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https://www.readbyqxmd.com/read/29234253/evaluation-of-sentinel-lymph-node-biopsy-and-axillary-lymph-node-dissection-for-breast-cancer-treatment-concepts-a-retrospective-study-of-1-214-breast-cancer-patients
#1
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
https://www.readbyqxmd.com/read/29201278/axillary-nodal-staging-with-contrast-enhanced-ultrasound
#2
REVIEW
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
https://www.readbyqxmd.com/read/29129549/application-of-acosog-z1071-effect-of-results-on-patient-care-and-surgical-decision-making
#3
Jacquelyn A V Palmer, Teresa Flippo-Morton, Kendall K Walsh, Lejla Hadzikadic Gusic, Terry Sarantou, Myra M Robinson, Richard L White
BACKGROUND: The ACOSOG (American College of Surgeons Oncology Group) Z1071 assessed the feasibility of performing sentinel lymph node biopsy (SLNB) in node-positive patients who completed neoadjuvant chemotherapy (NACT). Historically, adoption of clinical research into practice takes years. The goal of this study was to determine the effect of Z1071 on our practice. MATERIALS AND METHODS: This is a retrospective review of Z1071's influence on a single institution's practice...
October 12, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/29100726/expanding-implementation-of-acosog-z0011-in-surgeon-practice
#4
Anna Weiss, Elizabeth A Mittendorf, Sarah M DeSnyder, Rosa F Hwang, Vivian Bea, Isabelle Bedrosian, Karen Hoffman, Beatriz Adrade, Aysegul A Sahin, Henry M Kuerer, Kelly K Hunt, Abigail S Caudle
BACKGROUND: After publication of American College of Surgeons Oncology Group (ACOSOG) Z0011, surgeons at our institution limited axillary surgery to sentinel lymph node dissection (SLND) in 76% of patients meeting trial eligibility criteria. Our study objective was to assess incorporation of the trial data into practice 5 years later. PATIENTS AND METHODS: Patients with clinical T1-2, N0 invasive breast cancer undergoing breast conserving surgery were included. Comparisons were made between patients who underwent axillary lymph node dissection (ALND) and those that had no further surgery...
October 13, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/29033068/axillary-treatment-in-breast-cancer-surgery-systematic-review-of-its-impact-on-survival
#5
Alejandra García Novoa, Benigno Acea Nebril
Sentinel lymph node biopsy and ACOSOG-Z0011 criteria have modified axillary treatment in breast cancer surgery. We performed a systematic review of studies assessing the impact of axillary treatment on survival. The search showed 6891 potentially eligible items. Of them, 23 clinical trials and 12 meta-analyses published between 1980 and 2017 met the study criteria. The review revealed that axillary lymph node dissection (ALND) can be omitted in patients pN0 and pN1mic, without compromising survival. In patients pN1 it is proposed not to treat the axilla or replace ALND for axillary radiotherapy...
October 12, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29031423/the-state-of-surgical-axillary-management-and-adjuvant-radiotherapy-for-early-stage-invasive-breast-cancer-in-the-modern-era
#6
Justin M Mann, Xian Wu, Paul Christos, Himanshu Nagar
BACKGROUND: For clinical T1-2N0 breast cancer, sentinel lymph node biopsy (SLNB) has been shown in American College of Surgeons Oncology Group (ACOSOG) Z0011 to be sufficient for women with 1 to 2 positive sentinel lymph nodes with no added benefit for completion axillary lymph node dissection (ALND). Z0011 specified whole breast radiotherapy (RT) using standard tangential fields; however, later analysis showed variation in field design. We assessed nationwide practice patterns and examined factors associated with patients undergoing completion ALND and subsequent radiation field design...
September 19, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28970853/development-of-a-nomogram-to-predict-n2-or-n3-stage-in-t1-2-invasive-breast-cancer-patients-with-no-palpable-lymphadenopathy
#7
Isaac Kim, Jai Min Ryu, Jai Myeong Kim, Hee Jun Choi, Se Kyung Lee, Jong Hwan Yu, Jeong Eon Lee, Seok Won Kim, Seok Jin Nam
PURPOSE: Subsequent to the American College of Surgeons Oncology Group (ACOSOG) Z0011 and After Mapping of the Axilla: Radiotherapy or Surgery (AMAROS) trials, complete axillary lymph node dissection is not routinely performed, even in cases where metastatic sentinel lymph nodes are detected. We investigated the percentage of N2 or N3 stages in T1-2 invasive breast cancer patients with no lymphadenopathy and developed a nomogram to predict the possibility of N2 or N3 stages in these patients...
September 2017: Journal of Breast Cancer
https://www.readbyqxmd.com/read/28898379/effect-of-axillary-dissection-vs-no-axillary-dissection-on-10-year-overall-survival-among-women-with-invasive-breast-cancer-and-sentinel-node-metastasis-the-acosog-z0011-alliance-randomized-clinical-trial
#8
RANDOMIZED CONTROLLED TRIAL
Armando E Giuliano, Karla V Ballman, Linda McCall, Peter D Beitsch, Meghan B Brennan, Pond R Kelemen, David W Ollila, Nora M Hansen, Pat W Whitworth, Peter W Blumencranz, A Marilyn Leitch, Sukamal Saha, Kelly K Hunt, Monica Morrow
Importance: The results of the American College of Surgeons Oncology Group Z0011 (ACOSOG Z0011) trial were first reported in 2005 with a median follow-up of 6.3 years. Longer follow-up was necessary because the majority of the patients had estrogen receptor-positive tumors that may recur later in the disease course (the ACOSOG is now part of the Alliance for Clinical Trials in Oncology). Objective: To determine whether the 10-year overall survival of patients with sentinel lymph node metastases treated with breast-conserving therapy and sentinel lymph node dissection (SLND) alone without axillary lymph node dissection (ALND) is noninferior to that of women treated with axillary dissection...
September 12, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28879416/patient-age-and-tumor-subtype-predict-the-extent-of-axillary-surgery-among-breast-cancer-patients-eligible-for-the-american-college-of-surgeons-oncology-group-trial-z0011
#9
Cecilia T Ong, Samantha M Thomas, Rachel C Blitzblau, Oluwadamilola M Fayanju, Tristen S Park, Jennifer K Plichta, Laura H Rosenberger, Terry Hyslop, E Shelley Hwang, Rachel A Greenup
BACKGROUND: The American College of Surgeons Oncology Group (ACOSOG) Z0011 trial established the safety of omitting axillary lymph node dissection (ALND) for early-stage breast cancer patients with limited nodal disease undergoing lumpectomy. We examined the extent of axillary surgery among women eligible for Z0011 based on patient age and tumor subtype. METHODS: Patients with cT1-2, cN0 breast cancers and one or two positive nodes diagnosed from 2009 to 2014 and treated with lumpectomy were identified in the National Cancer Data Base...
November 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28843225/managing-the-axilla-in-early-breast-cancer-impact-of-acosog-z0011-trial-in-changing-practices-in-a-low-middle-income-country
#10
Awais Amjad Malik, Namra Urooj, Romaisa Shamim, Mariam Salim, Razia Bano, Zulqurnain Chaudhry, Huma Majeed Khan, Amina Iqbal Khan
Objective: To determine the impact of the trial on surgeon practice patterns at our institution. Methodology: A comparison of patients undergoing surgery for early breast cancer before and after the implementation of the new guidelines was done. We adopted the new guidelines in April 2015. Patients meeting Z0011 inclusion criteria were identified. For group A (Pre Z0011) patients operated between Jan to Dec 2013 were studied. And for Group B (Post Z0011) patients operated between July 2014 to Jun 2015 were included...
August 27, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28766210/positive-ultrasound-guided-lymph-node-needle-biopsy-in-breast-cancer-may-not-mandate-axillary-lymph-node-dissection
#11
Christine K Harris, Hanh Tam Tran, Katherine Lee, Charles Mylander, Daina Pack, Martin Rosman, Lorraine Tafra, Christopher B Umbricht, Reema Andrade, Wen Liang, Rubie Sue Jackson
BACKGROUND: The ACOSOG Z0011 (Z11) trial demonstrated that in patients with nonpalpable axillary lymph nodes (LN) and one to two positive sentinel LN (SLN), axillary LN dissection (ALND) is unnecessary.JAMA 305:569-575, [2011], Ann Surg 264:413-42, [2016] The Z11 trial did not require preoperative axillary ultrasound (axUS). In many centers, preoperative axUS is part of the standard workup of a newly diagnosed breast cancer patient, but in light of the Z11 results, its role is now questioned...
October 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28752233/upper-limb-lymphedema-in-breast-cancer-patients-in-the-era-of-z0011-sentinel-lymph-node-biopsy-and-breast-conservation
#12
N R Bhatt, M R Boland, R McGovern, A Lal, S Tormey, A J Lowery, B A Merrigan
INTRODUCTION: Surgical techniques in breast cancer (BCa) have seen a dramatic change recently with breast-conserving surgery (BCS) and sentinel lymph node biopsy (SLNB). The ACOSOG-Z0011 trial reported equivalence in outcomes for certain patients with SLN metastases treated with axillary lymph node dissection (ALND) or SLNB alone. Our aim was to investigate changes in lymphedema referral patterns in BCa patients over the last 3 years in a specialist unit and to elucidate effects of SLNB, BCS, and Z0011 trial publication on such patterns...
July 27, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28742702/trends-on-axillary-surgery-in-nondistant-metastatic-breast-cancer-patients-treated-between-2011-and-2015-a-dutch-population-based-study-in-the-acosog-z0011-and-amaros-era
#13
Ingrid G M Poodt, Pauline E R Spronk, Guusje Vugts, Thijs van Dalen, M T F D Vrancken Peeters, Marjolijn L Rots, Anne Kuijer, Grard A P Nieuwenhuijzen, Robert-Jan Schipper
OBJECTIVES: To evaluate patterns of care in axillary surgery for Dutch clinical T1-4N0M0 (cT1-4N0M0) breast cancer patients and to assess the effect of the American College for Surgeons Oncology Group (ACOSOG)-Z0011 and After Mapping of the Axilla: Radiotherapy Or Surgery (AMAROS) trial on axillary surgery patterns in Dutch cT1-2N0M0 sentinel node positive breast cancer patients. BACKGROUND: Since publication of the ACOSOG-Z0011 and AMAROS trial, omitting a completion axillary lymph node dissection (cALND) in sentinel node positive breast cancer patients is proposed in selected patients...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28704697/the-use-of-ultrasound-in-the-clinical-re-staging-of-the-axilla-after-neoadjuvant-chemotherapy-nact
#14
Anastasia Peppe, Robin Wilson, Romney Pope, Kate Downey, Jennifer Rusby
INTRODUCTION: Ultrasound (US) is the imaging modality of choice for staging the axilla prior to surgery in patients with breast cancer (BC). High pathological complete response rates in the axilla after NACT mean a more conservative approach to surgery can be considered. Radiological re-staging is important in this decision making. After the presentation of results from ACOSOG Z1071 in December 2012, formal ultrasound re-assessment of the axilla after primary therapy was specifically requested in our institution...
October 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28657941/tumor-biology-and-response-to-chemotherapy-impact-breast-cancer-specific-survival-in-node-positive-breast-cancer-patients-treated-with-neoadjuvant-chemotherapy-long-term-follow-up-from-acosog-z1071-alliance
#15
Judy C Boughey, Karla V Ballman, Linda M McCall, Elizabeth A Mittendorf, William Fraser Symmans, Thomas B Julian, David Byrd, Kelly K Hunt
BACKGROUND: Women with node-positive breast cancer are at high risk for recurrence. We evaluate the impact of approximated tumor subtype and response to chemotherapy on long-term outcomes in a node-positive cohort receiving neoadjuvant chemotherapy. METHODS: ACOSOG Z1071 enrolled cT0-4N1-2 breast cancer patients treated with neoadjuvant chemotherapy from 2009 to 2011. Factors impacting breast cancer-specific survival (BCSS) and overall survival (OS) were analyzed...
October 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28656490/different-outcome-in-node-positive-breast-cancer-patients-found-by-axillary-ultrasound-or-sentinel-node-procedure
#16
Nicole C Verheuvel, Adri C Voogd, Vivianne C G Tjan-Heijnen, S Siesling, Rudi M H Roumen
BACKGROUND: The Z0011 trial initiated a paradigm shift in the axillary treatment of breast cancer patients with a positive sentinel lymph node biopsy (SLNB), disregarding patients with a positive ultrasound-guided lymph node biopsy (UGLNB). We examined whether relevant differences exist between these patients to determine if the conclusions of the ACOSOG Z0011 trial are applicable to UGLNB-positive patients. METHODS: Patients diagnosed with invasive breast cancer in the Netherlands between January 2008 and December 2014 were selected from the Netherlands Cancer Registry...
June 27, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28650355/axillary-dissection-and-nodal-irradiation-can-be-avoided-for-most-node-positive-z0011-eligible-breast-cancers-a-prospective-validation-study-of-793-patients
#17
Monica Morrow, Kimberly J Van Zee, Sujata Patil, Oriana Petruolo, Anita Mamtani, Andrea V Barrio, Deborah Capko, Mahmoud El-Tamer, Mary L Gemignani, Alexandra S Heerdt, Laurie Kirstein, Melissa Pilewskie, George Plitas, Virgilio S Sacchini, Lisa M Sclafani, Alice Ho, Hiram S Cody
OBJECTIVE: To determine rates of axillary dissection (ALND) and nodal recurrence in patients eligible for ACOSOG Z0011. BACKGROUND: Z0011 demonstrated that patients with cT1-2N0 breast cancers and 1 to 2 involved sentinel lymph nodes (SLNs) having breast-conserving therapy had no difference in locoregional recurrence or survival after SLN biopsy alone or ALND. The generalizability of the results and importance of nodal radiotherapy (RT) is unclear. METHODS: Patients eligible for Z0011 had SLN biopsy alone...
September 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28612227/development-of-a-ki-67-based-clinical-trial-assay-for-neoadjuvant-endocrine-therapy-response-monitoring-in-breast-cancer
#18
Rodrigo Goncalves, Katherine DeSchryver, Cynthia Ma, Yu Tao, Jeremy Hoog, Maggie Cheang, Erika Crouch, Neha Dahiya, Souzan Sanati, Michael Barnes, Luis Otávio Zanatta Sarian, John Olson, Donald Craig Allred, Matthew J Ellis
PURPOSE: The recent publication of the ACOSOG Z1031 trial results demonstrated that Ki-67 proliferation marker-based neoadjuvant endocrine therapy response monitoring could be used for tailoring the use of adjuvant chemotherapy in ER+HER2-negative breast cancer patients. In this paper, we describe the development of the Ki-67 clinical trial assay used for this study. METHODS: Ki-67 assay assessment focused on reproducing a 2.7% Ki-67 cut-point (CP) required for calculating the Preoperative Endocrine Prognostic Index and a 10% CP for poor endocrine therapy response identification within the first month of neoadjuvant endocrine treatment...
September 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28453704/genomic-characterization-of-her2-positive-breast-cancer-and-response-to-neoadjuvant-trastuzumab-and-chemotherapy-results-from-the-acosog-z1041-alliance-trial
#19
R Lesurf, O L Griffith, M Griffith, J Hundal, L Trani, M A Watson, R Aft, M J Ellis, D Ota, V J Suman, F Meric-Bernstam, A M Leitch, J C Boughey, G Unzeitig, A U Buzdar, K K Hunt, E R Mardis
Background: HER2 (ERBB2) gene amplification and its corresponding overexpression are present in 15-30% of invasive breast cancers. While HER2-targeted agents are effective treatments, resistance remains a major cause of death. The American College of Surgeons Oncology Group Z1041 trial (NCT00513292) was designed to compare the pathologic complete response (pCR) rate of distinct regimens of neoadjuvant chemotherapy and trastuzumab, but ultimately identified no difference. Patients and methods: In supplement to tissues from 37 Z1041 cases, 11 similarly treated cases were obtained from a single institution study (NCT00353483)...
May 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28338482/axillary-ultrasound-fine-needle-aspiration-biopsy-is-there-a-role-in-the-post-z-0011-era
#20
Sarah E Pesek, Heather M King, Susan Koelliker, Christina Raker, David Edmonson, Don S Dizon, Jennifer Gass
OBJECTIVES: Axillary ultrasound with fine needle aspiration (AXUSFNA) in early-stage breast cancer has required reappraisal. ACOSOG Z-0011 and after mapping of the axilla: radiotherapy or surgery have shown that women with limited nodal disease at sentinel lymph node biopsy got no survival advantage with completion axillary node dissection. We hypothesize that AXUSFNA may be sufficiently accurate for staging for some patients and sentinel lymph node biopsy need not be performed. We define the false negative rate (FNR) of AXUSFNA in different subsets of patients...
March 23, 2017: American Journal of Clinical Oncology
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