Does the Result of Completion Axillary Lymph Node Dissection Influence the Recommendation for Adjuvant Treatment in Sentinel Lymph Node–Positive Patients?

Sávolt, Ákos; Polgár, Csaba; Musonda, Patrick; Mátrai, Zoltán; Rényi-Vámos, F; Tóth, László; Kásler, Miklós; Péley, Gábor

doi:10.1016/j.clbc.2013.04.004

Cited by 25 publications

(15 citation statements)

References 24 publications

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“…Of these, 5 trials reported in 13 publications met the inclusion criteria, two studies were still ongoing (comparing ALND to SLNB [NCT01796444 (Wang 2013 ), and ALND or axillary radiotherapy [aRT] + adjuvant treatment versus adjuvant treatment alone [POSNOC (Goyal 2014a , b )], respectively) while the remaining 147 records were excluded because they were: not a randomised trial (n = 20), ineligible population (n = 101), unclear intervention (n = 2) and ineligible intervention (n = 24); See also Additional file 2 ). The five included studies compared ALND with sentinel lymph node dissection (SLND) to SLND alone [ACOSOG Z0011 (Lucci et al 2007 ; Olsen and McCall 2008 ; Giuliano et al 2010 , 2011 ); ATTRM-048-13-2000 (Sola et al 2013 ); IBCSG-23-01 (Galimberti et al 2011 , 2012 , 2013 )], and ALND to aRT [AMAROS (Straver et al 2010a , b ; Donker et al 2014 ); OTOASOR (Savolt et al 2013a , b )]. See Tables 1 and 2 for summary study details and risk-of-bias levels, respectively, and Additional file 3 for full study details and risk-of-bias assessments.…”

Section: Resultsmentioning

confidence: 99%

Axillary surgery in women with sentinel node-positive operable breast cancer: a systematic review with meta-analyses

Schmidt‐Hansen¹,

Bromham²,

Hasler³

et al. 2016

SpringerPlus

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Traditionally, women with node-positive operable breast cancer have received complete axillary lymph node dissection (ALND), which is associated with significant morbidity, but recently less invasive alternatives have been explored. We conducted a systematic review of randomised controlled trials assessing alternative approaches to axillary surgery in patients with pathologically-confirmed sentinel node-positive operable breast cancer. We searched on 16/3/15 the Specialized Register of the Cochrane Breast Cancer group; CENTRAL; MEDLINE; PreMEDLINE; EMBASE; WHO International Clinical Trials Registry Portal; ClinicalTrials.gov; conference proceedings from ASCO and the San Antonio Breast Cancer meetings; checked reference lists and contacted authors to identify relevant studies. Double, independent study sifting, extraction, appraisal and summarising were undertaken using standard Cochrane Collaboration methodology. We included three studies (2020 patients) comparing ALND with sentinel lymph node dissection (SLND) to SLND alone, and two studies (1899 patients) comparing ALND to axillary radiotherapy (aRT). No differences in survival or recurrence were observed between ALND and SLND or aRT, but morbidity may have been increased in ALND, and all the results were subject to different biases, such as recruitment bias, performance bias, and outcome-reporting bias. Whilst it is encouraging that there appears to be no adverse effect on recurrence or survival, it will be appropriate to confirm these findings and provide additional data confirming quality of life effects and long term outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-016-1712-9) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Axillary surgery in women with sentinel node-positive operable breast cancer: a systematic review with meta-analyses

Schmidt‐Hansen¹,

Bromham²,

Hasler³

et al. 2016

SpringerPlus

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“…29 Nonetheless, post hoc studies trying to estimate the impact of information gained from cALND in these situations have shown inconclusive results. 30,31 In EBC, chemotherapy is currently used more often neoadjuvantly for several reasons. First, NACT is used for in vivo sensitivity testing and enabling postneoadjuvant therapy escalation in cases of residual disease, to improve prognosis.…”

Section: Discussionmentioning

confidence: 99%

Time trends of neoadjuvant chemotherapy for early breast cancer

Riedel

Hoffmann

Moderow

et al. 2020

Intl Journal of Cancer

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Neoadjuvant chemotherapy (NACT) in early breast cancer (EBC) enables in vivo sensitivity testing and less radical surgery as compared to primary surgery and adjuvant chemotherapy (ACT). The aim of our study is to illustrate trends of systemic treatment of EBC. The study analyzed chemotherapy usage and time trends for patients with EBC treated at 104 German breast units between January 2008 and December 2017. The data were obtained through a quality-controlled benchmarking process. Altogether, 124 084 patients were included, of whom 46 279 (37.3%) received chemotherapy. For 44 765 of these cases, detailed information on systemic treatment and surgery were available. Overall use of chemotherapy declined from 42.0% in 2008 to 32.0% in 2017. During that same time, the proportion of NACT increased from 20.0% to 57.7%, irrespective of tumor subtype. The pathological complete response (pCR) rate (defined as ypT0 ypN0) at surgery after NACT increased from 15.0% to 34.2%. The results from this large cohort from the clinical routine reflect the refined indications for chemotherapy in EBC.

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“…Возможность такого подхода к хирургическому лечению больных ранним РМЖ была обоснована результатами ряда клинических рандомизированных исследований, таких как NSABP-B04, NSABP-B32, ACOSOGZ001157, IBCSG 23-0152, AMA-ROS61, AATRM53, OTOASOR и др. Эти исследования показали, что существенной разницы в частоте возникновения регионарных рецидивов и достоверных различий в общей и безрецидивной выживаемости больных ранним РМЖ с ПЛАЭ и без нее нет, даже при условии выявления метастатического поражения СЛУ [12][13][14][15][16][17][18][19][20].…”

Section: материал и методыunclassified

Experience in using the International Classification of Functioning, Disability and Health in patients with breast cancer after surgical treatment

Грушина¹,

Zikiryakhodzhaev²,

Старкова³

2018

Onkol. Z. im. P.A. Gercena

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научно-исследовательский онкологический институт им. П.А. Герцена-филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России, Москва, Россия Международная классификация функционирования, ограничений жизнедеятельности и здоровья (МКФ)-классификация, применяемая для анализа результатов различных вмешательств, методов лечения и реабилитации, а также при оценке функционирования людей с онкологическими заболеваниями. Цель исследования-ознакомить хирургов-онкологов с концепцией и структурой МКФ и создать на ее основе профиль функционирования больных раком молочной железы (МРЖ), перенесших хирургическое лечение. Материал и методы. На протяжении 3 лет под наблюдением авторов находились 380 больных РМЖ I-IIIБ стадии в возрасте 30-69 лет. Из них 330 больным выполнена мастэктомия в модификаци Маддена с подмышечной лимфаденэктомией (ПЛАЭ). 50 больным РМЖ c T1-2N0M0 выполнена мастэктомия в модификации Маддена с определением сторожевого лимфатического узла (СЛУ) без последующей лимфаденэктомии. Результаты. На основании наблюдения за 330 больными РМЖ возникающие у них проблемы функционирования после перенесенной мастэктомии в модификации Маддена с ПЛАЭ были отображены в терминологии МКФ по 83 категориям 2-го уровня детализации и по 119 категориям 2-3-го уровня детализации: для составляющей функции организма 26, структуры организма 13, активности и участия 49, факторов окружающей среды 31 категория. Для 50 больных РМЖ c T1-2N0M0 после мастэктомии по Маддену без подмышечной лимфаденэктомии, с биопсией СЛУ проблемы функционирования были отображены в терминологии МКФ по 50 категориям 2-го уровня детализации и по 60 категориям 2-3-го уровня детализации: для составляющей функции организма 14, структуры организма 1, активности и участия 17, факторов окружающей среды 28 категорий. Наборы кодов МКФ представлены в виде таблиц с пояснениями и методами оценки некоторых определителей. Заключение. Так как отказ от регионарной лимфаденэктомии уменьшает проблемы функционирования, крайне актуальной является оптимизация подходов к хирургическому лечению раннего РМЖ.

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Does the Result of Completion Axillary Lymph Node Dissection Influence the Recommendation for Adjuvant Treatment in Sentinel Lymph Node–Positive Patients?

Cited by 25 publications

References 24 publications

Axillary surgery in women with sentinel node-positive operable breast cancer: a systematic review with meta-analyses

Axillary surgery in women with sentinel node-positive operable breast cancer: a systematic review with meta-analyses

Time trends of neoadjuvant chemotherapy for early breast cancer

Experience in using the International Classification of Functioning, Disability and Health in patients with breast cancer after surgical treatment

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