Axillary treatment for operable primary breast cancer

Bromham, Nathan; Schmidt‐Hansen, Mia; Astin, Margaret; Hasler, Elise; Reed, Malcolm

doi:10.1002/14651858.cd004561.pub3

Cited by 66 publications

(68 citation statements)

References 92 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous randomized trials comparing ALND versus no axillary surgery in clinically node-negative patients (cN0) showed no benefit regarding overall survival for the ALND arm, even with long-term follow-up [31]. Currently, SLNB is accepted as staging procedure in cN0 patients with a false-negative rate of 6-8% [32].…”

Section: Surgeon's View: Pros and Cons For Slnbmentioning

confidence: 99%

“…Summarizing these data, avoiding axillary surgery in patients with clinically and sonographically unsuspicious lymph nodes seems to be a safe option, although it may slightly increase the risk of locoregional recurrence [31]. Further studies are needed to define subgroups of patients that do not profit from axillary staging and can be spared from its possible side effects.…”

Section: Surgeon's View: Pros and Cons For Slnbmentioning

confidence: 99%

See 1 more Smart Citation

Is Axillary Sentinel Lymph Node Biopsy Required in Patients Who Undergo Primary Breast Surgery

Reimer

Engel²,

Schmidt

et al. 2018

Breast Care

View full text Add to dashboard Cite

Local treatment of the axilla in clinically node-negative (cN0) early breast cancer patients with routine sentinel lymph node biopsy (SLNB) is debated for various reasons: i) pN staging information may not be necessary for the postoperative treatment decision regarding adjuvant systemic therapy in the great majority of patients; ii) the SLNB-positive rate is declining below 20% in specialized breast centers; iii) albeit being a minimally invasive procedure, SLNB causes a significant reduction in quality of life in 23% of patients; and iv) previous randomized trials from the pre-SLNB era did not show a disadvantage for patients without axillary surgery with regard to overall survival. These data support the hypothesis that avoiding axillary treatment in patients with clinically and sonographically unsuspicious lymph nodes seems to be a safe option, although omitting axillary surgery may increase the risk of locoregional recurrence. Currently, the information regarding node-positive status is essential to guide postoperative treatment such as systemic or radiation therapies in a non-negligible minority of patients. Three ongoing prospective European trials (SOUND, INSEMA, BOOG 2013-08) with axillary observation alone versus SLNB in cN0 patients and primary breast-conserving surgery have the objective to evaluate oncologic safety when omitting SLNB.

show abstract

Section: Surgeon's View: Pros and Cons For Slnbmentioning

confidence: 99%

Section: Surgeon's View: Pros and Cons For Slnbmentioning

confidence: 99%

Is Axillary Sentinel Lymph Node Biopsy Required in Patients Who Undergo Primary Breast Surgery

Reimer

Engel²,

Schmidt

et al. 2018

Breast Care

View full text Add to dashboard Cite

show abstract

“…While trends are emerging that advocate for a reduction in axillary surgery, selected patients to continue to benefit from axillary nodal clearance . Patients who require ALND are at increased risk for LE and its medical, social, and psychological implications .…”

Section: Discussionmentioning

confidence: 99%

Axillary reverse mapping and lymphaticovenous bypass: Lymphedema prevention through enhanced lymphatic visualization and restoration of flow

Schwarz

Grobmyer

Djohan

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

Background A lymphedema (LE) prevention surgery (LPS) paradigm for patients undergoing axillary lymphadenectomy (ALND) was developed to protect against LE through enhanced lymphatic visualization during axillary reverse mapping (ARM) and refinement in decision making during lymphaticovenous bypass (LVB). Methods A retrospective analysis of a prospective database was performed evaluating patients with breast cancer who underwent ALND, ARM, and LVB from September 2016 to December 2018. Patient and tumor characteristics, oncologic and reconstructive operative details, complications and LE development were analyzed. Results LPS was completed in 58 patients with a mean age of 51.7 years. An average of 14 lymph nodes (LN) were removed during ALND. An average of 2.1 blue lymphatic channels were visualized with an average of 1.4 LVBs performed per patient. End to end anastomosis was performed in 37 patients and a multiple lymphatic intussusception technique in 21. Patency was confirmed 96.5% of patients. Adjuvant radiation was administered to 89% of patients. Two patients developed LE with a median follow‐up of 11.8 months. Conclusion We report on our experience using a unique LPS technique. Refinements in ARM and a systematic approach to LVB allows for maximal preservation of lymphatic continuity, identification of transected lymphatics, and reestablishment of upper extremity lymphatic drainage pathways.

show abstract

“…8 Applying the same principle, the advent of sentinel lymph node mapping in the management of the axillary area implied a substantially reduced need for axillary dissection in early tumours, and hence lower risk of lymphoedema and its associated morbidities. 9,10 Moreover, advances in imaging techniques may further improve the accuracy of screening. In the Norwegian nationwide study of over 40 000 women with breast cancer, screening led to a reduction in mortality by 4.8 deaths per 100 000 person-years when compared with the nonscreened group.…”

Section: Is Now the Right Time To Abolish Breast Cancer Screening In mentioning

confidence: 99%

Is now the right time to abolish breast cancer screening in Hong Kong?

Chow

2018

Hong Kong Med J

View full text Add to dashboard Cite

Axillary treatment for operable primary breast cancer

Cited by 66 publications

References 92 publications

Is Axillary Sentinel Lymph Node Biopsy Required in Patients Who Undergo Primary Breast Surgery

Is Axillary Sentinel Lymph Node Biopsy Required in Patients Who Undergo Primary Breast Surgery

Axillary reverse mapping and lymphaticovenous bypass: Lymphedema prevention through enhanced lymphatic visualization and restoration of flow

Is now the right time to abolish breast cancer screening in Hong Kong?

Contact Info

Product

Resources

About