BACKGROUND: Most breast cancer patients require lumpectomy with axillary sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). The ACOSOG Z0011-trial failed to detect significant effects of ALND on disease-free and overall survival among patients with limited sentinel lymph node (SLN) metastases. Intense dose-dense chemotherapy and supraclavicular fossa radiation (SFR) are indicated for patients with extensive axillary metastases. In this multicentered study, we investigated the relevance of ALND after positive SLNB to determine adequate adjuvant therapy. METHODS: We retrospectively analyzed data from 1,214 patients with clinically nodal negative T1-T2 invasive breast cancer undergoing surgery at Hanau City Hospital Breast cancer center. RESULTS: 681 patients underwent ALND after SLNB. 20 patients (8.5%) from the group with 1 or 2 SLN metastases (n = 236) showed more than 3 lymph node metastases after ALND. 13 patients (31.7%) from the group with more than 2 SLN metastases (n = 41) were diagnosed with a minimum of 4 axillary lymph node metastases after ALND. CONCLUSIONS: In 8.5% of the patients with 1 or 2 SLN metastases, ALND detected more than 3 macrometastases, setting the indication for intense dose-dense chemotherapy and SFR. More than 2 SLN metastases, T stage and grading predict lymph node metastases.
BACKGROUND: Most breast cancer patients require lumpectomy with axillary sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). The ACOSOG Z0011-trial failed to detect significant effects of ALND on disease-free and overall survival among patients with limited sentinel lymph node (SLN) metastases. Intense dose-dense chemotherapy and supraclavicular fossa radiation (SFR) are indicated for patients with extensive axillary metastases. In this multicentered study, we investigated the relevance of ALND after positive SLNB to determine adequate adjuvant therapy. METHODS: We retrospectively analyzed data from 1,214 patients with clinically nodal negative T1-T2 invasive breast cancer undergoing surgery at Hanau City Hospital Breast cancer center. RESULTS: 681 patients underwent ALND after SLNB. 20 patients (8.5%) from the group with 1 or 2 SLN metastases (n = 236) showed more than 3 lymph node metastases after ALND. 13 patients (31.7%) from the group with more than 2 SLN metastases (n = 41) were diagnosed with a minimum of 4 axillary lymph node metastases after ALND. CONCLUSIONS: In 8.5% of the patients with 1 or 2 SLN metastases, ALND detected more than 3 macrometastases, setting the indication for intense dose-dense chemotherapy and SFR. More than 2 SLN metastases, T stage and grading predict lymph node metastases.
Authors: Adam Gondos; Lina Jansen; Jörg Heil; Andreas Schneeweiss; Adri C Voogd; Jan Frisell; Irma Fredriksson; Ulla Johansson; Tove Filtenborg Tvedskov; Maj-Britt Jensen; Eva Balslev; Olaf Johan Hartmann-Johnsen; Milena Sant; Paolo Baili; Roberto Agresti; Tony van de Velde; Annegien Broeks; Jean-Marie Nogaret; Pierre Bourgeois; Michel Moreau; Zoltán Mátrai; Ákos Sávolt; Péter Nagy; Miklós Kásler; Petra Schrotz-King; Cornelia Ulrich; Hermann Brenner Journal: Acta Oncol Date: 2016-02-15 Impact factor: 4.089
Authors: Armando E Giuliano; Kelly K Hunt; Karla V Ballman; Peter D Beitsch; Pat W Whitworth; Peter W Blumencranz; A Marilyn Leitch; Sukamal Saha; Linda M McCall; Monica Morrow Journal: JAMA Date: 2011-02-09 Impact factor: 56.272
Authors: P Del Bianco; G Zavagno; P Burelli; G Scalco; L Barutta; P Carraro; P Pietrarota; G Meneghini; T Morbin; G Tacchetti; P Pecoraro; V Belardinelli; G L De Salvo Journal: Eur J Surg Oncol Date: 2007-07-05 Impact factor: 4.424
Authors: Linda Holmstrand Zetterlund; Jan Frisell; Athanasios Zouzos; Rimma Axelsson; Thomas Hatschek; Jana de Boniface; Fuat Celebioglu Journal: Breast Cancer Res Treat Date: 2017-02-21 Impact factor: 4.872