Is the presence of small volume disease in the sentinel node an indication for axillary clearance?
Identifieur interne : 003530 ( Main/Exploration ); précédent : 003529; suivant : 003531Is the presence of small volume disease in the sentinel node an indication for axillary clearance?
Auteurs : Darren K. Patten [Royaume-Uni] ; Daniel R. Leff ; Zubair Wani ; Susan J. Cleator ; Carlo Palmieri ; R Charles Coombes ; Dimitri J. HadjiminasSource :
- Breast (Edinburgh, Scotland) [ 1532-3080 ] ; 2013.
Descripteurs français
- KwdFr :
- Aisselle, Biopsie de noeud lymphatique sentinelle, Complications postopératoires (), Femelle, Humains, Lymphadénectomie, Lymphoedème (), Lymphoedème (étiologie), Micrométastase tumorale, Métastase lymphatique, Pronostic, Tumeurs du sein (), Tumeurs du sein (anatomopathologie), Tumeurs du sein (mortalité).
- MESH :
- anatomopathologie : Tumeurs du sein.
- mortalité : Tumeurs du sein.
- étiologie : Lymphoedème.
- Aisselle, Biopsie de noeud lymphatique sentinelle, Complications postopératoires, Femelle, Humains, Lymphadénectomie, Lymphoedème, Micrométastase tumorale, Métastase lymphatique, Pronostic, Tumeurs du sein.
English descriptors
- KwdEn :
- Axilla, Breast Neoplasms (mortality), Breast Neoplasms (pathology), Breast Neoplasms (surgery), Female, Humans, Lymph Node Excision, Lymphatic Metastasis, Lymphedema (etiology), Lymphedema (prevention & control), Neoplasm Micrometastasis, Postoperative Complications (prevention & control), Prognosis, Sentinel Lymph Node Biopsy.
- MESH :
- etiology : Lymphedema.
- mortality : Breast Neoplasms.
- pathology : Breast Neoplasms.
- prevention & control : Lymphedema, Postoperative Complications.
- surgery : Breast Neoplasms.
- Axilla, Female, Humans, Lymph Node Excision, Lymphatic Metastasis, Neoplasm Micrometastasis, Prognosis, Sentinel Lymph Node Biopsy.
Abstract
The finding of micrometastases (M(i)) and isolated tumour cells (ITC) within the axillary lymph nodes of patients with breast cancer has raised the question whether either/both have some prognostic significance. Several studies have shown that compared to node-negative patients, prognosis is significantly poorer in patients with M(i) and ITC. The fact that patients with M(i)/ITC in their sentinel lymph nodes have a systemic relapse risk that is higher than that of node-negative patients may be considered as an indication for systemic treatment. Most studies in the literature suggest that in patients with M(i) or ITC in their sentinel nodes who receive systemic therapy and whole breast radiotherapy, the risk of axillary relapse without axillary lymphadenectomy is under 2%. Given the fact that axillary lymphadenectomy is associated with a 5-25% risk of lymphoedema, we propose that a policy of close follow up should be adopted in these patients rather than axillary lymphadenectomy.
DOI: 10.1016/j.breast.2012.05.006
PubMed: 22721758
Affiliations:
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Patten</name><affiliation wicri:level="3"><nlm:affiliation>Department of Biosurgery and Surgical Oncology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK. darren.patten@gmail.com</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Biosurgery and Surgical Oncology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Leff, Daniel R" sort="Leff, Daniel R" uniqKey="Leff D" first="Daniel R" last="Leff">Daniel R. Leff</name></author><author><name sortKey="Wani, Zubair" sort="Wani, Zubair" uniqKey="Wani Z" first="Zubair" last="Wani">Zubair Wani</name></author><author><name sortKey="Cleator, Susan J" sort="Cleator, Susan J" uniqKey="Cleator S" first="Susan J" last="Cleator">Susan J. Cleator</name></author><author><name sortKey="Palmieri, Carlo" sort="Palmieri, Carlo" uniqKey="Palmieri C" first="Carlo" last="Palmieri">Carlo Palmieri</name></author><author><name sortKey="Coombes, R Charles" sort="Coombes, R Charles" uniqKey="Coombes R" first="R Charles" last="Coombes">R Charles Coombes</name></author><author><name sortKey="Hadjiminas, Dimitri J" sort="Hadjiminas, Dimitri J" uniqKey="Hadjiminas D" first="Dimitri J" last="Hadjiminas">Dimitri J. Hadjiminas</name></author></analytic><series><title level="j">Breast (Edinburgh, Scotland)</title><idno type="eISSN">1532-3080</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Axilla</term><term>Breast Neoplasms (mortality)</term><term>Breast Neoplasms (pathology)</term><term>Breast Neoplasms (surgery)</term><term>Female</term><term>Humans</term><term>Lymph Node Excision</term><term>Lymphatic Metastasis</term><term>Lymphedema (etiology)</term><term>Lymphedema (prevention & control)</term><term>Neoplasm Micrometastasis</term><term>Postoperative Complications (prevention & control)</term><term>Prognosis</term><term>Sentinel Lymph Node Biopsy</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Aisselle</term><term>Biopsie de noeud lymphatique sentinelle</term><term>Complications postopératoires ()</term><term>Femelle</term><term>Humains</term><term>Lymphadénectomie</term><term>Lymphoedème ()</term><term>Lymphoedème (étiologie)</term><term>Micrométastase tumorale</term><term>Métastase lymphatique</term><term>Pronostic</term><term>Tumeurs du sein ()</term><term>Tumeurs du sein (anatomopathologie)</term><term>Tumeurs du sein (mortalité)</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Lymphedema</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Axilla</term><term>Female</term><term>Humans</term><term>Lymph Node Excision</term><term>Lymphatic Metastasis</term><term>Neoplasm Micrometastasis</term><term>Prognosis</term><term>Sentinel Lymph Node Biopsy</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Aisselle</term><term>Biopsie de noeud lymphatique sentinelle</term><term>Complications postopératoires</term><term>Femelle</term><term>Humains</term><term>Lymphadénectomie</term><term>Lymphoedème</term><term>Micrométastase tumorale</term><term>Métastase lymphatique</term><term>Pronostic</term><term>Tumeurs du sein</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The finding of micrometastases (M(i)) and isolated tumour cells (ITC) within the axillary lymph nodes of patients with breast cancer has raised the question whether either/both have some prognostic significance. Several studies have shown that compared to node-negative patients, prognosis is significantly poorer in patients with M(i) and ITC. The fact that patients with M(i)/ITC in their sentinel lymph nodes have a systemic relapse risk that is higher than that of node-negative patients may be considered as an indication for systemic treatment. Most studies in the literature suggest that in patients with M(i) or ITC in their sentinel nodes who receive systemic therapy and whole breast radiotherapy, the risk of axillary relapse without axillary lymphadenectomy is under 2%. Given the fact that axillary lymphadenectomy is associated with a 5-25% risk of lymphoedema, we propose that a policy of close follow up should be adopted in these patients rather than axillary lymphadenectomy.</div></front></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><noCountry><name sortKey="Cleator, Susan J" sort="Cleator, Susan J" uniqKey="Cleator S" first="Susan J" last="Cleator">Susan J. Cleator</name><name sortKey="Coombes, R Charles" sort="Coombes, R Charles" uniqKey="Coombes R" first="R Charles" last="Coombes">R Charles Coombes</name><name sortKey="Hadjiminas, Dimitri J" sort="Hadjiminas, Dimitri J" uniqKey="Hadjiminas D" first="Dimitri J" last="Hadjiminas">Dimitri J. Hadjiminas</name><name sortKey="Leff, Daniel R" sort="Leff, Daniel R" uniqKey="Leff D" first="Daniel R" last="Leff">Daniel R. Leff</name><name sortKey="Palmieri, Carlo" sort="Palmieri, Carlo" uniqKey="Palmieri C" first="Carlo" last="Palmieri">Carlo Palmieri</name><name sortKey="Wani, Zubair" sort="Wani, Zubair" uniqKey="Wani Z" first="Zubair" last="Wani">Zubair Wani</name></noCountry><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Patten, Darren K" sort="Patten, Darren K" uniqKey="Patten D" first="Darren K" last="Patten">Darren K. Patten</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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