidity following sentinel lymph node biopsy or axillary lymph node dissection: a study from the Danish Breast Cancer Cooperative Group.

https://arctichealth.org/en/permalink/ahliterature85822
Source
Breast. 2008 Apr;17(2):138-47
Publication Type
Article
Date
Apr-2008
Author
Husted Madsen Anders
Haugaard Karen
Soerensen Jan
Bokmand Susanne
Friis Esbern
Holtveg Helle
Peter Garne Jens
Horby John
Christiansen Peer
Author Affiliation
Department of Surgery, Aarhus University Hospital, JageHansensgade 2, 8000 Aarhus C, Denmark. husted@ki.au.dk
Source
Breast. 2008 Apr;17(2):138-47
Date
Apr-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Arm
Axilla
Breast Neoplasms - pathology
Denmark
Female
Humans
Joint Diseases - etiology
Lymph Node Excision - adverse effects
Lymph Nodes - pathology
Lymphatic Metastasis
Lymphedema - etiology
Middle Aged
Morbidity
Neoplasm Staging
Peripheral Nerves
Prospective Studies
Range of Motion, Articular
Sentinel Lymph Node Biopsy - adverse effects
Shoulder Joint
Trauma, Nervous System - etiology
Abstract
BACKGROUND: Sentinel lymph node biopsy was implemented in the treatment of early breast cancer with the aim of reducing shoulder and arm morbidity. Relatively few prospective studies have been published where the morbidity was assessed by clinical examination. Very few studies have examined the impact on shoulder mobility of node positive patients having a secondary axillary dissection because of the findings of metastases postoperatively. AIM: We aimed to investigate the objective and subjective arm morbidity in node negative and node positive patients. METHODS AND MATERIALS: In a prospective study, 395 patients with tumors less than 4 cm, were included. Patients were recruited from seven Danish breast cancer clinics. Both subjective and objective arm and shoulder morbidity were measured before, 6 and 18 months after the operation. RESULTS: Comparing node negative patients having a sentinel lymph node biopsy with node negative patients having a lymph node dissection of levels I and II of the axilla, we found significant increase in arm volume among the patients who had an axillary dissection. Only minor, but significant, differences in shoulder mobility were observed comparing the two groups of node negative patients. Highly significant difference was found comparing sensibility. Comparing the morbidity in node positive patients who had a one-step axillary dissection with patients having a two-step procedure (sentinel lymph node biopsy followed by delayed axillary dissection) revealed no difference in objective or subjective arm morbidity. CONCLUSION: Node negative patients operated with sentinel lymph node biopsy have less arm morbidity compared with node negative patients operated with axillary lymph node dissection. Node positive patients who had a secondary axillary lymph node dissection after sentinel lymph node biopsy had no difference in either objective or subjective morbidity compared with node positive patients having a one-step axillary dissection.
PubMed ID
17928226 View in PubMed
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204 records – page 1 of 21.