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https://www.readbyqxmd.com/read/29142748/intraoperative-prediction-of-the-two-axillary-lymph-node-macrometastases-threshold-in-patients-with-breast-cancer-using-a-one-step-nucleic-acid-cytokeratin-19-amplification-assay
#1
Victoria Fung, Stan Kohlhardt, Patricia Vergani, Gregory J Zardin, Norman R Williams
The aim of the present study was to assess the sensitivity, specificity and practicality of using a one-step nucleic acid amplification (OSNA) assay during breast cancer staging surgery to predict and discriminate between at least 2 involved nodes and more than 2 involved nodes and facilitate the decision to provide axillary conservation in the presence of a low total axillary node tumour burden. A total of 700 consecutive patients, not treated with neo-adjuvant chemotherapy, received intraoperative sentinel lymph node (SLN) analysis using OSNA for cT1-T3 cN0 invasive breast cancer...
November 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29100726/expanding-implementation-of-acosog-z0011-in-surgeon-practice
#2
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/29094254/comparison-of-ck-ihc-assay-on-serial-frozen-sections-the-osna-assay-and-in-combination-for-intraoperative-evaluation-of-sln-metastases-in-breast-cancer
#3
Hideo Shigematsu, Shinji Ozaki, Daisuke Yasui, Junichi Zaitsu, Daiki Taniyama, Akihisa Saitou, Kazuya Kuraoka, Hiroyasu Yamashiro, Kiyomi Taniyama
BACKGROUND: Intraoperative evaluations of sentinel lymph node (SLN) metastases are performed for providing appropriate and immediate axillary treatments in breast cancer patients who do not meet Z0011 criteria; however, standard intraoperative procedure has not yet been established. METHODS: We consecutively performed intraoperative evaluation for SLN metastases using both a cytokeratin immunohistochemistry (CK-IHC) assay on serial frozen sections and a one-step nucleic acid amplification (OSNA) assay of the remaining whole node in patients with invasive breast cancer...
November 1, 2017: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://www.readbyqxmd.com/read/29033068/axillary-treatment-in-breast-cancer-surgery-systematic-review-of-its-impact-on-survival
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28762114/the-optimal-treatment-plan-to-avoid-axillary-lymph-node-dissection-in-early-stage-breast-cancer-patients-differs-by-surgical-strategy-and-tumor-subtype
#11
Melissa Pilewskie, Emily C Zabor, Anita Mamtani, Andrea V Barrio, Michelle Stempel, Monica Morrow
BACKGROUND: Strategies to reduce the likelihood of axillary lymph node dissection (ALND) include application of Z0011 or use of neoadjuvant chemotherapy (NAC). Indications for ALND differ by treatment plan, and nodal pathologic complete response rates after NAC vary by tumor subtype. This study compared ALND rates for cT1-2N0 tumors treated with upfront surgery versus those treated with NAC. METHODS: The ALND rates for cT1-2N0 breast cancer patients were compared by tumor subtype among women undergoing upfront surgery to NAC...
November 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/28721184/axillary-lymph-node-dissection-on-the-run
#14
N Maeseele, J Faes, T Van de Putte, J Vlasselaer, E de Jonge, J C Schobbens, K Deraedt, G Debrock, G Van de Putte
The standard approach of performing a completion axillary lymph node dissection (cALND) after a positive sentinel node for breast cancer patients is no longer generally accepted. This study applied the criterion of a 27% risk of having residual positive lymph nodes calculated by the MD Anderson nomogram to perform a cALND. This 27% cut-off is based on the number of positive non-sentinels in the Z0011 trial. A cohort of 166 cN0, sentinel positive breast cancer patients was used to validate the MD Anderson nomogram...
March 2017: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/28656490/different-outcome-in-node-positive-breast-cancer-patients-found-by-axillary-ultrasound-or-sentinel-node-procedure
#15
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
#16
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/28295828/are-the-acosog-z0011-trial-findings-being-applied-to-breast-cancer-patients-undergoing-neoadjuvant-chemotherapy
#17
Olga Kantor, Catherine Pesce, Erik Liederbach, Chi-Hsiung Wang, David J Winchester, Katharine Yao
In 2010, the ACOSOG Z0011 trial showed equivalent survival and recurrence between sentinel lymph node biopsy (SLNB) alone versus axillary lymph node dissection (ALND) for those with a tumor positive sentinel node (SN). We examined national trends in axillary surgery following neoadjuvant chemotherapy (NAC) for clinically node positive disease in the years prior to and after the Z0011 trial publication. 12,063 women with cT1-4N1M0 invasive breast cancer who underwent NAC from 2006 to 2013 and had 1-3 positive nodes on pathology were selected from the National Cancer Data Base...
September 2017: Breast Journal
https://www.readbyqxmd.com/read/28258414/what-to-do-with-non-visualized-sentinel-nodes-a-dutch-nationwide-survey-study
#18
Nicole C Verheuvel, Adri C Voogd, Vivianne C G Tjan-Heijnen, Rudi M H Roumen
INTRODUCTION: International guidelines differ regarding their recommendations on axillary treatment of patients with non-visualized sentinel lymph nodes (non-vSLN). Therefore, we distributed a survey among Dutch oncological surgeons to determine their routine practice and opinion regarding axillary treatment in case of a non-vSLN, with the emphasis on whether these practices and opinions have changed since publication of the Z0011 trial. METHODS: A Dutch nationwide survey containing 10 questions regarding clinical routine during the sentinel node procedure and axillary treatment of non-vSLN patients was distributed among 510 oncological surgeons...
August 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28254641/role-of-total-tumour-load-of-sentinel-lymph-node-on-survival-in-early-breast-cancer-patients
#19
Vicente Peg, Irene Sansano, Begoña Vieites, Laia Bernet, Rafael Cano, Alicia Córdoba, Magdalena Sancho, María Dolores Martín, Felip Vilardell, Alicia Cazorla, Martín Espinosa-Bravo, José Manuel Pérez-García, Javier Cortés, Isabel T Rubio, Santiago Ramón Y Cajal
BACKGROUND: Axillary staging (pN) is considered one of the most important prognostic factors in breast cancer patients. However, the Z0011 study data drastically reduced the number of surgical axillary dissections in a selected group of patients, limiting the prognostic information relating to axillary involvement to the sentinel lymph node (SLN). It is known that there is a relationship between SLN total tumour load (TTL) and axillary involvement. The objective of this study is to analyse the relationship between the TTL and outcomes in patients with early stage breast cancer...
June 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28161935/can-we-skip-intraoperative-evaluation-of-sentinel-lymph-nodes-nomogram-predicting-involvement-of-three-or-more-axillary-lymph-nodes-before-breast-cancer-surgery
#20
Soo Kyung Ahn, Min Kyoon Kim, Jongjin Kim, Eunshin Lee, Tae-Kyung Yoo, Han-Byoel Lee, Young Joon Kang, Jisun Kim, Hyeong-Gon Moon, Jung Min Chang, Nariya Cho, Woo Kyung Moon, In Ae Park, Dong-Young Noh, Wonshik Han
PURPOSE: The American College of Surgeons Oncology Group Z0011 trial reported that complete dissection of axillary lymph nodes (ALNs) may not be warranted in women with clinical T1-T2 tumors and one or two involved ALNs who were undergoing lumpectomy plus radiation followed by systemic therapy. The present study was conducted to identify preoperative imaging predictors of ≥ 3 ALNs. MATERIALS AND METHODS: The training set consisted of 1,917 patients with clinical T1-T2 and node negative invasive breast cancer...
October 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
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