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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
#1
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
#2
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...
September 6, 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
#3
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
#4
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
#5
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...
July 31, 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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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...
February 27, 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
#14
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 (ACOSOG) 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 1917 patients with clinical T1-T2 and node negative invasive breast cancer...
January 25, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28139361/is-intraoperative-touch-imprint-cytology-indicated-in-the-surgical-treatment-of-early-breast-cancers
#15
Z Horváth, A Paszt, Z Simonka, M Látos, V Oláh, D Nagyszegi, L Kaizer, Z Fejes, S Hamar, E Csörgő, K Ormándi, M Lázár, G Lázár
INTRODUCTION: Intraoperative touch imprint cytology (TIC) of the sentinel lymph node(s) (SLN(s)) in the treatment of breast cancer has significantly reduced the number of axillary block dissections (ABD) required during second surgeries. Based on recent studies, ABD was not considered necessary if the presence of tumor cells/micrometastasis was confirmed in the SLN(s) or in the case of macrometastases in a patient group meeting the inclusion criteria for the ACOSOG Z0011 study. Our aim was to determine the sensitivity and usefulness of TIC with regard to these results...
July 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27900818/healthcare-costs-reduced-after-incorporating-the-results-of-the-american-college-of-surgeons-oncology-group-z0011-trial-into-clinical-practice
#16
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
https://www.readbyqxmd.com/read/27697620/preoperative-ultrasound-staging-of-the-axilla-make-s-peroperative-examination-of-the-sentinel-node-redundant-in-breast-cancer-saving-tissue-time-and-money
#17
Christophe Van Berckelaer, Manon Huizing, Mireille Van Goethem, Andrew Vervaecke, Konstantinos Papadimitriou, Inge Verslegers, Bich X Trinh, Peter Van Dam, Sevilay Altintas, Tim Van den Wyngaert, Ivan Huyghe, Vasiliki Siozopoulou, Wiebren A A Tjalma
OBJECTIVE: To evaluate the role of preoperative axillary staging with ultrasound (US) and fine needle aspiration cytology (FNAC). Can we avoid intraoperative sentinel lymph node (SLN) examination, with an acceptable revision rate by preoperative staging? DESIGN: This study is based on the retrospective data of 336 patients that underwent US evaluation of the axilla as part of their staging. A FNAC biopsy was performed when abnormal lymph nodes were visualized. Patients with normal appearing nodes on US or a benign diagnostic biopsy had removal of the SLNs without intraoperative pathological examination...
November 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27696171/extending-acosog-z0011-to-encompass-mastectomy-what-happens-without-rt
#18
EDITORIAL
Hiram S Cody
No abstract text is available yet for this article.
September 30, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27674369/national-practice-patterns-of-axillary-management-and-adjuvant-radiation-after-acosog-z0011
#19
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
https://www.readbyqxmd.com/read/27557827/axillary-ultrasound-for-all-for-none-to-diagnose-positive-nodes-or-to-support-avoiding-sentinel-lymph-node-biopsy-altogether
#20
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
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