Muriel Brackstone1, Fulvia G Baldassarre2, Francisco E Perera1, Tulin Cil3, Mariana Chavez Mac Gregor4, Ian S Dayes5, Jay Engel6, Janet K Horton7, Tari A King8, Anat Kornecki9, Ralph George10, Sandip K SenGupta11, Patricia A Spears12, Andrea F Eisen13. 1. London Health Sciences Centre, London, Ontario, Canada. 2. Program in Evidence-Based Care, McMaster University, Hamilton, Ontario, Canada. 3. University Health Network, Princess Margaret Hospital, Toronto, Ontario, Canada. 4. University of Texas MD Anderson Cancer Center, Houston, TX. 5. Juravinski Cancer Centre, Hamilton, Ontario, Canada. 6. Cancer Center of Southeastern Ontario, Kingston General Hospital, Kingston, Ontario, Canada. 7. Research Triangle Park, Chapel Hill, NC. 8. Dana Farber/Brigham & Women's Cancer Center, Boston, MA. 9. Western University, London, Ontario, Canada. 10. Division of General Surgery, St Michael's Hospital, CIBC Breast Centre, Toronto, Ontario, Canada. 11. Pathology Department, Kingston General Hospital, Kingston, Ontario, Canada. 12. University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC. 13. University of Toronto, Odette Cancer Centre, Toronto, Ontario, Canada.
Abstract
PURPOSE: To provide recommendations on the best strategies for the management and on the best timing and treatment (surgical and radiotherapeutic) of the axilla for patients with early-stage breast cancer. METHODS: Ontario Health (Cancer Care Ontario) and ASCO convened a Working Group and Expert Panel to develop evidence-based recommendations informed by a systematic review of the literature. RESULTS: This guideline endorsed two recommendations of the ASCO 2017 guideline for the use of sentinel lymph node biopsy in patients with early-stage breast cancer and expanded on that guideline with recommendations for radiotherapy interventions, timing of staging after neoadjuvant chemotherapy (NAC), and mapping modalities. Overall, the ASCO 2017 guideline, seven high-quality systematic reviews, 54 unique studies, and 65 corollary trials formed the evidentiary basis of this guideline. RECOMMENDATIONS: Recommendations are issued for each of the objectives of this guideline: (1) To determine which patients with early-stage breast cancer require axillary staging, (2) to determine whether any further axillary treatment is indicated for women with early-stage breast cancer who did not receive NAC and are sentinel lymph node-negative at diagnosis, (3) to determine which axillary strategy is indicated for women with early-stage breast cancer who did not receive NAC and are pathologically sentinel lymph node-positive at diagnosis (after a clinically node-negative presentation), (4) to determine what axillary treatment is indicated and what the best timing of axillary treatment for women with early-stage breast cancer is when NAC is used, and (5) to determine which are the best methods for identifying sentinel nodes.Additional information is available at www.asco.org/breast-cancer-guidelines.
PURPOSE: To provide recommendations on the best strategies for the management and on the best timing and treatment (surgical and radiotherapeutic) of the axilla for patients with early-stage breast cancer. METHODS: Ontario Health (Cancer Care Ontario) and ASCO convened a Working Group and Expert Panel to develop evidence-based recommendations informed by a systematic review of the literature. RESULTS: This guideline endorsed two recommendations of the ASCO 2017 guideline for the use of sentinel lymph node biopsy in patients with early-stage breast cancer and expanded on that guideline with recommendations for radiotherapy interventions, timing of staging after neoadjuvant chemotherapy (NAC), and mapping modalities. Overall, the ASCO 2017 guideline, seven high-quality systematic reviews, 54 unique studies, and 65 corollary trials formed the evidentiary basis of this guideline. RECOMMENDATIONS: Recommendations are issued for each of the objectives of this guideline: (1) To determine which patients with early-stage breast cancer require axillary staging, (2) to determine whether any further axillary treatment is indicated for women with early-stage breast cancer who did not receive NAC and are sentinel lymph node-negative at diagnosis, (3) to determine which axillary strategy is indicated for women with early-stage breast cancer who did not receive NAC and are pathologically sentinel lymph node-positive at diagnosis (after a clinically node-negative presentation), (4) to determine what axillary treatment is indicated and what the best timing of axillary treatment for women with early-stage breast cancer is when NAC is used, and (5) to determine which are the best methods for identifying sentinel nodes.Additional information is available at www.asco.org/breast-cancer-guidelines.
Authors: Lisa Rydén; Ida Skarping; Kristoffer Nilsson; Looket Dihge; Adam Fridhammar; Mattias Ohlsson; Linnea Huss; Pär-Ola Bendahl; Katarina Steen Carlsson Journal: Breast Cancer Res Treat Date: 2022-07-05 Impact factor: 4.624
Authors: Francisco Pimentel Cavalcante; Felipe Zerwes; Eduardo Camargo Millen; Guilherme Novita; Alessandra Borba Anton de Souza; João Henrique Penna Reis; Helio Rubens de Oliveira Filho; Luciana Naíra de B L Limongi; Barbara Pace Silva de Assis Carvalho; Adriana Magalhães de Oliveira Freitas; Monica Travassos Jourdan; Vilmar Marques de Oliveira; Ruffo Freitas-Junior Journal: Ecancermedicalscience Date: 2022-02-18