E Barranger1, G Houvenaeghel, J-M Classe. 1. Service de gynécologie-obstétrique, hôpital Lariboisière, AP-HP, université Paris-7, Paris, France. emmanuel.barranger@lrb.aphp.fr
Abstract
OBJECTIVE: To establish an inventory concerning the consistency of current medical practices in the management of axillary support for non-metastatic breast cancer since the publication of the ACOSOG-Z0011 randomized trial. PATIENTS AND METHODS: A descriptive survey practice using a questionnaire sent by email was conducted in medical care teams for breast cancer. RESULTS: Forty-eight medical teams across the French territory answered to the questionnaire. It has been noted that 72.9% of medical teams have said to consistently achieve an additional axillary lymph node dissection (ALND) in case of macrometastatic sentinel node (SN), 12.5% in case of micrometastatic SN and only 2.1% in isolated tumor cells SN. The majority of medical teams (61.9%) claimed they did not perform the procedure GS before or after neoadjuvant chemotherapy (NAC). The SN biopsy was performed in only 29.1% of teams before and 9% after NAC, outside study. Axillary irradiation was performed in case of macrometastatic SN without complementary by 27.1% of interviewed medical teams and by 4.1% in the case of micrometastic SN. DISCUSSION AND CONCLUSION: This survey of practice in patients with breast cancer highlights the evolution of medical practice for the axillary management in France. It also illustrates the diversity of practices in medical teams and the significant compensatory increase in the expansion of radiation fields in patients with metastatic SN without additional ALND.
OBJECTIVE: To establish an inventory concerning the consistency of current medical practices in the management of axillary support for non-metastatic breast cancer since the publication of the ACOSOG-Z0011 randomized trial. PATIENTS AND METHODS: A descriptive survey practice using a questionnaire sent by email was conducted in medical care teams for breast cancer. RESULTS: Forty-eight medical teams across the French territory answered to the questionnaire. It has been noted that 72.9% of medical teams have said to consistently achieve an additional axillary lymph node dissection (ALND) in case of macrometastatic sentinel node (SN), 12.5% in case of micrometastatic SN and only 2.1% in isolated tumor cells SN. The majority of medical teams (61.9%) claimed they did not perform the procedure GS before or after neoadjuvant chemotherapy (NAC). The SN biopsy was performed in only 29.1% of teams before and 9% after NAC, outside study. Axillary irradiation was performed in case of macrometastatic SN without complementary by 27.1% of interviewed medical teams and by 4.1% in the case of micrometastic SN. DISCUSSION AND CONCLUSION: This survey of practice in patients with breast cancer highlights the evolution of medical practice for the axillary management in France. It also illustrates the diversity of practices in medical teams and the significant compensatory increase in the expansion of radiation fields in patients with metastatic SN without additional ALND.