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Breast J. 2016 Jul;22(4):413-9. doi: 10.1111/tbj.12595. Epub 2016 Apr 20.

Management of Early Node-Positive Breast Cancer in Australia: A Multicentre Study.

Author information

1
The Breast Service, The Royal Melbourne Hospital & The Royal Women's Hospital, Parkville, Victoria, Australia.
2
Department of Surgery, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
3
Focus Pathology, East Melbourne, Victoria, Australia.
4
Department of Surgery, The Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.
5
Department of Surgery, Monash Medical Centre, Clayton, Victoria, Australia.
6
Department of Surgery, The Austin Hospital, Heidelberg, Victoria, Australia.
7
Department of Surgery, The Alfred Hospital, Melbourne, Victoria, Australia.
8
Department of Surgery, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
9
Melbourne EpiCentre, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.
10
Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia.

Abstract

To examine practice patterns for breast cancer patients with limited sentinel node (SN) disease in light of the ACOSOG Z0011 results. Retrospective analysis of patients with T1-2 breast cancer and positive sentinel lymph node biopsy (SLNB) admitted between January 2009 and December 2012. Patient demographics, tumor characteristics, and treatments were recorded. Eight hundred positive SLNBs were identified. A total of 452 (56.5%) proceeded to completion axillary lymph node dissection (cALND). cALND rate decreased from 65.1% to 49.7% from 2009-2010 to 2011-2012. cALND was performed for micrometastasis or isolated tumor cells in 39.3% in 2009-2010 and 22.2% in 2011-2012, whereas for macrometastases the rates were 83.1% and 68.6%, respectively. cALND rates diminished for both Z0011-eligible and -ineligible patients. The ACOSOG Z0011 trial presentation and publication coincided with a reduction in cALND for breast cancer with limited nodal disease. There appears equipoise regarding management of macrometastatic SN disease.

KEYWORDS:

ACOSOG Z0011 trial; axillary lymph node dissection; breast cancer; sentinel lymph node biopsy

PMID:
27095381
DOI:
10.1111/tbj.12595
[Indexed for MEDLINE]

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