nach oben

Erschienen in:

24.06.2019 | Clinical trial

Non-sentinel axillary tumor burden applying the ACOSOG Z0011 eligibility criteria to a large routine cohort

verfasst von: Fabian Riedel, Jörg Heil, Manuel Feißt, Mahdi Rezai, Mareike Moderow, Christof Sohn, Florian Schütz, Michael Golatta, André Hennigs

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 2/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

In the ACOSOG Z0011 trial, patients with primary breast cancer (BC) and 1–2 tumor-involved sentinel lymph nodes (SLN) undergoing breast-conserving surgery gained no benefit from completing axillary lymph node dissection (cALND). This paper reports cALND rates performed in clinical routine on patients who would meet the Z0011 criteria. Further, patients still received cALND were analyzed concerning the number of non-sentinel metastases (NSM) to estimate occult axillary tumor burden.

Methods

Data were retrospectively analyzed from patients treated in 179 German breast centers between 2008 and 2015. Time-trend rates were determined for cALND regarding the presence of axillary macrometastases or micrometastases. Descriptive statistics were used to report the number of NSM depending on the number of SLN removed, tumor-involved SLN, tumor stage (pT1–2), and immunohistochemical subtype. Factors associated with NSM were identified using multivariable logistic regression.

Results

Altogether, data for 188,909 patients were available, of whom 13,741 (7.3%) were identified eligible for the Z0011 criteria. For these patients, the cALND rate for macrometastases declined from 96.4% in 2008 to 49.7% in 2015, for micrometastases from 86.7 to 5.9%. In total 9773 patients still received cALND, 33.4% of whom had NSM. The NSM rates were: 38.8% for pN(1/1sn), 28.6% for pN(1/2sn), and 50.9% for pN(2/2sn). Hormone receptor (HR) positive/HER2+ showed the highest NSM rate (41.6%), HR−/HER2− the lowest rate (29.4%).

Conclusions

The rate of cALND for ACOSOG Z0011 eligible patients has decreased substantially in routine care in our nationwide cohort. Our data reveal a relatively high prevalence of additional axillary NSM tumor burden.

Whelan TJ, Olivotto IA, Parulekar WR, Ackerman I, Chua BH, Nabid A et al (2015) Regional nodal irradiation in early-stage breast cancer. N Engl J Med 373(4):307–316CrossRefPubMedPubMedCentral

Moebus V, Jackisch C, Lueck HJ, du Bois A, Thomssen C, Kurbacher C et al (2010) Intense dose-dense sequential chemotherapy with epirubicin, paclitaxel, and cyclophosphamide compared with conventionally scheduled chemotherapy in high-risk primary breast cancer: mature results of an AGO phase III study. J Clin Oncol 28(17):2874–2880CrossRefPubMed

Network NCC (2016) NCCN clinical practice guidelines in oncology (NCCN Guidelines). Breast Cancer 2016. 1

Perou CM, Sorlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA et al (2000) Molecular portraits of human breast tumours. Nature 406(6797):747–752CrossRefPubMed

Cardoso F, van’t Veer LJ, Bogaerts J, Slaets L, Viale G, Delaloge S et al (2016) 70-gene signature as an aid to treatment decisions in early-stage breast cancer. N Engl J Med 375(8):717–729CrossRefPubMed

Gluz O, Nitz UA, Christgen M, Kates RE, Shak S, Clemens M et al (2016) West German Study Group Phase III PlanB trial: first prospective outcome data for the 21-gene recurrence score assay and concordance of prognostic markers by central and local pathology assessment. J Clin Oncol 34(20):2341–2349CrossRefPubMed

Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V et al (2003) A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med 349(6):546–553CrossRefPubMed

Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Costantino JP et al (2010) Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncol 11(10):927–933CrossRefPubMedPubMedCentral

DiSipio T, Rye S, Newman B, Hayes S (2013) Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol 14(6):500–515CrossRefPubMed

10.

Giuliano AE, McCall L, Beitsch P, Whitworth PW, Blumencranz P, Leitch AM et al (2010) Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons Oncology Group Z0011 randomized trial. Ann Surg 252(3):426–432 (discussion 32-3) PubMed

11.

Giuliano AE, Ballman K, McCall L, Beitsch P, Whitworth PW, Blumencranz P et al (2016) Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: long-term follow-up from the American College of Surgeons Oncology Group (Alliance) ACOSOG Z0011 randomized trial. Ann Surg 264(3):413–420CrossRefPubMed

12.

Giuliano AE, Ballman KV, McCall L, Beitsch PD, Brennan MB, Kelemen PR et al (2017) Effect of axillary dissection vs no axillary dissection on 10-year overall survival among women with invasive breast cancer and sentinel node metastasis: the ACOSOG Z0011 (Alliance) randomized clinical trial. JAMA 318(10):918–926CrossRefPubMedPubMedCentral

13.

Maguire A, Brogi E (2016) Sentinel lymph nodes for breast carcinoma: a paradigm shift. Arch Pathol Lab Med 140(8):791–798CrossRefPubMedPubMedCentral

14.

Guth U, Myrick ME, Viehl CT, Schmid SM, Obermann EC, Weber WP (2012) The post ACOSOG Z0011 era: does our new understanding of breast cancer really change clinical practice? Eur J Surg Oncol 38(8):645–650CrossRefPubMed

15.

Shah-Khan M, Boughey JC (2012) Evolution of axillary nodal staging in breast cancer: clinical implications of the ACOSOG Z0011 trial. Cancer Control 19(4):267–276CrossRefPubMed

16.

Morrow M, Giuliano AE (2011) To cut is to cure: can we really apply Z11 in practice? Ann Surg Oncol 18(9):2413–2415CrossRefPubMed

17.

Galimberti V, Cole BF, Zurrida S, Viale G, Luini A, Veronesi P et al (2013) Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol 14(4):297–305CrossRefPubMedPubMedCentral

18.

Galimberti V, Cole BF, Viale G, Veronesi P, Vicini E, Intra M et al (2018) Axillary dissection versus no axillary dissection in patients with breast cancer and sentinel-node micrometastases (IBCSG 23-01): 10-year follow-up of a randomised, controlled phase 3 trial. Lancet Oncol 19(10):1385–1393CrossRefPubMed

19.

Donker M, van Tienhoven G, Straver ME, Meijnen P, van de Velde CJ, Mansel RE et al (2014) Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol 15(12):1303–1310CrossRefPubMedPubMedCentral

20.

Savolt A, Peley G, Polgar C, Udvarhelyi N, Rubovszky G, Kovacs E et al (2017) Eight-year follow up result of the OTOASOR trial: the Optimal Treatment Of the Axilla - Surgery Or Radiotherapy after positive sentinel lymph node biopsy in early-stage breast cancer: a randomized, single centre, phase III, non-inferiority trial. Eur J Surg Oncol 43(4):672–679CrossRefPubMed

21.

Riedel F, Heil J, Golatta M, Schaefgen B, Hug S, Schott S et al (2018) Changes of breast and axillary surgery patterns in patients with primary breast cancer during the past decade. Arch Gynecol Obstet 299(4):1043–1053CrossRefPubMed

22.

Wockel A, Festl J, Stuber T, Brust K, Stangl S, Heuschmann PU et al (2018) Interdisciplinary screening, diagnosis, therapy and follow-up of breast cancer. Guideline of the DGGG and the DKG (S3-Level, AWMF Registry Number 032/045OL, December 2017) - Part 1 with Recommendations for the Screening, Diagnosis and Therapy of Breast Cancer. Geburtshilfe Frauenheilkd 78(10):927–948CrossRefPubMedPubMedCentral

23.

Gradishar WJ, Anderson BO, Balassanian R, Blair SL, Burstein HJ, Cyr A et al (2017) NCCN guidelines insights: breast cancer, version 1.2017. J Natl Compr Cancer Netw 15(4):433–451CrossRef

24.

WBC, Westdeutsches Brust-Centrum GmbH (2015) Benchmarking WBC - 2014, Jahresbericht, Kennzahlen

25.

Hennigs A, Kopke M, Feisst M, Riedel F, Rezai M, Nitz U et al (2019) Which patients with sentinel node-positive breast cancer after breast conservation still receive completion axillary lymph node dissection in routine clinical practice? Breast Cancer Res Treat 173(2):429–438CrossRefPubMed

26.

Goldhirsch A, Wood WC, Coates AS, Gelber RD, Thurlimann B, Senn HJ (2011) Strategies for subtypes–dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol 22(8):1736–1747CrossRefPubMedPubMedCentral

27.

Hennigs A, Riedel F, Gondos A, Sinn P, Schirmacher P, Marmé F et al (2016) Prognosis of breast cancer molecular subtypes in routine clinical care: a large prospective cohort study. BMC Cancer 16(1):1–9CrossRef

28.

Dengel LT, Van Zee KJ, King TA, Stempel M, Cody HS, El-Tamer M et al (2014) Axillary dissection can be avoided in the majority of clinically node-negative patients undergoing breast-conserving therapy. Ann Surg Oncol 21(1):22–27CrossRefPubMed

29.

Yao K, Liederbach E, Pesce C, Wang CH, Winchester DJ (2015) Impact of the American College of Surgeons Oncology Group Z0011 randomized trial on the number of axillary nodes removed for patients with early-stage breast cancer. J Am Coll Surg 221(1):71–81CrossRefPubMed

30.

Poodt IGM, Spronk PER, Vugts G, van Dalen T, Peeters M, Rots ML et al (2018) Trends on axillary surgery in nondistant metastatic breast cancer patients treated between 2011 and 2015: a Dutch Population-based Study in the ACOSOG-Z0011 and AMAROS Era. Ann Surg 268(6):1084–1090CrossRefPubMed

31.

Gondos A, Jansen L, Heil J, Schneeweiss A, Voogd AC, Frisell J et al (2016) Time trends in axilla management among early breast cancer patients: persisting major variation in clinical practice across European centers. Acta Oncol 55(6):712–719CrossRefPubMed

32.

Naidoo K, Pinder SE (2017) Micro- and macro-metastasis in the axillary lymph node: a review. Surgeon 15(2):76–82CrossRefPubMed

33.

Bauerfeind I, Kümmel S. (Working Group Gynecological Oncology) (2011) Diagnosis and treatment of patients with primary and metastatic breast cancer: Guidelines of the AGO Breast Commission. 03/2011

34.

Yi M, Kuerer HM, Mittendorf EA, Hwang RF, Caudle AS, Bedrosian I et al (2013) Impact of the American College of Surgeons Oncology Group Z0011 criteria applied to a contemporary patient population. J Am Coll Surg 216(1):105–113CrossRefPubMed

35.

Tsao MW, Cornacchi SD, Hodgson N, Simunovic M, Thabane L, Cheng J et al (2016) A population-based study of the effects of a regional guideline for completion axillary lymph node dissection on axillary surgery in patients with breast cancer. Ann Surg Oncol 23(10):3354–3364CrossRefPubMed

36.

Freedman GM, Fowble BL, Li T, Hwang ES, Schechter N, Devarajan K et al (2014) Risk of positive nonsentinel nodes in women with 1-2 positive sentinel nodes related to age and molecular subtype approximated by receptor status. Breast J 20(4):358–363CrossRefPubMedPubMedCentral

37.

Millar EK, Graham PH, O’Toole SA, McNeil CM, Browne L, Morey AL et al (2009) Prediction of local recurrence, distant metastases, and death after breast-conserving therapy in early-stage invasive breast cancer using a five-biomarker panel. J Clin Oncol 27(28):4701–4708CrossRefPubMed

38.

Wiechmann L, Sampson M, Stempel M, Jacks LM, Patil SM, King T et al (2009) presenting features of breast cancer differ by molecular subtype. Ann Surg Oncol 16(10):2705–2710CrossRefPubMed

39.

Gangi A, Mirocha J, Leong T, Giuliano AE (2014) Triple-negative breast cancer is not associated with increased likelihood of nodal metastases. Ann Surg Oncol 21(13):4098–4103CrossRefPubMed

40.

Gianni L, Pienkowski T, Im YH, Tseng LM, Liu MC, Lluch A et al (2016) 5-year analysis of neoadjuvant pertuzumab and trastuzumab in patients with locally advanced, inflammatory, or early-stage HER2-positive breast cancer (NeoSphere): a multicentre, open-label, phase 2 randomised trial. Lancet Oncol 17(6):791–800CrossRefPubMed

41.

Hennigs A, Riedel F, Marme F, Sinn P, Lindel K, Gondos A et al (2016) Changes in chemotherapy usage and outcome of early breast cancer patients in the last decade. Breast Cancer Res Treat 160(3):491–499CrossRefPubMedPubMedCentral

42.

Savolt A, Polgar C, Musonda P, Matrai Z, Renyi-Vamos F, Toth L et al (2013) Does the result of completion axillary lymph node dissection influence the recommendation for adjuvant treatment in sentinel lymph node-positive patients? Clin Breast Cancer 13(5):364–370CrossRefPubMed

43.

Poodt IGM, Rots ML, Vugts G, van Dalen T, Kuijer A, Vriens BEPJ et al (2018) The administration of adjuvant chemo(-immuno) therapy in the post ACOSOG-Z0011 era; a population based study. Eur J Surg Oncol 44(8):1151–1156CrossRefPubMed

44.

Aigner J, Smetanay K, Hof H, Sinn HP, Sohn C, Schneeweiss A et al (2013) Omission of axillary dissection according to ACOSOG Z0011: impact on adjuvant treatment recommendations. Ann Surg Oncol 20(5):1538–1544CrossRefPubMed

45.

Lucci A, McCall LM, Beitsch PD, Whitworth PW, Reintgen DS, Blumencranz PW et al (2007) Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011. J Clin Oncol 25(24):3657–3663CrossRefPubMed

Titel: Non-sentinel axillary tumor burden applying the ACOSOG Z0011 eligibility criteria to a large routine cohort
verfasst von: Fabian Riedel
Jörg Heil
Manuel Feißt
Mahdi Rezai
Mareike Moderow
Christof Sohn
Florian Schütz
Michael Golatta
André Hennigs
Publikationsdatum: 24.06.2019
Verlag: Springer US
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 2/2019
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-019-05327-4

Neu im Fachgebiet Onkologie

18.04.2024 | Wirbelsäulenmetastase | Nachrichten

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Non-sentinel axillary tumor burden applying the ACOSOG Z0011 eligibility criteria to a large routine cohort

Abstract

Purpose

Methods

Results

Conclusions

Neu im Fachgebiet Onkologie

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Adjuvante Brustkrebstherapie: Doppelt hält besser

Manche Gestagene können das Risiko für Meningeome erhöhen

Einladung zum PSA-Screening senkt die Krebssterblichkeit

Update Onkologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2019

Associations between mammographic density and tumor characteristics in Chinese women with breast cancer

Effects of high-intensity interval training on vascular endothelial function and vascular wall thickness in breast cancer patients receiving anthracycline-based chemotherapy: a randomized pilot study

Do clinical trials truly mirror their target population? An external validity analysis of national register versus trial data from the Swedish prospective SENOMIC trial on sentinel node micrometastases in breast cancer

Treatment and survival of Asian women diagnosed with breast cancer in New Zealand

Dietary intake from birth through adolescence in relation to risk of benign breast disease in young women

Adherence to anti-estrogen therapy in women with hormone receptor-positive breast cancer utilizing bubble packaging: a pilot study

Neu im Fachgebiet Onkologie

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Adjuvante Brustkrebstherapie: Doppelt hält besser

Manche Gestagene können das Risiko für Meningeome erhöhen

Einladung zum PSA-Screening senkt die Krebssterblichkeit

Update Onkologie