***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Sentinel lymph node biopsy ( SLNB ) is the st and ard surgical procedure for the axilla in early node-negative breast cancer . To date , the " gold st and ard " to localize the sentinel lymph node ( SLN ) is the radiotracer (99m)Tc with or without blue dye . The aim of this study was to evaluate potential equivalency of the new SentiMag ( ® ) technique in comparison to the " gold st and ard " . Within this prospect i ve , multicentric and multinational non-inferiority study including 150 patients (99m)Tc was compared with the magnetic technique , using superparamagnetic iron oxide particles ( SPIOs , Sienna+ ( ® ) ) for localization of SLNs . The results showed a detection rate per patient of 97.3 % ( 146/150 ) for (99m)Tc vs. 98.0 % ( 147/150 ) for Sienna+ ( ® ) with a similar average number of removed SLNs per patient and a higher per patient malignancy detection rate for the SPIO tracer . We obtained convincing results that magnetic SLNB can be performed easily , safely and equivalently well in comparison to the radiotracer method Background Sentinel lymph node biopsy ( SLNB ) in melanoma is currently performed using the st and ard dual technique ( radioisotope and blue dye ) . The magnetic technique is non-radioactive and provides a brown color change in the sentinel lymph node ( SLN ) through an intradermal injection of a magnetic tracer , and utilizes a h and held magnetometer . The MELAMAG Trial compared the magnetic technique with the st and ard technique for SLNB in melanoma . Methods Clinical ly node-negative patients with primary cutaneous melanoma were recruited from four centers . SLNB was undertaken after intradermal administration of both the st and ard ( blue dye and radioisotope ) and magnetic tracers . The SLN identification rate per patient , with the two techniques , was compared . Results A total of 133 patients were recruited , 129 of which were available for final analysis . The sentinel node identification rate was 97.7 % ( 126/129 ) with the st and ard technique and 95.3 % ( 123/129 ) with the magnetic technique [ 2.3 % difference ; 95 % upper confidence limit ( CL ) 6.4 ; 5.4 % discordance ] . With radioisotope alone , the SLN identification rate was 95.3 % ( 123/129 ) , as with the magnetic technique ( 0 % difference ; 95 % upper CL 4.5 ; 7.8 % discordance ) . The lymph node retrieval rate was 1.99 nodes per patient overall , 1.78 with the st and ard technique and 1.87 with the magnetic technique . Conclusions The magnetic technique is feasible for SLNB in melanoma with a high SLN identification rate , but is associated with skin staining . When compared with the st and ard dual technique , it did not reach our predefined non-inferiority margin BACKGROUND AND OBJECTIVES The French Sentimag feasibility trial evaluated a new method for the localization of  breast cancer sentinel lymph node ( SLN ) using Sienna+ ® , superparamagnetic iron oxide particles , and Sentimag ® detection in comparison to the st and ard technique ( isotopes ± blue dye ) . METHODS We conducted a prospect i ve multicentric paired comparison trial on 115 patients .  SLN localization was performed using both the magnetic technique and the st and ard method . Detection rate and concordance between magnetic and st and ard tracers were calculated . Post-operative complications were assessed after 30 days . RESULTS Results are based on 108 patients . SLN identification rate was 98.1 % [ 93.5 - 99.8 ] for both methods , 97.2 % [ 92.1 - 99.4 ] for Sienna+ ® and 95.4 % [ 89.5 - 98.5 ] for st and ard technique . A mean of 2.1 SLNs per patient was removed . The concordance rate was 99.0 % [ 94.7 - 100.0 % ] per patient and 97.4 % [ 94.1 - 99.2 ] per node . Forty-six patients ( 43.4 % ) had nodal involvement . Among involved SLNs , concordance rate was 97.7 % [ 88.0 - 99.9 ] per patient and 98.1 % [ 90.1 - 100.0 ] per node . CONCLUSIONS This new magnetic tracer is a feasible method and a promising alternative to the isotope . It could offer benefits for ambulatory surgery or sites without nuclear medicine departments . J. Surg . Oncol . 2016;113:501 - 507 . © 2016 Wiley Periodicals , Background The r and omized EORTC 10981 - 22023 AMAROS trial investigates whether breast cancer patients with a tumor-positive sentinel node biopsy ( SNB ) are best treated with an axillary lymph node dissection ( ALND ) or axillary radiotherapy ( ART ) . The aim of the current sub study was to evaluate the identification rate and the nodal involvement . Methods The first 2,000 patients participating in the AMAROS trial were evaluated . Associations between the identification rate and technical , patient- , and tumor-related factors were evaluated . The outcome of the SNB procedure and potential further nodal involvement was assessed . Results In 65 patients , the sentinel node could not be identified . As a result , the sentinel node identification rate was 97 % ( 1,888 of 1,953 ) . Variables affecting the success rate were age , pathological tumor size , histology , year of accrual , and method of detection . The SNB results of 65 % of the patients ( n = 1,220 ) were negative and the patients underwent no further axillary treatment . The SNB results were positive in 34 % of the patients ( n = 647 ) , including macrometastases ( n = 409 , 63 % ) , micrometastases ( n = 161 , 25 % ) , and isolated tumor cells ( n = 77 , 12 % ) . Further nodal involvement in patients with macrometastases , micrometastases , and isolated tumor cells undergoing an ALND was 41 , 18 , and 18 % , respectively . Conclusions With a 97 % detection rate in this prospect i ve international multicenter study , the SNB procedure is highly effective , especially when the combined method is used . Further nodal involvement in patients with micrometastases and isolated tumor cells in the sentinel node was similar — both were 18 % BACKGROUND Sentinel lymph node biopsy in women with operable breast cancer is routinely used in some countries for staging the axilla despite limited data from r and omized trials on morbidity and mortality outcomes . We conducted a multicenter r and omized trial to compare quality -of-life outcomes between patients with clinical ly node-negative invasive breast cancer who received sentinel lymph node biopsy and patients who received st and ard axillary treatment .  METHODS The primary outcome measures were arm and shoulder morbidity and quality of life .  From November 1999 to October 2003 , 1031 patients were r and omly assigned to undergo sentinel lymph node biopsy ( n = 515 ) or st and ard axillary surgery ( n = 516 ) . Patients with sentinel lymph node metastases proceeded to delayed axillary clearance or received axillary radiotherapy ( depending on the protocol at the treating institution ) . Intention-to-treat analyses of data at 1 , 3 , 6 , and 12 months after surgery are presented . All statistical tests were two-sided . RESULTS The relative risks of any lymphedema and sensory loss for the sentinel lymph node biopsy group compared with the st and ard axillary treatment group at 12 months were 0.37 ( 95 % confidence interval [ CI ] = 0.23 to 0.60 ; absolute rates : 5 % versus 13 % ) and 0.37 ( 95 % CI = 0.27 to 0.50 ; absolute rates : 11 % versus 31 % ) , respectively . Drain usage , length of hospital stay , and time to resumption of normal day-to-day activities after surgery were statistically significantly lower in the sentinel lymph node biopsy group ( all P < .001 ) , and axillary operative time was reduced ( P = .055 ) . Overall patient-recorded quality of life and arm functioning scores were statistically significantly better in the sentinel lymph node biopsy group throughout ( all P < or = .003 ) . These benefits were seen with no increase in anxiety levels in the sentinel lymph node biopsy group ( P > .05 ) . CONCLUSION Sentinel lymph node biopsy is associated with reduced arm morbidity and better quality of life than st and ard axillary treatment and should be the treatment of choice for patients who have early-stage breast cancer with clinical ly negative nodes A mini-symposium was held in Montreal , Canada , at the International Surgical Week for the Breast Surgical International in 2007 addressing the question whether breast cancer is the same disease in Asian and Western countries . Numerous investigators from Asian and Western countries presented the epidemiologic and clinical outcome data of women with breast cancer . Although there are significant similarities , the striking difference is that the peak age for breast cancer is between 40 and 50 years in the Asian countries , whereas the peak age in the Western countries is between 60 and 70 years . Also , the incidence of breast cancer in Asia is rising and is associated with increased mortality . In the West , although the incidence is increasing , the mortality rate is definitely decreasing . Future prospect i ve data collection from Asian and Western countries may provide further interesting epidemiologic and outcome data regarding the outcome of women with breast cancer from Asian and Western countries . Background Whether breast cancer is the same disease in Asian and Western countries was the topic of a 2007 Breast Surgery International symposium at International Surgical Week . Methods Participating investigators from China , Taiwan , India , Japan , South Korea , Sweden , Canada , and the United States were asked beforeh and to provide data on the epidemiology and treatment outcome of women in their countries . Results Comparisons of the epidemiologic and clinical outcome data of women with breast cancer  showed significant similarities , but the striking difference is that the peak age is between 40 and 50 years in Asian countries , but is between 60 and 70 years in Western countries . The incidence of breast cancer in Asia is rising and is associated with increased mortality . In the West , although the incidence is also increasing , the mortality rate is definitely decreasing . Discussion Future prospect i ve data collection from Asian and Western countries may provide further interesting epidemiologic and outcome data regarding the outcome of women with breast cancer from Asian and Western countries Background [99mTc]Tilmanocept is a CD206 receptor-targeted radiopharmaceutical design ed for sentinel lymph node ( SLN ) identification . Two nearly identical nonr and omized phase III trials compared [99mTc]tilmanocept to vital blue dye . Methods Patients received [99mTc]tilmanocept and blue dye .  SLNs identified intraoperatively as radioactive and /or blue were excised and histologically examined . The primary end point , concordance , was the proportion of blue nodes detected by [99mTc]tilmanocept ; 90 % concordance was the prespecified minimum concordance level . Reverse concordance , the proportion of radioactive nodes detected by blue dye , was also calculated . The prospect i ve statistical plan combined the data from both trials . Results Fifteen centers contributed 154 melanoma patients who were injected with both agents and were intraoperatively evaluated . Intraoperatively , 232 of 235 blue nodes were detected by [99mTc]tilmanocept , for 98.7 % concordance ( p < 0.001 ) . [99mTc]Tilmanocept detected 364 nodes , for 63.7 % reverse concordance ( 232 of 364 nodes ) . [99mTc]Tilmanocept  detected at least one node in more patients ( n = 150 ) than blue dye ( n = 138 , p = 0.002 ) . In 135 of 138 patients with at least one blue node , all blue nodes were radioactive . Melanoma was identified in the SLNs of 22.1 % of patients ; all 45 melanoma-positive SLNs were detected by [99mTc]tilmanocept , whereas blue dye detected only 36 ( 80 % ) of 45 ( p = 0.004 ) . No positive SLNs were detected exclusively by blue dye . Four of 34 node-positive patients were identified only by [99mTc]tilmanocept , so 4 ( 2.6 % ) of 154 patients were correctly staged only by [99mTc]tilmanocept .  No serious adverse events were attributed to [99mTc]tilmanocept . Conclusions [99mTc]Tilmanocept met the prespecified concordance primary end point , identifying 98.7 % of blue nodes . It identified more SLNs in more patients , and identified more melanoma-containing nodes than blue dye Background The SentiMAG Multicentre Trial evaluated a new magnetic technique for sentinel  lymph node biopsy ( SLNB ) against the st and ard ( radioisotope and blue dye or radioisotope alone ) . The magnetic technique does not use radiation 
    Output:
    
The magnetic technique for SLNB is non-inferior to the st and ard technique , with a high identification rate but with a significantly higher lymph node retrieval rate