Erschienen in:
16.08.2022 | ASO Author Reflections
ASO Author Reflections: Avoiding Overtreatment: Benefits of Selective Use of Frozen Sections Among cN0 Breast Cancer Patients Having Upfront Mastectomy
verfasst von:
Austin D. Williams, MD, MSEd, Anita Mamtani, MD
Erschienen in:
Annals of Surgical Oncology
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Ausgabe 13/2022
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Excerpt
The AMAROS and OTOASOR trials have demonstrated that axillary radiotherapy is associated with equivalent outcomes when compared with axillary lymph node dissection (ALND) among clinically node-negative (cN0) patients with one to two positive sentinel lymph nodes (SLNs) who undergo upfront surgery.
1,2 Traditionally, ALND has been performed for any SLN macrometastasis identified in patients undergoing upfront mastectomy, although in patients with limited nodal disease for whom postmastectomy radiation and regional nodal irradiation (PMRT) is indicated, ALND may be omitted. In the absence of consensus guidelines, it has been challenging to identify patients who will require PMRT, leading to substantial overtreatment with ALND+PMRT, which is associated with a significantly increased risk of lymphedema.
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