Axillary Irradiation as an Imperative Alternative to Axillary Dissection in Clinically Lymph Node-Negative but Sentinel Node-Positive Breast Cancer Patients?
Identifieur interne : 004781 ( Pmc/Curation ); précédent : 004780; suivant : 004782Axillary Irradiation as an Imperative Alternative to Axillary Dissection in Clinically Lymph Node-Negative but Sentinel Node-Positive Breast Cancer Patients?
Auteurs : Mirko Nitsche [Allemagne] ; Robert HermannSource :
- Breast Care [ 1661-3791 ] ; 2011.
Abstract
At the moment, positive sentinel lymph node dissection (SLND) of the axilla is followed by axillary lymph node dissection (ALND) as standard of care. Recent data proves that omitting ALND after positive SLND in clinically lymph node-negative early stage breast cancer patients is feasible with low recurrence rates. The well known effect of radiotherapy to destroy occult tumor cells highly contributes to these results as a large extent of level I and II lymph nodes are unavoidably included in standard tangential radiation treatment fields. Reviewing the up to date published data on axillary lymph node treatment with radiotherapy, we hypothesize that full dosage coverage of level I and II of the axilla in early stage breast cancer will improve outcome and should be further evaluated.
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DOI: 10.1159/000333835
PubMed: 22619644
PubMed Central: 3357141
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Robert Hermann<affiliation><nlm:aff id="aff2">Zentrum für Strahlentherapie und Radioonkologie, Ärztehaus an der Ammerlandklinik, Westerstede</nlm:aff><wicri:noCountry code="subfield">Westerstede</wicri:noCountry></affiliation>Le document en format XML
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Breast Care (Basel)</journal-id><journal-id journal-id-type="iso-abbrev">Breast Care (Basel)</journal-id><journal-id journal-id-type="publisher-id">BRC</journal-id><journal-title-group><journal-title>Breast Care</journal-title></journal-title-group><issn pub-type="ppub">1661-3791</issn><issn pub-type="epub">1661-3805</issn><publisher><publisher-name>S. Karger GmbH</publisher-name><publisher-loc>Lörracherstrasse 16 a, P.O. Box · Postfach · Case postale, D–79095, Freiburg, Germany · Deutschland · Allemagne, Phone: +49 761 45 20 70, Fax: +49 761 4 52 07 14, information@karger.de</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22619644</article-id><article-id pub-id-type="pmc">3357141</article-id><article-id pub-id-type="doi">10.1159/000333835</article-id><article-id pub-id-type="publisher-id">brc-0006-0353</article-id><article-categories><subj-group subj-group-type="heading"><subject>Review Article · Übersichtsarbeit</subject></subj-group></article-categories><title-group><article-title>Axillary Irradiation as an Imperative Alternative to Axillary Dissection in Clinically Lymph Node-Negative but Sentinel Node-Positive Breast Cancer Patients?</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Nitsche</surname><given-names>Mirko</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Hermann</surname><given-names>Robert</given-names></name><xref ref-type="aff" rid="aff2"><sup>b</sup></xref></contrib></contrib-group><aff id="aff1"><sup>a</sup>Zentrum für Strahlentherapie und Radioonkologie, Ärztehaus am DIAKO, Bremen, Germany</aff><aff id="aff2"><sup>b</sup>Zentrum für Strahlentherapie und Radioonkologie, Ärztehaus an der Ammerlandklinik, Westerstede</aff><author-notes><corresp id="cor1">*Dr. med. Mirko Nitsche, Facharzt für Strahlentherapie und Radioonkologie, Zentrum für Strahlentherapie und Radioonkologie, Ärztehaus am DIAKO Gröpelinger Heerstraße 406–408, 28239 Bremen, Germany Tel. +49 421 610266–66, Fax −76, <email>nitsche@strahlentherapie-bremen.com</email>, <ext-link ext-link-type="uri" xlink:href="http://www.strahlentherapie-bremen.com">www.strahlentherapie-bremen.com</ext-link></corresp></author-notes><pub-date pub-type="ppub"><month>10</month><year>2011</year></pub-date><pub-date pub-type="epub"><day>31</day><month>10</month><year>2011</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>10</month><year>2012</year></pub-date><pmc-comment> PMC Release delay is 12 months and 0 days and was based on the
<volume>6</volume><issue>5</issue><fpage>353</fpage><lpage>358</lpage><permissions><copyright-statement>Copyright © 2011 by S. Karger GmbH, Freiburg</copyright-statement><copyright-year>2011</copyright-year></permissions><abstract><p>At the moment, positive sentinel lymph node dissection (SLND) of the axilla is followed by axillary lymph node dissection (ALND) as standard of care. Recent data proves that omitting ALND after positive SLND in clinically lymph node-negative early stage breast cancer patients is feasible with low recurrence rates. The well known effect of radiotherapy to destroy occult tumor cells highly contributes to these results as a large extent of level I and II lymph nodes are unavoidably included in standard tangential radiation treatment fields. Reviewing the up to date published data on axillary lymph node treatment with radiotherapy, we hypothesize that full dosage coverage of level I and II of the axilla in early stage breast cancer will improve outcome and should be further evaluated.</p></abstract><trans-abstract xml:lang="de"><p>Der aktuelle Therapiestandard beim Vorliegen eines positiven Wächterlymphknotens ist die Durchführung einer kompletten Axilladissektion. Neuere Studien zeigen aber, dass bei klinisch negativer Axilla und positivem Wächterlymphknoten auf eine Axilladissektion bei niedriger lokaler Rezidivrate verzichtet werden kann. Der bekannte Effekt, dass durch Radiotherapie okkulte Tumorzellen zerstört werden, hat mit Sicherheit zu den Ergebnissen beigetragen, wird doch ein großer Anteil von Level-I/II-Lymphknoten bei der standardmäßigen tangentialen Radiotherapie der Mamma durch die Einstrahlungsfelder erfasst. Nach Zusammenschau der bisher publizierten Daten zur Radiotherapie der axillären Lymphknoten stellen wir die Hypothese auf, dass eine volle Dosisabdeckung der Level-I-und-II-Lymphknoten die Ergebnisse beim frühen Mammakarzinom weiter verbessern kann. Dies sollte in klinischen Studien weiter evaluiert werden.</p></trans-abstract><kwd-group><title>Keywords</title><kwd>Adjuvant treatment</kwd><kwd>Breast cancer</kwd><kwd>Curative radiotherapy</kwd><kwd>Sentinel lymph node</kwd></kwd-group><counts><fig-count count="1"></fig-count><ref-count count="34"></ref-count><page-count count="6"></page-count></counts></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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