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Acosog z0011

Ritika Gera, Abdul Kasem, Kefah Mokbel
The sentinel lymph node biopsy (SLNB) has become the new standard-of-care for patients with clinically node-negative invasive breast cancer. The focused examination of fewer lymph nodes in addition to improvements in histopathological and molecular analysis have increased the rate at which micrometastases and isolated tumor cells are identified. We reviewed the literature and summarized the evidence regarding the need for complete axillary lymph node dissection (ALND) following the finding of a positive sentinel node biopsy through the identification of the most important outcomes and evaluation of quality of evidence...
November 2018: In Vivo
André Hennigs, Melitta Köpke, Manuel Feißt, Fabian Riedel, Mahdi Rezai, Ulrike Nitz, Mareike Moderow, Michael Golatta, Christof Sohn, Andreas Schneeweiss, Jörg Heil
PURPOSE: In the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial, patients with 1 or 2 tumour-involved sentinel lymph nodes (SLNs) gained no benefit from completion axillary lymph dissection (cALND). We examined implementation of evidence from this trial into routine clinical management. METHODS: Data were included from patients diagnosed with primary breast cancer in German breast cancer units between 2008 and 2015 and analysed retrospectively from a prospective maintained database...
October 12, 2018: Breast Cancer Research and Treatment
Michael Yan, Mohamed Ahmed Abdi, Conrad Falkson
Optimal regional management in breast cancer patients has yet to be established. In patients who are clinically node-negative, but sentinel lymph node biopsy (SLNB)-positive, the treatment paradigm has shifted toward the de-escalation of further axillary management. In patients with 2 or fewer positive sentinel nodes, the standard of practice has shifted away from complete axillary lymph node dissection (ALND) as a result of the ACOSOG Z0011 trial. The role of regional nodal irradiation (RNI) to the axilla, supraclavicular and internal mammary regions has also been investigated in the setting of positive SLNB in trials such as the MA20 and EORTC 22922...
August 22, 2018: Clinical Breast Cancer
Xin Zhang, Ying Wang
The purpose of this national survey is to explore the patterns of surgical management for early stage breast cancer patients in China. A paper questionnaire survey was sent to the representatives from 520 hospitals who attended an international symposium in Guangzhou, China, 2014. The questionnaire included demographic information, initials and most preferred approaches for breast cancer surgery. The results were presented descriptively. The response rate was 42.5%. Only 7% of hospitals with >50% rate of breast conserving surgery (BCS)...
July 2018: Oncoscience
Brian J Gebhardt, Joel Thomas, Zachary D Horne, Colin E Champ, Daniel J Farrugia, Emilia Diego, Gretchen M Ahrendt, Sushil Beriwal
Purpose: The American College of Surgeons Oncology Group trial Z0011 demonstrated that axillary node dissection (ALND) can be omitted in patients managed with breast conserving surgery and 1 to 2 positive sentinel lymph nodes (SLNs) without adverse effects on locoregional recurrence or disease-free survival (DFS). We investigated patients with breast cancer for whom clinicopathologic features were underrepresented in the Z0011 trial and analyzed radiation therapy treatment patterns and clinical outcomes...
July 2018: Advances in Radiation Oncology
Maria Grazia Lazzaretti, Antonio Ponti, Maria Piera Mano, Alessandra Barca, Denise Casella, Alfonso Frigerio, Livia Giordano, Paola Mantellini, Adriana Paduos, Sabina Pitarella, Alessandra Ravaioli, Mario Taffurelli, Mariano Tomatis, Nereo Segnan
OBJECTIVES: Available evidence on axillary surgery has accumulated dramatically in the last two decades in favor of less invasive care. The aim of this paper is to study 16-years trends in the surgical management of the axilla in a large population-based data set of screen-detected breast cancers in Italy and to document at what extent recommendations have been adopted in actual clinical care. MATERIAL AND METHODS: This is a retrospective cohort study documenting the surgical management of the axilla in primary breast cancer patients over time...
August 14, 2018: Breast: Official Journal of the European Society of Mastology
Apoorve Nayyar, Paula D Strassle, Mary R Shen, Jonathan A Black, Kristalyn K Gallagher, Kandace P McGuire
BACKGROUND: The American College of Surgeons Oncology Group (ACOSOG) Z0011 trial demonstrated equivalent survival in early-stage breast cancer (BC) patients receiving either axillary lymph node dissection (ALND) or sentinel lymph node dissection (SLND) alone. However, institutional studies have called into question the generalization of these findings outside of a clinical trial. METHODS: Early-stage BC patients diagnosed in 2013, that received lumpectomy with whole-breast irradiation, and underwent either ALND or SLND alone, in National Cancer Database were included...
October 2018: American Journal of Surgery
Monica Morrow, Reshma Jagsi, M Chandler McLeod, Dean Shumway, Steven J Katz
Importance: The American College of Surgeons Oncology Group (ACOSOG) Z0011 study demonstrated the safety of sentinel node biopsy alone in clinically node-negative women with metastases in 1 or 2 sentinel nodes treated with breast conservation. Little is known about surgeon perspectives regarding when axillary lymph node dissection (ALND) can be omitted. Objectives: To determine surgeon acceptance of ACOSOG Z0011 findings, identify characteristics associated with acceptance of ACOSOG Z0011 results, and examine the association between acceptance of the Society of Surgical Oncology and American Society for Radiation Oncology negative margin of no ink on tumor and surgeon preference for ALND...
November 1, 2018: JAMA Oncology
Wolfram Malter, Martin Hellmich, Mayhar Badian, Verena Kirn, Peter Mallmann, Stefan Krämer
BACKGROUND/AIM: Sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) for axillary staging in patients with early-stage breast cancer. The need for therapeutic ALND is the subject of ongoing debate especially after the publication of the ACOSOG Z0011 trial. In a retrospective trial with univariate and multivariate analyses, factors predictive of sentinel lymph node involvement should be analyzed in order to define tumor characteristics of breast cancer patients, where SLNB should not be spared to receive important indicators for adjuvant treatment decisions (e...
June 2018: Anticancer Research
Nobuyoshi Kittaka, Ryu Tokui, Chika Ota, Yoko Hashimoto, Kazuyoshi Motomura, Makoto Ishitobi, Takahiro Nakayama, Yasuhiro Tamaki
BACKGROUND: In patients undergoing breast-conserving surgery and having positive sentinel lymph nodes (SLNs), the ACOSOG Z0011 trial showed equivalent loco-regional outcomes for patients receiving SLN dissection (SLND) alone and those receiving axillary lymph node dissection (ALND). We conducted a prospective single-arm study to confirm the applicability of the Z0011 criteria to Japanese patients with breast cancer. METHODS: Patients meeting the Z0011 inclusion criteria and providing consent to receive no additional ALND were prospectively enrolled at the Osaka International Cancer Institute from April 2012 to December 2016...
October 2018: International Journal of Clinical Oncology
T Nowikiewicz, W Zegarski, K Pagacz, M Nowacki, A Morawiec-Sztandera, I Glowacka-Mrotek, M Sowa, M Biedka, A Kolacinska
The main objective of the ACOSOG Z0011 trial was to determine the impact of abandoning complete axillary lymph node dissection (ALND) on survival of breast cancer patients with sentinel node lymph (SLN) metastasis in whom breast conserving therapy (BCT) had been performed. The aim of our study was to assess the clinical value of intra-operative histopathological examination of SLN. Our study comprised 1284 invasive breast cancer patients in whom sentinel lymph node biopsy (SLNB) was carried out. SLN intra-operative histopathological assessment was routinely performed in patients treated within the first period (07...
March 14, 2018: Neoplasma
Beth T Harrison, Jane E Brock
Objectives: Management of the axilla in breast cancer patients has evolved considerably since the introduction of the sentinel lymph node (SLN) biopsy in the 1990s. Several new clinical and technological developments in the last decade warrant special consideration due to their impact on pathology practice. Methods: This review covers the SLN biopsy procedure, issues in the histopathologic and molecular diagnosis of the SLN, and most importantly, evidence from recent practice-changing clinical trials...
May 31, 2018: American Journal of Clinical Pathology
Nao Imai, Mika Kitayama, Akiko Shibahara, Yuri Bessho, Mai Shibusawa, Aya Noro, Keiko Inakami, Noriko Hanamura, Hiroshi Imai, Tomoko Ogawa
BACKGROUND: After the ACOSOG Z0011 trial, it became important to evaluate the number of metastatic axillary lymph nodes (LNs) preoperatively. The purpose of this paper is to confirm whether the number of metastases can be accurately diagnosed by preoperative computed tomography (CT), ultrasound sonography (US), and US-guided fine-needle aspiration cytology (FNAC). METHODS: We retrospectively analyzed the axillary LNs finding of preoperative CT/US of 470 breast cancer patients...
April 13, 2018: Asian Journal of Surgery
Ingrid G M Poodt, Marjolijn L Rots, Guusje Vugts, Thijs van Dalen, Anne Kuijer, Birgit E P J Vriens, Grard A P Nieuwenhuijzen, Robert-Jan Schipper
PURPOSE: The ACOSOG-Z0011-study has resulted in a trend to a more conservative treatment of the axilla for selected sentinel-node-positive patients. However, axillary nodal involvement has always been an important factor for tumor staging and tailoring adjuvant chemotherapy plans. This study evaluates the impact of omitting completion axillary lymph node dissection (cALND) on the administration of adjuvant chemo (-immuno)therapy in Dutch clinical T1-2N0M0 (cT1-2N0M0) sentinel-node-positive breast cancer patients...
August 2018: European Journal of Surgical Oncology
Alison E Hunter-Smith, Zenon Rayter
Breast cancer is the most common cancer in women, worldwide, and 1,400 deaths per day are attributed to it. The success of national screening programs has seen breast cancers being diagnosed at an earlier stage. With conservative surgery to the breast demonstrating equivalent long-term outcomes, the last 10 years have seen a growing interest in the safety of less invasive management for the axilla in breast cancer patients. One-step nucleic acid amplification (OSNA) is a validated, reliable, and efficient tool in identifying micro- and macro-metastases intraoperatively...
2018: Breast Cancer: Targets and Therapy
N A O'Keeffe, C O'Neill, A Zahere, V Livingstone, T J Browne, H P Redmond, M A Corrigan
BACKGROUND: The presence of extranodal extension (ENE) is well documented as a predictor of non-sentinel lymph node (NSLN) metastasis. The ACOSOG Z0011 trial (2011) concluded that patients who satisfy criteria including the absence of sentinel lymph node (SLN) ENE can forgo axillary clearance (AC). Currently there are no studies analysing the rate of ENE in NSLN metastasis in which the sentinel node was positive but had no ENE. Determining this incidence will help determine if current paradigms are resulting in residual ENE in NSLN metastasis by forgoing AC based on the Z0011 trial...
April 2018: Breast: Official Journal of the European Society of Mastology
Augusto Lombardi, Giuseppe Nigri, Stefano Maggi, Gianluca Stanzani, Valeria Vitale, Andrea Vecchione, Alessandro Nania, Claudio Amanti
BACKGROUND: Intraoperative frozen sections (FS) of sentinel lymph nodes (SLN) were evaluated to avoid the need for deferred axillary lymph node dissection (ALND) in patients with early breast cancer (EBC). However, FS has low sensitivity for detecting micro-metastases (<2 mm), resulting in patients who later undergo deferred ALND. The aim of the study was to determine the best clinical approach for selecting patients who would derive real benefit from ALND, as well as to minimize the functional and psychological damage caused by delayed surgery, and the risk of undertreating EBC patients...
August 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Javier Del Riego, María Jesús Diaz-Ruiz, Milagros Teixidó, Judit Ribé, Mariona Vilagran, Lydia Canales, Melcior Sentís
PURPOSE: (a) To compare the axillary tumor burden detected by fine-needle aspiration cytology (FNAC) versus sentinel lymph node biopsy (SLNB). (b) To evaluate the relationship between axillary tumor burden and the number of suspicious lymph nodes detected by axillary ultrasonography (US). (c) To calculate the false-positive and false-negative rates for FNAC in patients fulfilling ACOSOG Z0011 criteria. METHODS: Retrospective multicenter cross-sectional study of 355 pT1 breast cancers...
January 2018: European Journal of Radiology
Roland G Stein, Roland Fricker, Thomas Rink, Hartmut Fitz, Sebastian Blasius, Joachim Diessner, Sebastian F M Häusler, Tanja N Stüber, Victoria Andreas, Achim Wöckel, Thomas Müller
Background: Most breast cancer patients require lumpectomy with axillary sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). The ACOSOG Z0011-trial failed to detect significant effects of ALND on disease-free and overall survival among patients with limited sentinel lymph node (SLN) metastases. Intense dose-dense chemotherapy and supraclavicular fossa radiation (SFR) are indicated for patients with extensive axillary metastases. In this multicentered study, we investigated the relevance of ALND after positive SLNB to determine adequate adjuvant therapy...
October 2017: Breast Care
Nisha Sharma, Karina Cox
Purpose of Review: Axillary staging in the context of breast cancer is a contentious topic due to the varied practices across UK, Europe, and America. The ACOSOG Z0011 trial has questioned the role of axillary ultrasound in women with breast cancer. Published data has shown that women with ultrasound-positive lymph nodes have a worse prognosis than those with ultrasound-negative lymph nodes. Axillary ultrasound is limited as the sentinel lymph node (SLN) cannot be identified using B-mode ultrasound; however, with the advent of contrast-enhanced ultrasound (CEUS), this has now changed...
2017: Current Breast Cancer Reports
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