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Acosog z0011

Michelle M Fillion, Katherine E Glass, Joe Hayek, Allison Wehr, Gary Phillips, Alicia Terando, Doreen M Agnese
The purpose of our study was to quantitate the changes in axillary lymph node dissection (ALND), frozen section (FS), and the impact on costs after the publication of the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial. We compared axillary nodal management and cost data in breast cancer patients who met Z0011 criteria and were treated with lumpectomy and sentinel lymph nodes (SLN) biopsy from 2007 to July 2013. Of 800 patients, 67 (13.5%) and 34 (12.5%) patients in the pre- and post-Z0011 era had 1-2 positive SLN...
November 30, 2016: Breast Journal
Hiram S Cody
No abstract text is available yet for this article.
September 30, 2016: Annals of Surgical Oncology
J M Mann, X Wu, P Christos, D Nori, S C Formenti, H Nagar
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Dalliah Black
Axillary ultrasound is increasingly utilized for nodal staging preoperatively in patients presenting with invasive breast cancer to provide guidance for preoperative chemotherapy or proceeding directly to surgery. Improvements in ultrasound technology make it possible to assess the nodal burden in order to identify those patients not eligible for ACOSOG Z0011 management. However, its ability to detect metastasis is variable and dependent on operator's skills, size of metastatic deposit, and primary tumor histology subtype...
January 2017: Annals of Surgical Oncology
Yasuhiro Tamaki
The one-step nucleic acid amplification (OSNA) assay was initially developed for the intraoperative assessment of sentinel lymph node metastases in breast cancer. This assay measures cytokeratin 19 (CK19) mRNA copy number and is widely used in hospitals. The results of the IBCSG 23-01, ACOSOG Z0011, and AMAROS trials demonstrated that no further axillary dissection is required for patients with sentinel lymph nodes that tested positive for cancer, which has led to a decreasing trend in the need for intraoperative assessment of lymph nodes...
August 22, 2016: International Journal of Clinical Oncology
Armando E Giuliano, Karla Ballman, Linda McCall, Peter Beitsch, Pat W Whitworth, Peter Blumencranz, A Marilyn Leitch, Sukamal Saha, Monica Morrow, Kelly K Hunt
BACKGROUND AND OBJECTIVE: The early results of the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial demonstrated no difference in locoregional recurrence for patients with positive sentinel lymph nodes (SLNs) randomized either to axillary lymph node dissection (ALND) or sentinel lymph node dissection (SLND) alone. We now report long-term locoregional recurrence results. METHODS: ACOSOG Z0011 prospectively examined overall survival of patients with SLN metastases undergoing breast-conserving therapy randomized to undergo ALND after SLND or no further axillary specific treatment...
September 2016: Annals of Surgery
Kalnisha Naidoo, Sarah E Pinder
Pathologists typically examine the sentinel lymph nodes excised from patients with invasive breast cancer more thoroughly than they have historically those from axillary lymph node clearance specimens. This, it is thought, increases the chances of detecting small metastatic foci (i.e. macrometastases (>2 mm), micrometastases (0.2-2 mm), or isolated tumour cell clusters (<0.2 mm or <200 cancer cells in one section)). However, the clinical significance of these small metastatic deposits remains unclear...
August 3, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Viet H Le, Kathleen N Brant, Dawn W Blackhurst, Christine M G Schammel, David P Schammel, Wendy R Cornett, Brian P McKinley
BACKGROUND: Axillary dissection (AD) was historically recommended for all patients with breast tumor involvement discovered by sentinel lymph node biopsy (+SLNB). However, after the ACOSOG Z0011 trial, omission of AD became the recommendation for selected patients with a +SLNB. We report the impact of ACOSOG Z0011 on the completion AD rate in patients with +SLNB at our institution. METHODS: We retrospectively reviewed all patients diagnosed with breast cancer between March 2009 and February 2013 (n = 1781)...
October 2016: Breast: Official Journal of the European Society of Mastology
Miriam W Tsao, Sylvie D Cornacchi, Nicole Hodgson, Marko Simunovic, Lehana Thabane, Ji Cheng, Mary Ann O'Brien, Barbara Strang, Som D Mukherjee, Peter J Lovrics
INTRODUCTION: Evidence from the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial suggests completion axillary lymph node dissection (cALND) after positive sentinel lymph node biopsy (+SLNB) does not improve outcomes in select patients, leading to practice variation. A multidisciplinary group of surgeons, oncologists, and pathologists developed a regional guideline for cALND which was disseminated in August 2012. We assessed the impact of Z0011 and the regional guideline on cALND rates...
October 2016: Annals of Surgical Oncology
N C Verheuvel, A C Voogd, V C G Tjan-Heijnen, R M H Roumen
BACKGROUND: The ACOSOG Z0011 trial, a randomized controlled trial among patients with sentinel node positive breast cancer treated with breast conserving therapy, concluded that axillary lymph node dissection (ALND) can be omitted in these patients. However, questions were raised on the general applicability if the results of the Z0011 trial. Therefore, the aim of this study was to assess the practice changing effect of the Z0011 trial by quantifying the proportion of all node positive breast cancer patients who meet the inclusion criteria which are based on the Z0011 trial, thus in whom an ALND could be omitted...
August 2016: European Journal of Surgical Oncology
Anita Mamtani, Sujata Patil, Kimberly J Van Zee, Hiram S Cody, Melissa Pilewskie, Andrea V Barrio, Alexandra S Heerdt, Monica Morrow
BACKGROUND: The American College of Surgeons Oncology Group Z0011 trial demonstrated the safety of omitting axillary lymph node dissection (ALND) for women with fewer than three positive sentinel lymph nodes (SLNs) who are undergoing breast-conservation therapy (BCT). Because most of the women were postmenopausal with estrogen receptor (ER) positive cancers, applicability of ALND for younger patients and those with triple-negative (TN) or human epidermal growth factor receptor 2 (HER2) overexpressing (HER2+) tumors remains controversial...
October 2016: Annals of Surgical Oncology
Emma Gannan, Jeremy Khoo, Sophie Nightingale, Thomas Surya Suhardja, Jocelyn Lippey, Holly Keane, Kian Jin Tan, David Clouston, Alexandra Gorelik, Gregory Bruce Mann
To examine practice patterns for breast cancer patients with limited sentinel node (SN) disease in light of the ACOSOG Z0011 results. Retrospective analysis of patients with T1-2 breast cancer and positive sentinel lymph node biopsy (SLNB) admitted between January 2009 and December 2012. Patient demographics, tumor characteristics, and treatments were recorded. Eight hundred positive SLNBs were identified. A total of 452 (56.5%) proceeded to completion axillary lymph node dissection (cALND). cALND rate decreased from 65...
July 2016: Breast Journal
Ying Zhu, Wei Zhou, Jian-Qiao Zhou, Xiao-Chun Fei, Ting-Jun Ye, Ou Huang, Xiao-Song Chen, Wei-Wei Zhan
OBJECTIVES: Ultrasound (US)-guided fine-needle aspiration cytology (FNAC) is able to identify patients with extensive node involvement before surgery. In this study, we aimed to establish the optimal US criterion to identify abnormal lymph nodes on US-guided FNAC for detection of patients with 3 or more metastatic axillary nodes. METHODS: A total of 445 axillae from 443 patients with histologically confirmed invasive breast cancer (cT1-2 cN0) were examined with US at Ruijin Hospital from August 2013 to August 2014...
May 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
G M Kramer, M W H Leenders, L J Schijf, H L S Go, T van der Ploeg, M P van den Tol, W H Schreurs
This study evaluated the accuracy of ultrasound-guided fine-needle aspiration cytology of the sonographically most suspicious axillary lymph node (US/FNAC) to select early breast cancer patients with three or more tumour-positive axillary lymph nodes. Between 2004 and 2014, a total of 2130 patients with histologically proven early breast cancer were evaluated and treated in the Noordwest Clinics Alkmaar. US/FNAC was performed preoperatively in all these patients. We analysed the results of US/FNAC retrospectively...
April 2016: Breast Cancer Research and Treatment
Adam Gondos, Lina Jansen, Jörg Heil, Andreas Schneeweiss, Adri C Voogd, Jan Frisell, Irma Fredriksson, Ulla Johansson, Tove Filtenborg Tvedskov, Maj-Britt Jensen, Eva Balslev, Olaf Johan Hartmann-Johnsen, Milena Sant, Paolo Baili, Roberto Agresti, Tony van de Velde, Annegien Broeks, Jean-Marie Nogaret, Pierre Bourgeois, Michel Moreau, Zoltán Mátrai, Ákos Sávolt, Péter Nagy, Miklós Kásler, Petra Schrotz-King, Cornelia Ulrich, Hermann Brenner
Background We examined time trends in axilla management among patients with early breast cancer in European clinical settings. Material and methods EUROCANPlatform partners, including population-based and cancer center-specific registries, provided routinely available clinical cancer registry data for a comparative study of axillary management trends among patients with first non-metastatic breast cancer who were not selected for neoadjuvant therapy during the last decade. We used an additional short questionnaire to compare clinical care patterns in 2014...
June 2016: Acta Oncologica
Timothy C Kenny, James Dove, Mohsen Shabahang, Nicole Woll, Marie Hunsinger, April Morgan, Joseph Blansfield
The ACOSOG Z0011 trial demonstrated that axillary lymph node dissection (ALND) is not necessary for all breast cancer patients. Patients who underwent breast conservation surgery (BCS) or total mastectomy (TM) and met Z0011 criteria were identified and sorted into pre- and post- Z0011 cohorts. Four hundred ninety four patients had breast cancer surgery from July 2008 to February 2013. Of these, 255 were pre-Z0011 and 239 were post. Pre-Z0011, 14 patients met Z0011 inclusion criteria in BCS subgroup. ALND was performed in 10 of these patients (71%)...
January 2016: American Surgeon
Aoife Maguire, Edi Brogi
Sentinel lymph node (SLN) biopsy has been established as the standard of care for axillary staging in patients with invasive breast carcinoma and clinically negative lymph nodes (cN0). Historically, all patients with a positive SLN underwent axillary lymph node dissection (ALND). The ACOSOG Z0011 trial showed that women with T1-T2 disease and cN0 who undergo breast-conserving surgery and whole-breast radiotherapy can safely avoid ALND. The main goal of SLN examination should be to detect all macrometastases (>2 mm)...
January 2016: Histopathology
Melissa Pilewskie, Maxine Jochelson, Jessica C Gooch, Sujata Patil, Michelle Stempel, Monica Morrow
BACKGROUND: American College of Surgeons Oncology Group (ACOSOG) Z0011 results support the omission of axillary lymph node dissection (ALND) in women with less than 3 positive sentinel lymph nodes (SLNs) undergoing breast-conserving surgery (BCS) and radiation therapy. We sought to determine if abnormal axillary imaging is predictive of the need for ALND in this population. STUDY DESIGN: Patients with cT1-2N0 breast cancer by physical examination undergoing BCS were managed according to Z0011 criteria independent of axillary imaging...
February 2016: Journal of the American College of Surgeons
Melissa Pilewskie, Starr Koslow Mautner, Michelle Stempel, Anne Eaton, Monica Morrow
BACKGROUND: American College of Surgeons Oncology Group (ACOSOG) Z0011 defined clinical node negativity by physical examination alone. Although axillary ultrasound with biopsy has a positive predictive value for lymph node (LN) metastases approaching 100 %, it may not appropriately identify clinically node-negative women with ≥3 positive LNs who require axillary lymph node dissection (ALND). We sought to identify the total number of positive LNs in women presenting with cT1-2N0 breast carcinoma with a positive preoperative LN biopsy to evaluate the potential for overtreatment when ALND is performed on the basis of a positive needle biopsy in patients who otherwise meet ACOSOG Z0011 eligibility criteria...
April 2016: Annals of Surgical Oncology
Ruoxi Hong, Zhen Dai, Wenjie Zhu, Binghe Xu
PURPOSE: Results of the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial indicated that complete axillary node dissection (ALND) may not be warranted in some breast cancer patients with low tumor burden who are undergoing breast-conserving surgery following whole-breast irradiation. However, this study did not address patients undergoing mastectomy or those undergoing breast-conserving surgery without whole-breast radiotherapy. Given that lymph node ratio (LNR; ratio of positive lymph nodes to the total number removed) has been shown to be a prognostic factor in breast cancer, we first sought to determine the prognostic value of LNR in a low risk population comparable to that of the Z0011 trial and further to investigate whether the prognostic significance differs with local treatment modality...
2015: PloS One
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