Erschienen in:
01.11.2012 | Breast Oncology
Does the Rapid Acceptance of ACOSOG Z0011 Compromise Selection of Systemic Therapy?
verfasst von:
Hiram S. Cody III, MD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 12/2012
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Excerpt
The acceptance of sentinel lymph node (SLN) biopsy as standard care in cN0 breast cancer is one of the great success stories in contemporary surgical oncology and is supported by the results of at least 69 observational studies, 7 randomized trials, and extensive literature covering all aspects of the procedure.
1,
2 The logical next question in the evolution of axillary staging is to ask whether all SLN-positive patients require axillary lymph node dissection (ALND), and it is clear that for many American surgeons they do not. In a retrospective study from the National Cancer Data Base, Bilimoria et al. report on 97,314 SLN-positive patients treated nationwide between 1998 and 2006.
3 They show 23 % of patients with SLN macrometastases (>2 mm, pN1) and 55 % with SLN micrometastases (0.2–2 mm, pN1mi) did not have ALND, yet for both pN1 and pN1mi SLN disease, axillary local recurrence and 5-year relative survival were the same with or without ALND. …
