Axillary Recurrence After a Tumor-Positive Sentinel Lymph Node Biopsy Without Axillary Treatment: A Review of the Literature
Identifieur interne : 005038 ( Ncbi/Merge ); précédent : 005037; suivant : 005039Axillary Recurrence After a Tumor-Positive Sentinel Lymph Node Biopsy Without Axillary Treatment: A Review of the Literature
Auteurs : Claire M. T. P. Francissen [Pays-Bas] ; Pim J. M. Dings [Pays-Bas] ; Thijs Van Dalen [Pays-Bas] ; Luc J. A. Strobbe [Pays-Bas] ; Hanneke W. M. Van Laarhoven [Pays-Bas] ; Johannes H. W. De Wilt [Pays-Bas]Source :
- Annals of Surgical Oncology [ 1068-9265 ] ; 2012.
Abstract
Sentinel lymph node biopsy (SLNB) has become standard of care as a staging procedure in patients with invasive breast cancer. A positive SLNB allows completion axillary lymph node dissection (cALND) to be performed. The axillary recurrence rate (ARR) after cALND in patients with positive SLNB is low. Recently, several studies have reported a similar low ARR when cALND is not performed. This review aims to determine the ARR when cALND is omitted in SLNB-positive patients.
A literature search was performed in the PubMed database with the search terms “breast cancer,” “sentinel lymph node biopsy,” “axillary” and “recurrence.” Articles with data regarding follow-up of patients with SLNB-positive breast cancer were identified. To be eligible, patients should not have received cALND and ARR should be reported.
Thirty articles were analyzed. This resulted in 7,151 patients with SLNB-positive breast cancer in whom a cALND was omitted (median follow-up of 45 months, range 1–142 months). Overall, 41 patients developed an axillary recurrence. 27 studies described 3,468 patients with micrometastases in the SLNB, of whom 10 (0.3 %) developed an axillary recurrence. ARR varied between 0 and 3.7 %. Sixteen studies described 3,268 patients with macrometastases, 24 (0.7 %) axillary recurrences were seen. ARR varied between 0 and 7.1 %. Details regarding type of surgery and adjuvant treatment were lacking in the majority of studies.
ARR appears to be low in SLNB-positive patients even when a cALND is not performed. Withholding cALND may be safe in breast cancer selected patients such as those with isolated tumor cells or micrometastatic disease.
Url:
DOI: 10.1245/s10434-012-2490-4
PubMed: 22890590
PubMed Central: 3505491
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Sentinel lymph node biopsy (SLNB) has become standard of care as a staging procedure in patients with invasive breast cancer. A positive SLNB allows completion axillary lymph node dissection (cALND) to be performed. The axillary recurrence rate (ARR) after cALND in patients with positive SLNB is low. Recently, several studies have reported a similar low ARR when cALND is not performed. This review aims to determine the ARR when cALND is omitted in SLNB-positive patients.</p>
</sec>
<sec><title>Methods</title>
<p>A literature search was performed in the PubMed database with the search terms “breast cancer,” “sentinel lymph node biopsy,” “axillary” and “recurrence.” Articles with data regarding follow-up of patients with SLNB-positive breast cancer were identified. To be eligible, patients should not have received cALND and ARR should be reported.</p>
</sec>
<sec><title>Results</title>
<p>Thirty articles were analyzed. This resulted in 7,151 patients with SLNB-positive breast cancer in whom a cALND was omitted (median follow-up of 45 months, range 1–142 months). Overall, 41 patients developed an axillary recurrence. 27 studies described 3,468 patients with micrometastases in the SLNB, of whom 10 (0.3 %) developed an axillary recurrence. ARR varied between 0 and 3.7 %. Sixteen studies described 3,268 patients with macrometastases, 24 (0.7 %) axillary recurrences were seen. ARR varied between 0 and 7.1 %. Details regarding type of surgery and adjuvant treatment were lacking in the majority of studies.</p>
</sec>
<sec><title>Conclusions</title>
<p>ARR appears to be low in SLNB-positive patients even when a cALND is not performed. Withholding cALND may be safe in breast cancer selected patients such as those with isolated tumor cells or micrometastatic disease.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Surg Oncol</journal-id>
<journal-id journal-id-type="iso-abbrev">Ann. Surg. Oncol</journal-id>
<journal-title-group><journal-title>Annals of Surgical Oncology</journal-title>
</journal-title-group>
<issn pub-type="ppub">1068-9265</issn>
<issn pub-type="epub">1534-4681</issn>
<publisher><publisher-name>Springer-Verlag</publisher-name>
<publisher-loc>New York</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">22890590</article-id>
<article-id pub-id-type="pmc">3505491</article-id>
<article-id pub-id-type="publisher-id">2490</article-id>
<article-id pub-id-type="doi">10.1245/s10434-012-2490-4</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Breast Oncology</subject>
</subj-group>
</article-categories>
<title-group><article-title>Axillary Recurrence After a Tumor-Positive Sentinel Lymph Node Biopsy Without Axillary Treatment: A Review of the Literature</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Francissen</surname>
<given-names>Claire M. T. P.</given-names>
</name>
<degrees>MD</degrees>
<address><email>clairefrancissen@hotmail.com</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Dings</surname>
<given-names>Pim J. M.</given-names>
</name>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>van Dalen</surname>
<given-names>Thijs</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="Aff2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Strobbe</surname>
<given-names>Luc J. A.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="Aff3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>van Laarhoven</surname>
<given-names>Hanneke W. M.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="Aff4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>de Wilt</surname>
<given-names>Johannes H. W.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<aff id="Aff1"><label>1</label>
Department of Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</aff>
<aff id="Aff2"><label>2</label>
Department of Surgery, Diakonessenhuis, Utrecht, The Netherlands</aff>
<aff id="Aff3"><label>3</label>
Department of Surgery, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands</aff>
<aff id="Aff4"><label>4</label>
Department of Medical Oncology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands</aff>
</contrib-group>
<pub-date pub-type="epub"><day>14</day>
<month>8</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>14</day>
<month>8</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="ppub"><month>12</month>
<year>2012</year>
</pub-date>
<volume>19</volume>
<issue>13</issue>
<fpage>4140</fpage>
<lpage>4149</lpage>
<history><date date-type="received"><day>30</day>
<month>7</month>
<year>2011</year>
</date>
</history>
<permissions><copyright-statement>© The Author(s) 2012</copyright-statement>
</permissions>
<abstract id="Abs1"><sec><title>Background</title>
<p>Sentinel lymph node biopsy (SLNB) has become standard of care as a staging procedure in patients with invasive breast cancer. A positive SLNB allows completion axillary lymph node dissection (cALND) to be performed. The axillary recurrence rate (ARR) after cALND in patients with positive SLNB is low. Recently, several studies have reported a similar low ARR when cALND is not performed. This review aims to determine the ARR when cALND is omitted in SLNB-positive patients.</p>
</sec>
<sec><title>Methods</title>
<p>A literature search was performed in the PubMed database with the search terms “breast cancer,” “sentinel lymph node biopsy,” “axillary” and “recurrence.” Articles with data regarding follow-up of patients with SLNB-positive breast cancer were identified. To be eligible, patients should not have received cALND and ARR should be reported.</p>
</sec>
<sec><title>Results</title>
<p>Thirty articles were analyzed. This resulted in 7,151 patients with SLNB-positive breast cancer in whom a cALND was omitted (median follow-up of 45 months, range 1–142 months). Overall, 41 patients developed an axillary recurrence. 27 studies described 3,468 patients with micrometastases in the SLNB, of whom 10 (0.3 %) developed an axillary recurrence. ARR varied between 0 and 3.7 %. Sixteen studies described 3,268 patients with macrometastases, 24 (0.7 %) axillary recurrences were seen. ARR varied between 0 and 7.1 %. Details regarding type of surgery and adjuvant treatment were lacking in the majority of studies.</p>
</sec>
<sec><title>Conclusions</title>
<p>ARR appears to be low in SLNB-positive patients even when a cALND is not performed. Withholding cALND may be safe in breast cancer selected patients such as those with isolated tumor cells or micrometastatic disease.</p>
</sec>
</abstract>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© Society of Surgical Oncology 2012</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Pays-Bas</li>
</country>
<region><li>Gueldre</li>
<li>Utrecht (province)</li>
</region>
<settlement><li>Nimègue</li>
<li>Utrecht</li>
</settlement>
</list>
<tree><country name="Pays-Bas"><region name="Gueldre"><name sortKey="Francissen, Claire M T P" sort="Francissen, Claire M T P" uniqKey="Francissen C" first="Claire M. T. P." last="Francissen">Claire M. T. P. Francissen</name>
</region>
<name sortKey="De Wilt, Johannes H W" sort="De Wilt, Johannes H W" uniqKey="De Wilt J" first="Johannes H. W." last="De Wilt">Johannes H. W. De Wilt</name>
<name sortKey="Dings, Pim J M" sort="Dings, Pim J M" uniqKey="Dings P" first="Pim J. M." last="Dings">Pim J. M. Dings</name>
<name sortKey="Strobbe, Luc J A" sort="Strobbe, Luc J A" uniqKey="Strobbe L" first="Luc J. A." last="Strobbe">Luc J. A. Strobbe</name>
<name sortKey="Van Dalen, Thijs" sort="Van Dalen, Thijs" uniqKey="Van Dalen T" first="Thijs" last="Van Dalen">Thijs Van Dalen</name>
<name sortKey="Van Laarhoven, Hanneke W M" sort="Van Laarhoven, Hanneke W M" uniqKey="Van Laarhoven H" first="Hanneke W. M." last="Van Laarhoven">Hanneke W. M. Van Laarhoven</name>
</country>
</tree>
</affiliations>
</record>
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