Erschienen in:
21.05.2020 | ASO Author Reflections
ASO Author Reflections: Refining Risk Assessment in Node-Positive Breast Cancer Patients Eligible for Sentinel Lymph Node Biopsy Alone
verfasst von:
Anita Mamtani, MD, Monica Morrow, MD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 10/2020
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Excerpt
The American College of Surgeons Oncology Group (ACOSOG) Z0011 trial transformed the treatment of early-stage breast cancers by demonstrating the safety of omitting axillary dissection (ALND) for T1-T2, clinically node-negative (T1-T2cN0) patients with one or two positive sentinel nodes (SLNs) undergoing breast-conservation therapy.
1 Adoption of this approach has maintained excellent oncologic outcomes while avoiding overtreatment in the axilla by using a multidisciplinary approach to achieve locoregional control for patients with limited nodal disease. However, in the modern era of surgical de-escalation, it remains crucial to accurately identify patients at highest risk of a significant residual nodal disease burden and to individualize treatment when appropriate. High-risk features not examined in early trials, such as microscopic extracapsular extension (mECE), have been associated with an increased residual nodal burden for patients with limited SLN metastases.
2,3 This study sought to examine the significance of extranodal tumor deposits (ETDs) in the axillary fat of such patients, something unknown before the current study.
4 …
