Abstract P5-22-21: Radioactive seed and targeted axillary dissection: A feasibility study
Bibliographic record
Abstract
Abstract Targeted axillary dissection (TAD) with a radioactive seed is a new and promising technique to evaluate the axillary status in post-neoadjuvant chemotherapy (NACT) node-positive breast cancer patients. This study aims to evaluate the feasibility of TAD with a radioactive seed in a Canadian setting. We conducted a retrospective observational study of a prospectively gathered database of patients having undergone TAD with a radioactive seed implanted in a proven metastatic axillary node, between 2015 and 2017 in our institution. An iodine-125 radioactive seed was implanted under ultrasound guidance by trained radiologists. Patients then underwent standard sentinel lymph node biopsy (SLNB) using technicium-99 and blue dye, as well as selective removal of the node containing the radioactive seed. Data was gathered from electronic medical records and chart review. Nine patients with a median age of 54 underwent TAD for unilateral breast cancer post-NACT between 2015 and 2017, three of which were "triple-negative". A median of 3 lymph nodes were removed, including that which contained the radioactive seed. Postoperative pathological evaluation showed 4 patients with positive nodes and 5 pathologic complete responses in the axilla. In all patients, the seed had been accurately positioned in a positive node (no false negatives). The seed also located a positive retropectoral node that would otherwise have been missed using standard dual tracer SLNB. No complications due to the use of the radioactive seed were encountered. All implanted seeds were identified and retrieved within the pathology specimen. In our experience, TAD with a radioactive seed combined to dual tracer SLNB is an accurate and safe method of evaluating the axillary lymph node status in post-NACT node positive breast cancer patients. Further studies with larger cohorts are warranted to ensure continued feasibility and reproducibility of our positive results. Citation Format: Boulva K, Rodriguez-Qizilbash S, Guilarte L, Lazizi S, Robidoux A, Younan R, Patocskai E. Radioactive seed and targeted axillary dissection: A feasibility study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-22-21.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".