Rodrigo Arrangoiz MS, MD, FACS, FSSO

11/18/2025

Routine Identification of the External Branch of the Superior Laryngeal Nerve

👉The external branch of the superior laryngeal nerve (EBSLN) has been labelled ‘the neglected nerve’ of thyroid surgery. 👉Most surgeons have simply attempted to avoid this nerve on the assumption t…

11/16/2025

After being looked at with uncertainity !!!!!

ATA in officially recongnizing Active surveillence as a line of treatment of selected differentiated thyroid carcinomas.

This is a summary of how ATA looks at active surveillance in 2025

11/10/2025

AMAROS (EORTC 10981-22023): If a positive SLN needs axillary treatment, axillary RT (ART) gives equivalent control to ALND with far less lymphedema Design & who it applies to: Population: cT1 to cT2, clinically node-negative invasive breast cancer with a positive sentinel lymph node (SLN): Patients underwent BCT or mastectomy: Unlike Z0011, which was BCT-only Randomized to ALND (levels I to II) vs axillary radiotherapy (levels I to III ± supraclavicular fossa) Primary endpoint: Non-inferiority of 5-year axillary recurrence (ARR) Key results: 5-year (primary report, Lancet Oncol 2014):...

AMAROS (EORTC 10981-22023): If a positive SLN needs axillary treatment, axillary RT (ART) gives equivalent control to ALND with far less lymphedema Design & who it applies to: Population: cT1 …

11/10/2025

11/08/2025

👉SUPREMO ISRCTN Clinical Study
👉postmastectomy chest-wall irradiation in patients with breast cancer
classified as pN1 (with involvement of one to three axillary nodes) or pN0 (patho-
logically node negative) with additional risk factors is uncertain.
👉Os 81.4% with chest-wall irradiation and 81.9% with no chest-wall irradiation
👉after 10 years of follow up I think we need to start thinking abo it de escalation of radiaiton therapy in this cohort

11/08/2025

What they asked? Could intraoperative lymphatic mapping with a blue dye–guided sentinel lymphadenectomy accurately reflect axillary status in breast cancer" Is the SLN a reliable surrogate for the entire basin? PubMed Methods (early feasibility): Design / setting: Prospective feasibility / accuracy series at John Wayne Cancer Institute Technique: Vital blue dye injected at the primary site Surgeons traced stained lymphatics to the first (“sentinel”) node, excised it, then performed ALND on all patients to verify accuracy Cohort: 174 mapping procedures PubMed Key performance results: Identification rate: 65.5% (SLN found in ...

What they asked? Could intraoperative lymphatic mapping with a blue dye–guided sentinel lymphadenectomy accurately reflect axillary status in breast cancer” Is the SLN a reliable surrogate fo…

11/07/2025

What did they asked? Can a radioisotope-guided sentinel lymph node (SLN) biopsy accurately predict the status of the axilla in breast cancer across multiple surgeons and practice settings? Methods: Population and setting: 443 women with breast cancer: Treated by 11 surgeons at varied centers Everyone underwent complete axillary lymph node dissection (ALND) so SLNB performance could be verified Technique: Peritumoral / pericavity injection of: 4 mL technetium-99m sulfur colloid (≈1 mCi / 37 MBq): Intraoperative hand-held gamma probe to find “hot spots,” then SLN excision followed by ALND Key performance metrics: …...

What did they asked? Can a radioisotope-guided sentinel lymph node (SLN) biopsy accurately predict the status of the axilla in breast cancer across multiple surgeons and practice settings?  Me…

11/06/2025

📊 NATALEE Trial Update | CDK4/6 Inhibitors in Early Breast Cancer

The Phase III NATALEE study changed the adjuvant landscape for HR+/HER2– early breast cancer.
✅ Ribociclib + AI for 3 years significantly improved invasive disease-free survival (HR 0.75)
✅ Absolute iDFS benefit grows over time — now ~5% at 4 years
✅ Broader eligibility: includes stage II–III and select high-risk node-negative patients
✅ FDA-approved (Sept 2024) for stage II–III high-risk disease

Together with monarchE (abemaciclib), these trials confirm that CDK4/6 inhibition reduces recurrence risk in early HR+/HER2– breast cancer — a major step forward in curative-intent therapy.

11/06/2025

NATALEE at a Glance (ribociclib, adjuvant)

Design/Pop: Phase III, HR+/HER2– stage II–III EBC; broadened risk (included select stage IIA N0 with high genomic/grade risk). Randomized to ribociclib 400 mg (3 weeks on/1 off) for 3 years + NSAI …