The value of axillary dissection in T1a breast cancer

McGee, J. Michael; Youmans, Roger; Clingan, F. A.; Malnar, Karen F.; Bellefeuille, C. De; Berry, B. Michael

doi:10.1016/s0002-9610(96)00228-0

Cited by 35 publications

(4 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some authors [4, 34 -36, 38, 44] have proposed foregoing ALND in patients with T1a tumors because of the reported low incidence of axillary metastasis in this group, although the series involved are generally small. Others authors have been unable to confirm these findings [37,39] and are therefore less eager to exclude ALND as a staging technique in this group. Table 11 lists reported percentages of lymph node metastases in recently published series for the subset of patients with T1 tumors.…”

Section: T1 Tumors and Risk Of Axillary Metastasesmentioning

confidence: 77%

Is There a Role for Selective Axillary Dissection in Breast Cancer?

Gemignani

Borgen

2001

World j. surg.

View full text Add to dashboard Cite

Surgery is the most effective therapeutic intervention available for the treatment of breast cancer. It has been responsible for obtaining local control and long-term disease-free intervals in more patients over the past century than any other treatment modality. Trends toward earlier stage at diagnosis are likely to increase the importance of surgery and to secure its central role in the treatment of this disease. Unfortunately, during the 1990s the value of excellent local control of breast cancer has been minimized as the disease has come to be considered systemic from inception and as the results of adjuvant-therapy trials in patients with early-stage breast cancer have revealed survival advantages in patients receiving systemic therapy. Only rarely is it acknowledged that surgery alone achieves long-term disease-free states in 70% to 80% of all patients. At the core of this paradigmatic controversy is management of the axilla. The status of the axilla remains the most powerful predictor of outcome in patients with invasive carcinoma of the breast, and it is likely that a small but identifiable subset of patients obtains a survival benefit from the removal of disease-containing nodes. It is believed that no benefit is derived from the removal of negative nodes, and indeed there are even patients in whom complete elimination of the exploration of the axilla may be considered-all of which underscores the need to investigate the axilla selectively. Lymphatic mapping and sentinel lymph node (SLN) biopsy represents the most exciting development to date toward this end. The challenge today, as we move closer to a selective approach to the axilla, is to ensure that patients with positive nodes have those nodes identified and removed and patients with negative nodes experience minimal disturbance of their axilla.

show abstract

Section: T1 Tumors and Risk Of Axillary Metastasesmentioning

confidence: 77%

Is There a Role for Selective Axillary Dissection in Breast Cancer?

Gemignani

Borgen

2001

World j. surg.

View full text Add to dashboard Cite

show abstract

“…[5,6]. These features can provide valuable information for the characterization of abnormal ALNs [7][8][9], and help identify lymph nodes suitable for needle biopsy [10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Predictive value of comb-push ultrasound shear elastography for the differentiation of reactive and metastatic axillary lymph nodes: A preliminary investigation

et al. 2020

View full text Add to dashboard Cite

Objectives To evaluate the predictive performance of comb-push ultrasound shear elastography for the differentiation of reactive and metastatic axillary lymph nodes. Methods From June 2014 through September 2018, 114 female volunteers (mean age 58.1±13.3 years; range 28-88 years) with enlarged axillary lymph nodes identified by palpation or clinical imaging were prospectively enrolled in the study. Mean, standard deviation and maximum shear wave elastography parameters from 117 lymph nodes were obtained and compared to fine needle aspiration biopsy results. Mann-Whitney U test and ROC curve analysis were performed. Results The axillary lymph nodes were classified as reactive or metastatic based on the fine needle aspiration outcomes. A statistically significant difference between reactive and metastatic axillary lymph nodes was observed based on comb-push ultrasound shear elastography (CUSE) results (p<0.0001) from mean and maximum elasticity values. Mean elasticity showed the best separation with a ROC analysis resulting in 90.5% sensitivity, 94.4% specificity, 0.97 area under the curve, 95% positive predictive value, and 89.5% negative predictive value with a 30.2-kPa threshold.

show abstract

“…The likelihood of involvement is related to tumor size and location, histological grade and the presence of lymphatic invasion. 1 , 2 In patients with clinically node-negative breast cancer, sentinel lymph node biopsy identifies patients without axillary lymph node involvement, thereby making more extensive surgery unnecessary. Axillary lymph node dissection has traditionally been a routine procedure in the staging and management of breast cancer.…”

Section: Introductionmentioning

confidence: 99%

Axillary dissection compared to sentinel node biopsy for the treatment of pathologically node-negative breast cancer: a meta-analysis of four randomized trials with long-term follow up

Petrelli¹,

Lonati²,

Barni³

2012

Oncol Rev

View full text Add to dashboard Cite

Sentinel lymph node biopsy is now accepted as the initial approach for women with early stage breast cancer with clinically node-negative disease. We performed a pooled analysis of trials comparing axillary lymph node dissection to sentinel lymph node biopsy in patients with early stage breast cancer and pathologically negative sentinel lymph node analysis. A systematic MEDLINE review identified four randomized trials of axillary dissection versus sentinel lymph node biopsy in lymph node-negative early stage breast cancer patients. A meta-analysis was performed for survival and relapse. The combined analyses of these four trials found no significant difference in overall survival (relative risk [RR] 1.15; P=0.16; 95% CI: 0.95–1.39), breast cancer-specific (RR 1.03; P=0.85; 95% CI: 0.751.43) and disease-free survival (RR 1.07; P=0.3; 95% CI: 0.94–1.21), distant metastases (RR 1; P=0.98; 95% CI: 0.76–1.32), and ipsilateral breast recurrence (RR 1.64; P=0.34; 95% CI: 0.60–4.47) associated with sentinel lymph node biopsy. In particular, a similar rate of nodal recurrences was seen after sentinel lymph node biopsy (RR 1.74; P=0.13; 95% CI: 0.86–3.53). Axillary dissection does not confer a survival benefit nor prevent further nodal relapses in the setting of early stage, pathologically lymph node-negative breast cancer.

show abstract

The value of axillary dissection in T1a breast cancer

Cited by 35 publications

References 19 publications

Is There a Role for Selective Axillary Dissection in Breast Cancer?

Is There a Role for Selective Axillary Dissection in Breast Cancer?

Predictive value of comb-push ultrasound shear elastography for the differentiation of reactive and metastatic axillary lymph nodes: A preliminary investigation

Axillary dissection compared to sentinel node biopsy for the treatment of pathologically node-negative breast cancer: a meta-analysis of four randomized trials with long-term follow up

Contact Info

Product

Resources

About