Imaging of the Axilla and Approaches to Node-Negative Versus Node-Positive Disease at Presentation

2021 ◽  
pp. 65-84
Author(s):  
Leah H. Portnow ◽  
Allyson L. Chesebro ◽  
Eva C. Gombos
Keyword(s):  
Node Negative ◽  
Node Positive ◽  
Node Positive Disease ◽  
Versus Node

Cured of breast cancer?

1995 ◽  
Vol 13 (1) ◽  
pp. 62-69 ◽  
Author(s):  
H Joensuu ◽  
S Toikkanen
Keyword(s):  
Breast Cancer ◽  
Contralateral Breast Cancer ◽  
Survival Rates ◽  
Locoregional Therapy ◽  
Short Term ◽  
Node Negative ◽  
Node Positive ◽  
Node Positive Disease ◽  
Histologic Types

PURPOSE That patients can be ultimately cured of breast cancer has been questioned, because late deaths from the disease have been observed even several decades after the diagnosis. The purpose of this study was to investigate late mortality caused by breast cancer. PATIENTS AND METHODS Using the files of local hospitals and the Finnish Cancer Registry, we identified all patients with histologically diagnosed invasive breast cancer in a defined urban area (city of Turku, Finland) from 1945 to 1969 (n = 601). In 563 cases (94%), clinical data and histologic and autopsy slides could be reviewed, and these women had been monitored for a median of 29 years (range, 22 to 44; n = 66) or until death (n = 497). RESULTS Mortality from breast cancer was observed even during the fourth follow-up decade, but if women who were diagnosed with contralateral breast cancer were excluded (n = 30), no deaths from breast cancer were identified after the 27th year of follow-up evaluation. The 30-year survival rates were 62% (95% confidence interval [CI], 54% to 70%), 19% (95% CI, 13% to 25%), and 0% for women with pN0 (node-negative) and pN1 or pN2 (node-positive) disease, respectively. High 30-year survival rates were found in small (pT1N0M0) unilateral cancers (80% alive; 95% CI, 66 to 94%), and in the lobular (45% alive; 95% CI, 31% to 59%) and the special histologic types (81% alive; 95% CI, 67% to 95%). These survival rates were obtained when correcting either for known intercurrent deaths or for mortality in the age- and sex-matched general population. CONCLUSION Breast cancer, node-negative and node-positive, may be permanently cured even if treated with locoregional therapy only. The survival figures listed here may be considered as minimum values, because women with breast cancer diagnosed in the same area from 1970 to 1984 showed significantly improved short-term (< 20 years) survival rates over those diagnosed from 1945 to 1969.

Improvement in the prognosis of breast cancer from 1965 to 1984.

1998 ◽  
Vol 16 (3) ◽  
pp. 1030-1035 ◽  
Author(s):  
M J Edwards ◽  
J W Gamel ◽  
E J Feuer
Keyword(s):  
Breast Cancer ◽  
Survival Time ◽  
Median Survival ◽  
Median Survival Time ◽  
Parametric Analysis ◽  
Parametric Models ◽  
Node Negative ◽  
Node Positive ◽  
Significant Difference ◽  
Node Positive Disease

PURPOSE The prognosis of breast cancer has improved over the past three decades. It is uncertain, however, whether this improvement results from an increase in the cure rate, extension of the life span of uncured patients, or some combination. METHODS From the Connecticut Tumor Registry, we obtained data on 25,091 patients with localized (node-negative) and regionally metastatic (node-positive) breast cancer who were diagnosed over the two decades between 1965 and 1984, with follow-up through 1993. The data for these patients were analyzed using a variety of parametric models to quantitate likelihood of cure and median survival time among uncured patients. These models incorporate the assumption that time to death from breast cancer follows a specific distribution. RESULTS For patients with node-negative disease, parametric analysis revealed no significant difference in cured-fraction or median survival time over the two decades studied. For patients with node-positive disease, however, a significant increase in median survival time (P < .001) was found during the second decade (1970 to 1979). There was also a trend toward a higher cured-fraction over time, but this was not statistically significant. CONCLUSION This study confirms that patients with node-positive disease had an improved prognosis over the two decades studied. Parametric analysis suggests that this improvement reflects primarily an increase in the median survival time for uncured patients, although there is a trend toward an increase in the likelihood of cure.

Adjuvant Therapy for Breast Cancer: Practice Patterns of Community Physicians

2002 ◽  
Vol 20 (7) ◽  
pp. 1809-1817 ◽  
Author(s):  
Linda C. Harlan ◽  
Jeffrey Abrams ◽  
Joan L. Warren ◽  
Lin Clegg ◽  
Jennifer Stevens ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Hormonal Therapy ◽  
Population Based ◽  
National Institutes Of Health ◽  
Complex Nature ◽  
Node Negative ◽  
Younger Women ◽  
Node Positive ◽  
Node Positive Disease

PURPOSE: We evaluated the use of adjuvant therapy for breast cancer using the National Institutes of Health (NIH) Consensus Development Conference statements as guideposts for assessing how rapidly community physicians adopt recommended therapies. PATIENTS AND METHODS: Women with stage I through IIIA breast cancer diagnosed in 1987 through 1991 and in 1995 were randomly sampled from the population-based National Cancer Institute Surveillance, Epidemiology, and End-Results program. A total of 8,106 women were included in the study with younger women, ≤ 50 years, being oversampled. Their treating physicians were asked to verify whether chemotherapy, hormonal therapy, or both were given. RESULTS: After adjusting for clinical and nonclinical factors, the use of 1985 recommendations for adjuvant therapy in women with node-positive disease was already high at 80% in 1987 and increased slightly to 84% by 1995. Use of combined multidrug chemotherapy plus tamoxifen increased. In contrast, the use of 1990 recommendations for adjuvant therapy for node-negative disease was slightly less than 13% in 1987 and increased markedly to 57% by 1995. For women with node-negative tumors ≥ 1 cm in size diagnosed in 1995, 40% received tamoxifen, 16% combination chemotherapy, and 7% both, an increase from 10%, 5%, and 0.4%, respectively, in 1987. CONCLUSION: Community physicians began prescribing adjuvant chemotherapy and hormonal therapy in advance of publication of the NIH consensus statement in 1990. Adoption of recommended treatments for node-negative disease has been less complete compared with node-positive tumors, perhaps reflecting the more complex nature of the clinical trials data or the smaller anticipated benefit from adjuvant therapy for this disease subset.

Factors associated with receipt of adjuvant radioactive iodine in node-negative versus node-positive papillary thyroid cancer.

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. e17695-e17695
Author(s):  
Ryaz Chagpar ◽  
Eren Berber ◽  
Jamie Mitchell ◽  
Joyce Shin ◽  
Judy Jin ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Radioactive Iodine ◽  
Papillary Thyroid ◽  
Node Negative ◽  
Factors Associated ◽  
Node Positive ◽  
Versus Node

Beyond the guidelines: Clinical investigators' (CI) self-reported use of genomic assays (GA) to assist in decision-making regarding use of neoadjuvant (NA) and adjuvant chemotherapy for patients (pts) with ER-positive/HER2-negative (ER+/HER2-) early breast cancer (BC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18187-e18187
Author(s):  
Neil Love ◽  
Harold J. Burstein ◽  
Tari A. King ◽  
Gloria Kelly ◽  
Kirsten Miller ◽  
...  
Keyword(s):  
Decision Making ◽  
Adjuvant Chemotherapy ◽  
Management Strategies ◽  
Recurrence Score ◽  
Tumor Stage ◽  
Third Party ◽  
Node Negative ◽  
Node Positive ◽  
Node Positive Disease ◽  
Do So

e18187 Background: GA, specifically the 21-gene Recurrence Score (RS), have been widely used to help inform decisions regarding use of adjuvant chemotherapy in ER+/HER2- node-negative BC. Although substantial anecdotal evidence exists that clinicians, particularly BC-focused CI, are employing these tests in other situations (node-positive disease, the NA setting), ASCO guidelines do not endorse these practices. Here we aimed to quantify self-reported CI use of GA across a spectrum of hypothetical BC presentations. Methods: In December 2016, a 225-item survey was sent to 97 US-based surgical (S) and medical oncology (MO) CI from a proprietary database. A modest honorarium was provided. Results: 51 CI (26 S and 25 MO) completed the survey. CI generally recommend GA for node-negative tumors but less so for older pts with smaller lesions. 75% of CI reported that they would recommend GA for pts with 1 involved node and 55% would do so for those with 2 to 3 nodes. 31% of CI use GA to guide NA chemotherapy decisions, and 53% who do not use GA in NA decision-making altered their treatment approach when a GA result was available. Conclusions: CI prefer GA when the benefit of chemotherapy is uncertain based on tumor stage and pt age. CI are comfortable using GA in node-negative and node-positive hypothetical cases, and some do so to aid in decisions regarding NA therapy. Quantitative assessment of self-reported CI practice patterns can serve as a complement to established guidelines and provide physicians, pts and third-party payers additional viewpoints on possible appropriate management strategies. [Table: see text]

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