Potential impact of application to the Z0011 trial on the omission of axillary lymph node dissection in women undergoing sentinel node biopsy: a retrospective cohort study

Abstract Objectives: To evaluate the number of patients with early-stage breast cancer who could benefit from the omission of axillary surgery following the application of ACOSOG Z0011 trial criteria.Results: A total of 384 patients underwent breast-conserving surgery and sentinel lymph node biopsy. Of the total number of patients, 86 women underwent axillary lymph node dissection for metastatic sentinel lymph nodes. One patient underwent axillary node dissection due to a suspicious SLN intra-operatively. Among these patients, 82/87 (94.3%) had one to two involved sentinel lymph nodes and met criteria for the ACOSOG Z0011 trial with the omission of axillary lymph node dissection. Among the 82 eligible women, there were only 13 cases (15.9%) of lymphovascular invasion and 62 cases (75.6%) of tumors measuring up to 2cm in diameter (T1). The high rate of patients who met criteria for the ACOSOG Z0011 trial may be explained by the large number of patients with disease of a favorable prognosis. ACOSOG Z0011 trial criteria can be applied to a select group of SLN-positive patients, reducing the costs and morbidities of breast cancer surgery.

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Is completion axillary lymph node dissection necessary in patients who are underrepresented in the ACOSOG Z0011 trial?

Advances in Radiation Oncology ◽

10.1016/j.adro.2018.03.004 ◽

2018 ◽

Vol 3 (3) ◽

pp. 258-264 ◽

Cited By ~ 6

Author(s):

Brian J. Gebhardt ◽

Joel Thomas ◽

Zachary D. Horne ◽

Colin E. Champ ◽

Daniel J. Farrugia ◽

...

Keyword(s):

Lymph Node ◽

Axillary Lymph Node Dissection ◽

Lymph Node Dissection ◽

Axillary Lymph Node ◽

Axillary Lymph ◽

Node Dissection ◽

Acosog Z0011 ◽

Z0011 Trial

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Potential impact of application to the Z0011 trial on the omission of axillary lymph node dissection in women undergoing sentinel node biopsy: a retrospective cohort study

10.21203/rs.2.13474/v2 ◽

2020 ◽

Author(s):

Julia Yoriko Shinzato ◽

Katia Piton Serra ◽

Caroline Eugeni ◽

Cesar Cabello ◽

Cassio Cardoso Filho ◽

...

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Axillary Lymph Node Dissection ◽

Lymph Node Dissection ◽

Axillary Lymph Node ◽

Sentinel Lymph Nodes ◽

Axillary Lymph ◽

Node Dissection ◽

Acosog Z0011 ◽

Z0011 Trial

Abstract Background To evaluate the number of patients with early-stage breast cancer, undergoing axillary lymph node dissection for metastatic sentinel lymph nodes, who could benefit from the omission of axillary surgery following the application of ACOSOG Z0011 trial criteria. Methods A retrospective cohort study conducted in the Women’s Hospital of the State University of Campinas. The study population included 384 women diagnosed with early-stage invasive breast cancer, clinically negative axilla, treated with breast-conserving surgery and sentinel lymph node biopsy, radiation therapy, chemotherapy and/or endocrine therapy, from January 2005 to December 2010. ACOSOG Z0011 trial criteria were applied to this population and statistical analysis was carried out to make a comparison between populations. Results A total of 384 patients underwent breast-conserving surgery and sentinel lymph node biopsy. Of the total number of patients, 86 women underwent axillary lymph node dissection for metastatic sentinel lymph nodes. One patient underwent axillary node dissection due to a suspicious SLN intra-operatively. Among these patients, 82/87 (94.3%) had one to two involved sentinel lymph nodes and met criteria for the ACOSOG Z0011 trial with the omission of axillary lymph node dissection. Among the 82 eligible women, there were only 13 cases (15.9%) of lymphovascular invasion and 62 cases (75.6%) of tumors measuring up to 2cm in diameter (T1). Conclusions When eligibility for ACOSOG Z0011 trial criteria was retrospectively exported to our study population, 94.3% of the patients with one to two positive sentinel lymph nodes would benefit from the omission of axillary lymph node dissection. The high rate in our study may be explained by the large number of patients with tumors up to 2.0 cm in size and the small rate of lymphovascular invasion, which are indicative of a favorable prognosis.

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Potential impact of application to the Z0011 trial on the omission of axillary lymph node dissection in women undergoing sentinel node biopsy: a retrospective cohort study

10.21203/rs.2.13474/v1 ◽

2019 ◽

Author(s):

Julia Yoriko Shinzato ◽

Katia Piton Serra ◽

Caroline Eugeni ◽

Cesar Cabello ◽

Cassio Cardoso Filho ◽

...

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Axillary Lymph Node Dissection ◽

Lymph Node Dissection ◽

Axillary Lymph Node ◽

Sentinel Lymph Nodes ◽

Axillary Lymph ◽

Node Dissection ◽

Acosog Z0011 ◽

Z0011 Trial

Abstract Background To evaluate the number of patients with early-stage breast cancer, undergoing axillary lymph node dissection for metastatic sentinel lymph nodes, who could benefit from the omission of axillary surgery following the application of ACOSOG Z0011 trial criteria.Methods A retrospective cohort study conducted in the Women’s Hospital of the State University of Campinas. The study population included 384 women diagnosed with early-stage invasive breast cancer, clinically negative axilla, treated with breast-conserving surgery and sentinel lymph node biopsy, radiation therapy, chemotherapy and/or endocrine therapy, from January 2005 to December 2010. ACOSOG Z0011 trial criteria were applied to this population and statistical analysis was carried out to make a comparison between populations.Results A total of 384 patients underwent breast-conserving surgery and sentinel lymph node biopsy. Of the total number of patients, 86 women underwent axillary lymph node dissection for metastatic sentinel lymph nodes. One patient underwent axillary node dissection due to a suspicious SLN intra-operatively. Among these patients, 82/87 (94.3%) had one to two involved sentinel lymph nodes and met criteria for the ACOSOG Z0011 trial with the omission of axillary lymph node dissection. Among the 82 eligible women, there were only 13 cases (15.9%) of lymphovascular invasion and 62 cases (75.6%) of tumors measuring up to 2cm in diameter (T1).Conclusions When eligibility for ACOSOG Z0011 trial criteria was retrospectively exported to our study population, 94.3% of the patients with one to two positive sentinel lymph nodes would benefit from the omission of axillary lymph node dissection. The high rate in our study may be explained by the large number of patients with tumors up to 2.0 cm in size and the small rate of lymphovascular invasion, which are indicative of a favorable prognosis.

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Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy

European Journal of Surgical Oncology ◽

10.1053/ejso.2002.1385 ◽

2003 ◽

Vol 29 (4) ◽

pp. 341-350 ◽

Cited By ~ 192

Author(s):

M.P. Schijven ◽

A.J.J.M. Vingerhoets ◽

H.J.T. Rutten ◽

G.A.P. Nieuwenhuijzen ◽

R.M.H. Roumen ◽

...

Keyword(s):

Lymph Node ◽

Sentinel Node ◽

Sentinel Node Biopsy ◽

Axillary Lymph Node Dissection ◽

Lymph Node Dissection ◽

Axillary Lymph Node ◽

Axillary Lymph ◽

Node Dissection ◽

Node Biopsy

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Quality of Life After Sentinel Lymph Node Biopsy Versus Complete Axillary Lymph Node Dissection in Early Breast Cancer: A 3-Year Follow-up Study

Medicina ◽

10.3390/medicina49030018 ◽

2018 ◽

Vol 49 (3) ◽

pp. 18

Author(s):

Algirdas Boguševičius ◽

Daiva Čepulienė

Keyword(s):

Lymph Node ◽

Sentinel Lymph Node ◽

Sentinel Lymph Node Biopsy ◽

Axillary Lymph Node Dissection ◽

Lymph Node Dissection ◽

Axillary Lymph Node ◽

Lymph Node Biopsy ◽

Axillary Lymph ◽

Node Dissection ◽

Node Biopsy

Background and Objectives. The rating of life quality may belong to the method of surgical treatment: after the axillary lymph node dissection patients may suffer from arm symptoms; after sentinel lymph node biopsy women may highlight the anxiety about the success of radical treatment. The aim was to assess the influence of sentinel lymph node biopsy on the quality of life of the patients with early stage breast cancer compared with total axillary lymph node dissection. Material and Methods. In a prospective case-control study, 48 patients with early invasive breast cancer and no evidence of lymph nodes involvement underwent breast conserving surgery with sentinel lymph node biopsy. They were grouped as matched pairs with the patients who underwert axillary lymph node dissection, according to the age, TNM stage, localization, hormonal receptor status, and surgical characteristics. Quality of life was evaluated using the QLQ-C30 and QLQ-BR-23 questionnaires before surgery and after 1, 3, 6, 12, and 36 months. Results. The patients who underwent sentinel lymph node biopsy scored better on the emotional functioning, pain, sexual functioning, and future perspective scales in comparison with those who underwent axillary lymph node dissection. The score on the arm symptom scale remained significantly better in the sentinel lymph node biopsy group than the axillary lymph node dissection group within the overall follow-up period. Conclusions. The women who underwent sentinel lymph node biopsy experienced better quality of life than the patients who underwent axillary lymph node dissection.

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