Is axillary lymph node dissection necessary in the routine management of breast cancer? Yes.
Identifieur interne : 00B804 ( Ncbi/Curation ); précédent : 00B803; suivant : 00B805Is axillary lymph node dissection necessary in the routine management of breast cancer? Yes.
Auteurs : M P Moore [États-Unis] ; D W KinneSource :
- Important advances in oncology [ 0883-5896 ] ; 1996.
Descripteurs français
- KwdFr :
- Aisselle (), Carcinomes (), Carcinomes (anatomopathologie), Carcinomes (diagnostic), Carcinomes (mortalité), Essais cliniques comme sujet, Femelle, Humains, Lymphadénectomie (effets indésirables), Lymphoedème (étiologie), Métastase lymphatique (anatomopathologie), Métastase lymphatique (diagnostic), Pronostic, Récidive tumorale locale, Stade de la tumeur, Taux de survie, Tumeurs du sein (), Tumeurs du sein (anatomopathologie), Tumeurs du sein (mortalité), Études multicentriques comme sujet, Évolution de la maladie.
- MESH :
- anatomopathologie : Carcinomes, Métastase lymphatique, Tumeurs du sein.
- diagnostic : Carcinomes, Métastase lymphatique.
- effets indésirables : Lymphadénectomie.
- mortalité : Carcinomes, Tumeurs du sein.
- étiologie : Lymphoedème.
- Aisselle, Carcinomes, Essais cliniques comme sujet, Femelle, Humains, Pronostic, Récidive tumorale locale, Stade de la tumeur, Taux de survie, Tumeurs du sein, Études multicentriques comme sujet, Évolution de la maladie.
English descriptors
- KwdEn :
- Axilla (surgery), Breast Neoplasms (mortality), Breast Neoplasms (pathology), Breast Neoplasms (surgery), Carcinoma (diagnosis), Carcinoma (mortality), Carcinoma (pathology), Carcinoma (surgery), Clinical Trials as Topic, Disease Progression, Female, Humans, Lymph Node Excision (adverse effects), Lymphatic Metastasis (diagnosis), Lymphatic Metastasis (pathology), Lymphedema (etiology), Multicenter Studies as Topic, Neoplasm Recurrence, Local, Neoplasm Staging, Prognosis, Survival Rate.
- MESH :
- adverse effects : Lymph Node Excision.
- diagnosis : Carcinoma, Lymphatic Metastasis.
- etiology : Lymphedema.
- mortality : Breast Neoplasms, Carcinoma.
- pathology : Breast Neoplasms, Carcinoma, Lymphatic Metastasis.
- surgery : Axilla, Breast Neoplasms, Carcinoma.
- Clinical Trials as Topic, Disease Progression, Female, Humans, Multicenter Studies as Topic, Neoplasm Recurrence, Local, Neoplasm Staging, Prognosis, Survival Rate.
Abstract
Axillary dissection for primary operable cancer follows the basic tenets of surgical oncology and achieves the stated goals. Local control is excellent, with failure rates of 0% to 2%. Long-term, disease-free survival is improved with axillary dissection. It is often stated that axillary dissection is not required for the smallest lesions, but the 15% risk of axillary disease with the T1A lesion suggests otherwise. Axillary sampling would not achieve the stated goals because of the high probability of retained, potentially resectable disease in the node-positive group. Axillary recurrence is associated with unacceptably high morbidity and mortality rates. Although the survival is similar in the three treatment groups of NSABP B-04, the inordinately high systemic failure rate with axillary recurrence would suggest that more aggressive local control could prevent many of these failures. After all, long-term survival free of disease is reported in many series, even in patients with multiple involved nodes. Axillary dissection also generates the most accurate prognostic variable on which further therapeutic interventions are predicated. At present, no other diagnostic or therapeutic approach achieves all these goals. The value of the axillary dissection is to provide accurate prognostic information, provide excellent local control, and improve the survival rate in the node-positive group. Perhaps in the future, a diagnostic test such as PET scanning or sentinel node mapping will identify patients with a clear axilla, who therefore do not require an axillary dissection. There has yet to be a primary operable carcinoma that benefits from preservation of potentially fully resectable disease.
PubMed: 8791140
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Yes.</title><author><name sortKey="Moore, M P" sort="Moore, M P" uniqKey="Moore M" first="M P" last="Moore">M P Moore</name><affiliation wicri:level="2"><nlm:affiliation>Columbia-Presbyterian Medical Center, New York, New York, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Columbia-Presbyterian Medical Center, New York, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Kinne, D W" sort="Kinne, D W" uniqKey="Kinne D" first="D W" last="Kinne">D W Kinne</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1996">1996</date><idno type="RBID">pubmed:8791140</idno><idno type="pmid">8791140</idno><idno type="wicri:Area/PubMed/Corpus">005260</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">005260</idno><idno type="wicri:Area/PubMed/Curation">005260</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">005260</idno><idno type="wicri:Area/PubMed/Checkpoint">005260</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">005260</idno><idno type="wicri:Area/Ncbi/Merge">00B804</idno><idno type="wicri:Area/Ncbi/Curation">00B804</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Is axillary lymph node dissection necessary in the routine management of breast cancer? Yes.</title><author><name sortKey="Moore, M P" sort="Moore, M P" uniqKey="Moore M" first="M P" last="Moore">M P Moore</name><affiliation wicri:level="2"><nlm:affiliation>Columbia-Presbyterian Medical Center, New York, New York, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Columbia-Presbyterian Medical Center, New York, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Kinne, D W" sort="Kinne, D W" uniqKey="Kinne D" first="D W" last="Kinne">D W Kinne</name></author></analytic><series><title level="j">Important advances in oncology</title><idno type="ISSN">0883-5896</idno><imprint><date when="1996" type="published">1996</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Axilla (surgery)</term><term>Breast Neoplasms (mortality)</term><term>Breast Neoplasms (pathology)</term><term>Breast Neoplasms (surgery)</term><term>Carcinoma (diagnosis)</term><term>Carcinoma (mortality)</term><term>Carcinoma (pathology)</term><term>Carcinoma (surgery)</term><term>Clinical Trials as Topic</term><term>Disease Progression</term><term>Female</term><term>Humans</term><term>Lymph Node Excision (adverse effects)</term><term>Lymphatic Metastasis (diagnosis)</term><term>Lymphatic Metastasis (pathology)</term><term>Lymphedema (etiology)</term><term>Multicenter Studies as Topic</term><term>Neoplasm Recurrence, Local</term><term>Neoplasm Staging</term><term>Prognosis</term><term>Survival Rate</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Aisselle ()</term><term>Carcinomes ()</term><term>Carcinomes (anatomopathologie)</term><term>Carcinomes (diagnostic)</term><term>Carcinomes (mortalité)</term><term>Essais cliniques comme sujet</term><term>Femelle</term><term>Humains</term><term>Lymphadénectomie (effets indésirables)</term><term>Lymphoedème (étiologie)</term><term>Métastase lymphatique (anatomopathologie)</term><term>Métastase lymphatique (diagnostic)</term><term>Pronostic</term><term>Récidive tumorale locale</term><term>Stade de la tumeur</term><term>Taux de survie</term><term>Tumeurs du sein ()</term><term>Tumeurs du sein (anatomopathologie)</term><term>Tumeurs du sein (mortalité)</term><term>Études multicentriques comme sujet</term><term>Évolution de la maladie</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Lymph Node Excision</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Carcinomes</term><term>Métastase lymphatique</term><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Carcinoma</term><term>Lymphatic Metastasis</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Carcinomes</term><term>Métastase lymphatique</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Lymphadénectomie</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><term>Carcinoma</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Carcinomes</term><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Breast Neoplasms</term><term>Carcinoma</term><term>Lymphatic Metastasis</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Axilla</term><term>Breast Neoplasms</term><term>Carcinoma</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Clinical Trials as Topic</term><term>Disease Progression</term><term>Female</term><term>Humans</term><term>Multicenter Studies as Topic</term><term>Neoplasm Recurrence, Local</term><term>Neoplasm Staging</term><term>Prognosis</term><term>Survival Rate</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Aisselle</term><term>Carcinomes</term><term>Essais cliniques comme sujet</term><term>Femelle</term><term>Humains</term><term>Pronostic</term><term>Récidive tumorale locale</term><term>Stade de la tumeur</term><term>Taux de survie</term><term>Tumeurs du sein</term><term>Études multicentriques comme sujet</term><term>Évolution de la maladie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Axillary dissection for primary operable cancer follows the basic tenets of surgical oncology and achieves the stated goals. Local control is excellent, with failure rates of 0% to 2%. Long-term, disease-free survival is improved with axillary dissection. It is often stated that axillary dissection is not required for the smallest lesions, but the 15% risk of axillary disease with the T1A lesion suggests otherwise. Axillary sampling would not achieve the stated goals because of the high probability of retained, potentially resectable disease in the node-positive group. Axillary recurrence is associated with unacceptably high morbidity and mortality rates. Although the survival is similar in the three treatment groups of NSABP B-04, the inordinately high systemic failure rate with axillary recurrence would suggest that more aggressive local control could prevent many of these failures. After all, long-term survival free of disease is reported in many series, even in patients with multiple involved nodes. Axillary dissection also generates the most accurate prognostic variable on which further therapeutic interventions are predicated. At present, no other diagnostic or therapeutic approach achieves all these goals. The value of the axillary dissection is to provide accurate prognostic information, provide excellent local control, and improve the survival rate in the node-positive group. Perhaps in the future, a diagnostic test such as PET scanning or sentinel node mapping will identify patients with a clear axilla, who therefore do not require an axillary dissection. There has yet to be a primary operable carcinoma that benefits from preservation of potentially fully resectable disease.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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