Can Axillary Node Dissection Be Omitted in a Subset of Patients with Low Local and Regional Failure Rates?
Identifieur interne : 004829 ( Main/Exploration ); précédent : 004828; suivant : 004830Can Axillary Node Dissection Be Omitted in a Subset of Patients with Low Local and Regional Failure Rates?
Auteurs : Christina Barkley ; Harold Burstein ; Barbara Smith ; Jennifer Bellon ; Julia Wong ; Michele Gadd ; Alphonse Taghian [États-Unis] ; Eric Winer ; James Dirk Iglehart ; Jay Harris ; Mehra GolshanSource :
- The Breast Journal [ 1075-122X ] ; 2012-01.
Abstract
Abstract: Axillary node dissection (ALND) is the standard of care for patients who have a positive sentinel lymph node (SLN) on sentinel lymph node biopsy (SLNB). We sought to identify a low‐risk patient population with positive SLN that may not need cALND. We analyzed SLNB for breast cancer at our institutions between 1999 and 2007. We identified 130 patients who had a positive SLN but did not undergo completion ALND. We evaluated clinical data, adjuvant treatment patterns and intermediate locoregional and distant events. The median patient age was 50; 19% had N0(i+) disease, 53% had micrometastatic (N1mi) disease, and 28% had macrometastasis. Eighty‐eight percent of patients underwent radiation therapy; 66 patients (51%) had documented nodal radiation (of these 50 were treated with three fields and 14 with high tangents. Local recurrence in the breast occurred in two patients (2%) and nine patients (7%) developed distant metastases; there were no axillary/nodal recurrences. In this highly selected group of patients who had a positive SLNB but did not undergo cALND, we observed no axillary recurrences.
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DOI: 10.1111/j.1524-4741.2011.01178.x
Affiliations:
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We sought to identify a low‐risk patient population with positive SLN that may not need cALND. We analyzed SLNB for breast cancer at our institutions between 1999 and 2007. We identified 130 patients who had a positive SLN but did not undergo completion ALND. We evaluated clinical data, adjuvant treatment patterns and intermediate locoregional and distant events. The median patient age was 50; 19% had N0(i+) disease, 53% had micrometastatic (N1mi) disease, and 28% had macrometastasis. Eighty‐eight percent of patients underwent radiation therapy; 66 patients (51%) had documented nodal radiation (of these 50 were treated with three fields and 14 with high tangents. Local recurrence in the breast occurred in two patients (2%) and nine patients (7%) developed distant metastases; there were no axillary/nodal recurrences. In this highly selected group of patients who had a positive SLNB but did not undergo cALND, we observed no axillary recurrences.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Massachusetts</li></region></list><tree><noCountry><name sortKey="Barkley, Christina" sort="Barkley, Christina" uniqKey="Barkley C" first="Christina" last="Barkley">Christina Barkley</name><name sortKey="Bellon, Jennifer" sort="Bellon, Jennifer" uniqKey="Bellon J" first="Jennifer" last="Bellon">Jennifer Bellon</name><name sortKey="Burstein, Harold" sort="Burstein, Harold" uniqKey="Burstein H" first="Harold" last="Burstein">Harold Burstein</name><name sortKey="Gadd, Michele" sort="Gadd, Michele" uniqKey="Gadd M" first="Michele" last="Gadd">Michele Gadd</name><name sortKey="Golshan, Mehra" sort="Golshan, Mehra" uniqKey="Golshan M" first="Mehra" last="Golshan">Mehra Golshan</name><name sortKey="Harris, Jay" sort="Harris, Jay" uniqKey="Harris J" first="Jay" last="Harris">Jay Harris</name><name sortKey="Iglehart, James Dirk" sort="Iglehart, James Dirk" uniqKey="Iglehart J" first="James Dirk" last="Iglehart">James Dirk Iglehart</name><name sortKey="Smith, Barbara" sort="Smith, Barbara" uniqKey="Smith B" first="Barbara" last="Smith">Barbara Smith</name><name sortKey="Winer, Eric" sort="Winer, Eric" uniqKey="Winer E" first="Eric" last="Winer">Eric Winer</name><name sortKey="Wong, Julia" sort="Wong, Julia" uniqKey="Wong J" first="Julia" last="Wong">Julia Wong</name></noCountry><country name="États-Unis"><region name="Massachusetts"><name sortKey="Taghian, Alphonse" sort="Taghian, Alphonse" uniqKey="Taghian A" first="Alphonse" last="Taghian">Alphonse Taghian</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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