Pre-treatment axillary staging can reduce the need for axillary lymph node clearance (ALNC) in patients undergoing neo-adjuvant therapy for breast cancer

2013 ◽  
Vol 39 (5) ◽  
pp. 480
Author(s):  
Jonathan Horsnell ◽  
Victoria Banwell ◽  
Zoe Winters ◽  
Nar Thanvi ◽  
Zenon Rayter
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adjuvant Therapy ◽  
Axillary Lymph Node ◽  
Axillary Staging ◽  
Axillary Lymph ◽  
Axillary Lymph Node Clearance ◽  
Pre Treatment

Is axillary lymph node clearance required in node-positive breast cancer?

2014 ◽  
Vol 12 (1) ◽  
pp. 55-61 ◽  
Author(s):  
Nigel J. Bundred ◽  
Nicola L. P. Barnes ◽  
Emiel Rutgers ◽  
Mila Donker
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Axillary Lymph Node ◽  
Axillary Lymph ◽  
Node Positive ◽  
Axillary Lymph Node Clearance ◽  
Positive Breast Cancer

scholarly journals Hand surgery after axillary lymph node clearance for breast cancer: contra-indication to surgery?

2010 ◽  
Vol 92 (7) ◽  
pp. 573-576 ◽  
Author(s):  
Dean Fulford ◽  
Sam Dalal ◽  
John Winstanley ◽  
Mike J Hayton
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Axillary Lymph Node ◽  
Online Survey ◽  
Hand Surgery ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Axillary Lymph Node Clearance ◽  
Breast Care

INTRODUCTION Breast cancer patients who have had prior axillary lymph node clearance (ALNC) can present with ipsi lateral hand conditions that could easily be treated with surgical intervention. These patients are often advised to avoid interventional procedures due to risks of complications such as lymphoedema, infection and cellulitis. SUBJECTS AND METHODS Between April and June 2009, we conducted an online survey of hand surgeons, breast surgeons and breast-care nurses to obtain their views on hand surgery after ipsilateral axillary lymph node clearance. RESULTS The majority of hand surgeons (58%) felt there was no contra-indication to surgery in a breast cancer patient with prior ipsilateral ALNC compared to just 30% of breast surgeons and 10% of breast-care nurses. The majority of breast surgeons and breast-care nurses (70% and 89%, respectively) felt that hand surgery was a relative contra-indication compared to just 41% of hand surgeons. Postoperative lymphoedema was the commonest cited reason for avoiding surgery. The majority of hand surgeons (79%) and nearly two-thirds of breast surgeons (57%) would use a tourniquet during surgery if it was normal practice. CONCLUSIONS A review of the published literature does not support the notion that these patients experience increased complications; therefore, we recommend the advice given to breast cancer patients regarding ipsilateral surgery be re-evaluated.

Is Axillary Lymph Node Dissection Indicated for Early-Stage Breast Cancer? A Decision Analysis

1999 ◽  
Vol 17 (5) ◽  
pp. 1465-1465 ◽  
Author(s):  
Giovanni Parmigiani ◽  
Donald A. Berry ◽  
Eric P. Winer ◽  
Claudia Tebaldi ◽  
J. Dirk Iglehart ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Primary Tumors

PURPOSE: Axillary lymph node dissection (ALND) has been a standard procedure in the management of breast cancer. In a patient with a clinically negative axilla, ALND is performed primarily for staging purposes, to guide adjuvant treatment. Recently, the routine use of ALND has been questioned because the results of the procedure may not change the choice of adjuvant systemic therapy and/or the survival benefit of a change in adjuvant therapy would be small. We constructed a decision model to quantify the benefits of ALND for patients eligible for breast-conserving therapy. METHODS: Patients were grouped by age, tumor size, and estrogen receptor (ER) status. The model uses the Oxford overviews and three combined Cancer and Leukemia Group B studies. We assumed that patients who did not undergo ALND received axillary radiation therapy and that the two procedures are equally effective. All chemotherapy combinations were assumed to be equally efficacious. RESULTS: The largest benefits from ALND are seen in ER-positive women with small primary tumors who might not be candidates for adjuvant chemotherapy if their lymph nodes test negative. Virtually no benefit results in ER-negative women, almost all of whom would receive adjuvant chemotherapy. When adjusted for quality of life (QOL), ALND may have an overall negative impact. In general, the benefits of ALND increase with the expected severity of adjuvant therapy on QOL. CONCLUSION: Our model quantifies the benefits of ALND and assists decision making by patients and physicians. The results suggest that the routine use of ALND in breast cancer patients should be reassessed and may not be necessary in many patients.

scholarly journals ADEQUACY OF AXILLARY LYMPH NODE CLEARANCE IN BREAST CARCINOMA: ARE WE ACHIEVING THE RECOMMENDED STANDARDS?

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Dr. Subramaniyam Raviraj ◽  
Thileebphan Balasingam
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Axillary Lymph Node ◽  
Histopathological Analysis ◽  
Axillary Lymph ◽  
Tumor Type ◽  
True Negative ◽  
Cancer Management ◽  
Breast Cancer Management ◽  
Axillary Lymph Node Clearance

Introduction: In the setup of breast cancer management, axillary lymph node clearance plays a role in staging and planning of adjuvant chemotherapy and local control of cancer. Harvesting minimum of 10 lymph nodes for histopathological analysis is cut off value to consider a 90% certainty of a true negative axillary lymph node after axillary clearance. Aim: To assess the adequacy of axillary lymph node clearance considering influence of tumor factor (size, site, grade, type, lymphovascular invasion and hormonal and HER 2-NEU receptor status). Method: Retrospective analysis of histopathological report included 117 patients underwent mastectomy and axillary lymph node clearance from January 2011 to July 2016 in professorial surgical unit teaching hospital Jaffna. The analysis assessed the adequacy of the axillary lymph node clearance considering the influence of tumor factor. Results: Adequate axillary lymph node clearance was done in 89.7% (105). None of considered factors showed significance influence (p<0.05) except tumor type. Conclusion: Unit achieved desirable adequacy in axillary lymph node clearance, clearance adequacy is not associated with considered tumor factors except tumor type. Keywords: Axillary lymphnode clearance, Adequacy, Breast cancer, nodal status

scholarly journals Use of short-term drains in breast cancer patients undergoing axillary lymph node clearance

2013 ◽  
Vol 11 (8) ◽  
pp. 608
Author(s):  
Ankit Patel ◽  
Bryony Moore ◽  
Sue Jones ◽  
Peter Jones ◽  
Haresh Devalia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Axillary Lymph Node ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Short Term ◽  
Axillary Lymph Node Clearance

scholarly journals Is Axillary Lymph Node Clearance Indicated in Every Case of Breast Cancer?

2020 ◽  
Vol 88 (3) ◽  
pp. 375-380
Author(s):  
SHERIF ELPRINCE SAYED, M.D.; MAHMOUD S. AHMED, M.D. ◽  
ANWAR A. ELSHENAWY, M.D.; MOSTAFA ISMAEL HUSSEIN, M.Sc.
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Axillary Lymph Node ◽  
Axillary Lymph ◽  
Axillary Lymph Node Clearance

Impact of axillary lymph node dissection on the therapy of breast cancer patients.

1993 ◽  
Vol 11 (8) ◽  
pp. 1536-1544 ◽  
Author(s):  
P P Lin ◽  
D C Allison ◽  
J Wainstock ◽  
K D Miller ◽  
W C Dooley ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adjuvant Therapy ◽  
Cancer Patients ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Node Dissection

PURPOSE We studied a series of 283 breast cancer patients retrospectively to determine the actual benefits of axillary lymph node dissection (ALND) for these patients. PATIENTS AND METHODS The records of 283 women with invasive breast cancer treated between 1988 and 1990 were reviewed for histologic status of the axillary lymph nodes, tumor size, DNA content, hormone-receptor values, and actual adjuvant treatments received. RESULTS ALND was of possible therapeutic benefit for the 15% (43 of 283) of patients who had clinically positive nodes. Nodal metastases were found in 86% (37 of 43) of patients in this subgroup. ALND alone determined the indication for standard adjuvant therapy for a group of 31% (88 of 283) of patients who had favorable primary biopsy findings and clinically negative axillary nodes; ALND proved that 13% (11 of 88) of these latter patients had positive nodes. For 54% (152 of 283) of patients who had clinically negative nodes and unfavorable biopsies, ALND played no role in the decision as to whether standard adjuvant therapy was indicated. Only 5% (seven of 152) and 3% (four of 152) of these latter patients received radiation therapy and/or high-dose adjuvant chemotherapy, respectively, because of ALND. CONCLUSION The benefits of ALND vary greatly for different groups of breast cancer patients, and controlled studies may be needed to determine whether ALND is necessary for all breast cancer patients.

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