scholarly journals Surgical Technique can Prevent Arm Lymphoedema After Level III Clearance for Breast Cancer

2019 ◽  
Vol 21 (3) ◽  
pp. 210-213
Author(s):  
Saurav Kumar Ghosh ◽  
D.R. Burman
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Associated Factors ◽  
Axillary Vein ◽  
Nodal Metastases ◽  
Anterior Surface ◽  
Lymph Edema ◽  
Axillary Clearance ◽  
Arm Lymphoedema ◽  
Positive Breast Cancer

Clearance of the axillary tissue during operation is still the mainstay of treatment for node positive breast cancer. Level III axillary nodal clearance is supposed to increase the risk of lymph edema of arm, along with other factors. However, preservation of the fascia over the axillary vein during surgery reduces the risk of lymph edema greatly. In this study we measured the incidence of armlymphoedema that occured after Level III axillary clearance for breast cancer. During surgery, dissection over the anterior surface of axillary vein was limited to preserve the fascia covering axillaryvein. Other factors commonly implicated in the development of post-operative arm lymphoedema were also documented and their effect analysed. Forty three patients underwent operation for breast cancer including complete axillary clearance up to Level III. The incidence of lymphoedema was 25.5% (11 out of 43 patients). None of these patients had severe lymphoedema. On multivariate analysis, no other associated factors like BMI, chemotherapy and nodal metastases had any bearing on the development of lymph edema. We conclude that Level III axillary clearance of axilla is safe and not excessively morbid in terms of developing arm lymphoedema provided the fascia over axillary veinis preserved.

Randomized Trial of Low-Dose Chemotherapy Added to Tamoxifen in Patients With Receptor-Positive and Lymph Node–Positive Breast Cancer

1999 ◽  
Vol 17 (6) ◽  
pp. 1701-1701 ◽  
Author(s):  
R. Jakesz ◽  
H. Hausmaninger ◽  
K. Haider ◽  
E. Kubista ◽  
H. Samonigg ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Hormone Receptor ◽  
Low Dose ◽  
Premenopausal Patients ◽  
Low Dose Chemotherapy ◽  
Disease Free ◽  
Positive Breast Cancer

PURPOSE: To evaluate the outcome in patients with stage II hormone receptor–positive breast cancer treated or not treated with low-dose, short-term chemotherapy in addition to tamoxifen in terms of disease-free and overall survival. PATIENTS AND METHODS: A total of 613 patients were randomized to receive either low-dose chemotherapy (doxorubicin 20 mg/m2 and vincristine 1 mg/m2 on day 1; cyclophosphamide 300 mg/m2; methotrexate 25 mg/m2; and fluorouracil 600 mg/m2 on days 29 and 36 intravenously) or no chemotherapy in addition to 20 mg of tamoxifen orally for 2 years. A third group without any treatment (postmenopausal patients only) was terminated after the accrual of 79 patients due to ethical reasons. RESULTS: After a median follow-up period of 7.5 years, the addition of chemotherapy did not improve the outcome in patients as compared with those treated with tamoxifen alone, neither with respect to disease-free nor overall survival. Multivariate analysis of prognostic factors for disease-free survival revealed menopausal status, in addition to nodal status, progesterone receptor, and histologic grade as significant. Both untreated postmenopausal and tamoxifen-treated premenopausal patients showed identical prognoses significantly inferior to the tamoxifen-treated postmenopausal cohort. Prognostic factors for overall survival in the multivariate analysis showed nodal and tumor stage, tumor grade, and hormone receptor level as significant. CONCLUSION: Low-dose chemotherapy in addition to tamoxifen does not improve the prognosis of stage II breast cancer patients with hormone-responsive tumors. Tamoxifen-treated postmenopausal patients show a significantly better prognosis than premenopausal patients, favoring the hypothesis of a more pronounced effect of tamoxifen in the older age groups.

scholarly journals Internal Mammary Node Irradiation in Node-Positive Breast Cancer Treated with Mastectomy and Taxane-Based Chemotherapy

2021 ◽  
Author(s):  
Won Kyung Cho ◽  
Jee Suk Chang ◽  
Seung Gyu Park ◽  
Nalee Kim ◽  
Doo Ho Choi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Locoregional Recurrence ◽  
Disease Free Survival ◽  
Internal Mammary Node ◽  
Free Survival ◽  
Node Positive ◽  
Internal Mammary ◽  
Positive Breast Cancer

Abstract Purpose: It is important to continually reevaluate the risk/benefit calculus of internal mammary node irradiation (IMNI) in the era of modern systemic therapy. We aimed to investigate the effect of IMNI on survival in node-positive breast cancer treated with mastectomy and anthracycline plus taxane-based chemotherapy.Methods and Materials: We analyzed 348 patients who underwent mastectomy and anthracycline plus taxane-based chemotherapy for node-positive breast cancer between January 2006 and December 2011. All patients received adjuvant radiotherapy with IMNI (n = 105, 30.2%) or without IMNI (n = 243, 69.8%). The benefit of IMNI for disease-free survival (DFS) and overall survival (OS) was evaluated using multivariate analysis and inverse probability of treatment weighting (IPTW) to adjust for unbalanced covariates between the groups.Results: After a median follow-up of 95 months, the 10-year locoregional recurrence-free survival rate, DFS, and OS in all patients were 94.8%, 77.4%, and 86.2%, respectively. The IPTW-adjusted hazard ratio (HR) for the association of IMNI (vs. no IMNI) with DFS and OS was 0.208 (95% confidence intervals (CI) 0.045–0.966) and 0.460 (95% CI, 0.220-0.962). In multivariate analysis, IMNI was a favorable factor for DFS (HR, 0.458; p = 0.021) and OS (HR 0.233, p = 0.018).Conclusions: IMNI was associated with improved DFS and OS in node-positive patients treated with mastectomy, post-mastectomy radiation therapy, and taxane-based chemotherapy, although the rate of locoregional recurrence was low.

NODE-POSITIVE BREAST CANCER: A COMPARISON OF CLINICAL AND PATHOLOGICAL FINDINGS AND ASSESSMENT OF AXILLARY CLEARANCE

1980 ◽  
Vol 50 (6) ◽  
pp. 580-583 ◽  
Author(s):  
Paul R. B. Kitchen ◽  
Roger Mclennan ◽  
Adrienne Mursell
Keyword(s):  
Breast Cancer ◽  
Pathological Findings ◽  
Axillary Clearance ◽  
Node Positive ◽  
Positive Breast Cancer

scholarly journals Negative axillary clearance in sentinel node positive breast cancer

2015 ◽  
Vol 23 ◽  
pp. S27
Author(s):  
S.N. Rupasinghe ◽  
R. Dean ◽  
R. Vinayagam ◽  
J.M. Lund ◽  
M. Callaghan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Sentinel Node ◽  
Axillary Clearance ◽  
Node Positive ◽  
Positive Breast Cancer

Review of treatment strategies for HER2 positive breast cancer and their implementation in a major Swiss hospital

2020 ◽  
Author(s):  
F Geissler ◽  
M Vetter ◽  
A Schoetzau ◽  
C Montavon ◽  
C Kurzeder ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Strategies ◽  
Her2 Positive ◽  
Her2 Positive Breast Cancer ◽  
Positive Breast Cancer
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