Role of axillary ultrasound in defining surgical management of breast cancer patients with nodal disease

Syed, Abdul; Garbos, M.; Patel, Ashraf; Jenkins, Stephanie; Bradpiece, H.

doi:10.1016/j.ejso.2009.07.081

Cited by 2 publications

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“…When negative, sentinel lymph node technique seems to be a promising option to rule out any metastases. 27 …”

Section: Discussionmentioning

confidence: 99%

Management of early breast cancer in older women: from screening to treatment

Zine²,

Afif

et al. 2015

BCTT

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BackgroundBreast cancer is a common condition. It is a leading cause of death among women, and its incidence increases with age. Aging of the population and improvement of the quality of life of elders make it a major public health issue. We reviewed the literature to try to determine the management of breast cancer in older women.MethodsWe conducted a narrative review by literature searches using key words “breast cancer”, “elderly and older”, and “women” in Pubmed, Scopus, and Google Scholar. The aim of this review is to summarize the management of early breast cancer in older women by discussing the controversies of screening in older women. Then, we try to define the optimal strategy for these women, either surgery alone or primary endocrine therapy. We also discuss the indications of lymph node dissection, and we evaluate the benefit of adjuvant radiotherapy, chemotherapy, and the anti HER2 treatment for these women.ResultsMore than 50% of patients with breast cancer are 65 years or older, and around 30% are more than 70 years old. Most randomized trials did not include older women. Hence, the treatment of breast cancer in older patients is based on the management provided to younger women. Regardless of age, the treatment must aim for the best efficiency. Advanced age in itself should not be a limitation to treatment. There are no standard guidelines set for elderly patients. Surgical treatment for older patients evolved to avoid mastectomy, and conservative mammary surgery was proposed, similar to that used in younger patients. The proportion of elderly patients receiving adjuvant radiotherapy is increasing. The role of adjuvant radiotherapy in older patients with breast cancer was analyzed. Adjuvant chemotherapy is beneficial to women with hormone receptor-negative tumors. In those with hormone receptor-positive tumors, adjuvant chemotherapy in association to trastuzumab is beneficial for HER2-positive tumors, and for women with HER2-negative tumors adjuvant hormonal therapy is a very good option.ConclusionBreast cancer is common in older women. This population requires particular and adapted management. It is essential for older patients to be included in new clinical trials for individualized treatment recommendation.

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“…When negative, sentinel lymph node technique seems to be a promising option to rule out any metastases. 27 …”

Section: Discussionmentioning

confidence: 99%

Management of early breast cancer in older women: from screening to treatment

Zine²,

Afif

et al. 2015

BCTT

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“…To minimize the number of patients undergoing unnecessary axillary dissection, current practice relies on the use of preoperative ultrasonography of the axillary area and fine needle aspiration cytology of any suspicious node; if negative, patients are usually offered a sentinel lymph node biopsy (SLNB) to ascertain the presence of metastatic deposits [43]. The real advantages of axillary dissection are much debated; there are reports of survival gains in patients who undergo this procedure [44], while others report on the lack of advantages [45]. Further management recommendations include the use of minimal surgery (axillary sampling) to stage the axilla for patients with early invasive breast cancer and no evidence of lymph node involvement on ultrasonography or a needle biopsy; alternatively, targeted sampling may be considered (i.e.…”

Section: Management Of the Axillamentioning

confidence: 99%

Choices in Surgery for Older Women with Breast Cancer

2012

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Breast cancer is a major cause of mortality worldwide. As the population ages and life expectancy increases, the burden of cancer on health services will increase. Older patients with breast cancer are becoming more suitable for surgery; tailored surgical techniques and increasing healthy life expectancy alongside improved assessment of patients are aiding this trend. Surgery is also becoming a favoured treatment of personal choice for older patient with breast cancer. Evidence shows that surgery is almost always feasible for the older patient with outcomes (survival, progression, and recurrence rates) comparable to younger groups and superior to nonsurgical treatments. We aim to describe the current status of surgery for the older patient with breast cancer, showing it is an option that should not be denied. Surgery should always be considered regardless of age, after evaluation of comorbidities.

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Role of axillary ultrasound in defining surgical management of breast cancer patients with nodal disease

Cited by 2 publications

References 0 publications

Management of early breast cancer in older women: from screening to treatment

Management of early breast cancer in older women: from screening to treatment

Choices in Surgery for Older Women with Breast Cancer

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