5-year oncological outcomes of targeted axillary sampling in pT1-2N1 breast cancer

Lee, Jeeyeon; Jung, Jin Hyang; Kim, Wan Wook; Lee, Ryu Kyung; Kim, Hye Jung; Kim, Won Hwa; Park, Jiyoung; Lee, Jeong Eon; Chae, Yee Soo; Lee, Soo Jung; Park, Shin‐Hyung; Kim, Mi Young; Yang, Jung Dug; Lee, Jeong Woo; Lee, Joon Seok; Park, Ho Yong

doi:10.1016/j.asjsur.2018.10.004

Cited by 12 publications

(12 citation statements)

References 32 publications

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“…Using currently available data 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , the AGO has evaluated the following procedures to reduce false negative rates during the surgical staging of cases who are pN+ CNB before NACT and ycN0 after NACT with AGO + ( Fig. 1 ):…”

Section: Surgical Management Of the Axilla After Neoadjuvant Chemotherapymentioning

confidence: 99%

“…Basierend auf der derzeitigen Datenlage 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 bewertet die AGO folgende Verfahren zur Verringerung der Falsch-negativ-Rate des operativen Stagings bei pN+ CNB vor NACT und ycN0 nach NACT mit AGO + ( Abb. 1 ):…”

Section: Empfehlung Der Ago Kommission Mamma Zur Verringerung Der Falsch-negativ-rate Des Operativen Stagings Bei Stanzbioptisch Gesicherunclassified

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AGO Recommendations for the Surgical Therapy of the Axilla After Neoadjuvant Chemotherapy: 2021 Update

Friedrich

Kühn

Janni

et al. 2021

Geburtshilfe Frauenheilkd

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For many decades, the standard procedure to treat breast cancer included complete dissection of the axillary lymph nodes. The aim was to determine histological node status, which was then used as the basis for adjuvant therapy, and to ensure locoregional tumour control. In addition to the debate on how to optimise the therapeutic strategies of systemic treatment and radiotherapy, the current discussion focuses on improving surgical procedures to treat breast cancer. As neoadjuvant chemotherapy is becoming increasingly important, the surgical procedures used to treat breast cancer, whether they are breast surgery or axillary dissection, are changing. Based on the currently available data, carrying out SLNE prior to neoadjuvant chemotherapy is not recommended. In contrast, surgical axillary management after neoadjuvant chemotherapy is considered the procedure of choice for axillary staging and can range from SLNE to TAD and ALND. To reduce the rate of false negatives during surgical staging of the axilla in pN+CNB stage before NACT and ycN0 after NACT, targeted axillary dissection (TAD), the removal of > 2 SLNs (SLNE, no untargeted axillary sampling), immunohistochemistry to detect isolated tumour cells and micro-metastases, and marking positive lymph nodes before NACT should be the standard approach. This most recent update on surgical axillary management describes the significance of isolated tumour cells and micro-metastasis after neoadjuvant chemotherapy and the clinical consequences of low volume residual disease diagnosed using SLNE and TAD and provides an overview of this yearʼs AGO recommendations for surgical management of the axilla during primary surgery and in relation to neoadjuvant chemotherapy.

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Section: Surgical Management Of the Axilla After Neoadjuvant Chemotherapymentioning

confidence: 99%

Section: Empfehlung Der Ago Kommission Mamma Zur Verringerung Der Falsch-negativ-rate Des Operativen Stagings Bei Stanzbioptisch Gesicherunclassified

AGO Recommendations for the Surgical Therapy of the Axilla After Neoadjuvant Chemotherapy: 2021 Update

Friedrich

Kühn

Janni

et al. 2021

Geburtshilfe Frauenheilkd

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“…However, ALND is associated with lymphedema, arm pain, sensory defects, decreased range of motion, and other morbidities that could impair quality of life. Sentinel lymph node biopsy can decrease the risk of these morbidities and has become a standard method for the evaluation of axillary lymph nodes [19][20][21][22]27]. However, ALND remains standard care for patients with a clinically positive lymph node before neoadjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Axillary Sampling as an Alternative Option for Complete Nodal Response in Triple Negative and HER2 Type Breast Cancer Patients after Neoadjuvant Chemotherapy

et al. 2020

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“…Although this study did not mandate a specific type of axillary surgery, targeted axillary sampling (TAS) was used as our standard protocol for node-positive breast cancer patients. TAS has been previously described [10, 11]. This technique involves not only removing (sampling) SNs (SN biopsy) but also TNs and several nodes around the SNs and TNs; this shared criteria was strictly applied by all surgeons during study period.…”

Section: Methodsmentioning

confidence: 99%

Ultrasound-guided dual-localization for axillary nodes before and after neoadjuvant chemotherapy with clip and activated charcoal in breast cancer patients: a feasibility study

Kim

et al. 2019

BMC Cancer

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Background We report on our experience of ultrasound (US)-guided dual-localization for axillary nodes before and after neoadjuvant chemotherapy (NAC) with clip and activated charcoal to guide axillary surgery in breast cancer patients. Methods Between November 2017 and May 2018, a dual-localization procedure was performed under US guidance for the most suspicious axillary nodes noted at initial staging (before NAC, with clip) and restaging (after NAC, with activated charcoal) in 28 cytologically proven node-positive breast cancer patients. Patients underwent axillary sampling or dissection, which involved removing not only the sentinel nodes (SNs), but also clipped nodes (CNs) and tattooed nodes (TNs). Success (or failure) rates of biopsies of SNs, CNs, and TNs and inter-nodal concordance rates were determined. Sensitivities for the individual and combined biopsies were calculated. Results SN biopsy failed in four patients (14%), whereas the CN biopsy failed in one patient (4%). All TNs were identified in the surgical field. Concordance rates were 79% for CNs–TNs, 63% for CNs–SNs, and 58% for TNs–SNs. Sensitivity for SN, CN, and TN biopsy was 73%, 67%, and 67%, respectively. Sensitivity was 80% for any combination of biopsies (SN plus CN, SN plus TN, SN plus CN plus TN). Conclusions US-guided dual-localization of axillary nodes before and after NAC with clip and activated charcoal was a feasible approach that might facilitate more reliable nodal staging with less-invasive strategies in node-positive breast cancer patients.

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5-year oncological outcomes of targeted axillary sampling in pT1-2N1 breast cancer

Cited by 12 publications

References 32 publications

AGO Recommendations for the Surgical Therapy of the Axilla After Neoadjuvant Chemotherapy: 2021 Update

AGO Recommendations for the Surgical Therapy of the Axilla After Neoadjuvant Chemotherapy: 2021 Update

Axillary Sampling as an Alternative Option for Complete Nodal Response in Triple Negative and HER2 Type Breast Cancer Patients after Neoadjuvant Chemotherapy

Ultrasound-guided dual-localization for axillary nodes before and after neoadjuvant chemotherapy with clip and activated charcoal in breast cancer patients: a feasibility study

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