Contraindications of sentinel lymph node biopsy: Áre there any really?

BACKGROUND: One of the most exciting and talked about new surgical techniques in breast cancer surgery is the sentinel lymph node biopsy. It is an alternative procedure to standard axillary lymph node dissection, which makes possible less invasive surgery and side effects for patients with early breast cancer that wouldn't benefit further from axillary lymph node clearance. Sentinel lymph node biopsy helps to accurately evaluate the status of the axilla and the extent of disease, but also determines appropriate adjuvant treatment and long-term follow-up. However, like all surgical procedures, the sentinel lymph node biopsy is not appropriate for each and every patient. METHODS: In this article we review the absolute and relative contraindications of the procedure in respect to clinically positive axilla, neoadjuvant therapy, tumor size, multicentric and multifocal disease, in situ carcinoma, pregnancy, age, body-mass index, allergies to dye and/or radio colloid and prior breast and/or axillary surgery. RESULTS: Certain conditions involving host factors and tumor biologic characteristics may have a negative impact on the success rate and accuracy of the procedure. The overall fraction of patients unsuitable or with multiple risk factors that may compromise the success of the sentinel lymph node biopsy, is very small. Nevertheless, these patients need to be successfully identified, appropriately advised and cautioned, and so do the surgeons that perform the procedure. CONCLUSION: When performed by an experienced multi-disciplinary team, the SLNB is a highly effective and accurate alternative to standard level I and II axillary clearance in the vast majority of patients with early breast cancer

Through Their Voices: A Phenomenological Study of Undergraduate Women’s Experiences with Patriarchy in Higher Education

One in five women are sexually assaulted while in college (Cantor et al., 2015; Ali, 2011). Research has demonstrated that higher education is a patriarchal environment that is oppressive to women in a number of spheres (Acker, 1990; Burnett et al., 2009; Catalano, 2014; Miriam, 2007; Walby, 1989). Past research on sexual assault and patriarchy has focused on the prevalence of Division-I athletic programs (Crosset, 2016; Perkins & Craig, 2012; Wilson, Pritchard, & Schaffer, 2004; Ziering & Dick, 2015) or Greek life (Anderson & Clement, 2015; Armstrong & Hamilton, 2013; Armstrong, Hamilton, & Sweeney, 2006; Franklin, 2010; Howard, 2015). Less attention has been paid to the campus subcultures, groups, and physical spaces that women take part in as a part of their whole campus experience. In particular, less attention has been paid to medium-sized private institutions. This research employed a feminist framework to analyze the experiences of 14 women on two mid-sized private campuses in regards to their experiences of patriarchy. As a phenomenological study, the lived experiences of the participants within the culture of patriarchy in higher education were made visible (Butler, 1988; Creswell, 2013; Laverty, 2003), with specific focus on academics, extracurriculars, and campus party subcultures and spaces and how these influence women’s gender role performances, thus making them vulnerable to sexual assault. Data from the research indicated that while not all women are a victim of sexual assault, all women are subject to the patriarchal climate of higher education. This experience of patriarchy takes place across campus but also within the subcultures, groups, and physical spaces to which they belong. As such, women are constantly in a state of accommodating men and men’s desires, whether in the classroom, in their involvement, or at parties. At times, women are able to use their agency to enact their gender role performance in a way that is empowering or are able to seek alternative subcultures that allow them to resist against these patriarchal norms. However, when this is not possible, they use their agency to have their voices heard and to stay safe within the dominant culture. The knowledge gained from this research will allow practitioners, scholars, and policymakers to better understand the experiences of women in order to create programs and practices that make our campuses safe and welcoming for students of all gender identities