Management of Early Node-Positive Breast Cancer in Australia: A Multicentre Study

Breast J. 2016 Jul;22(4):413-9. doi: 10.1111/tbj.12595. Epub 2016 Apr 20.

Abstract

To examine practice patterns for breast cancer patients with limited sentinel node (SN) disease in light of the ACOSOG Z0011 results. Retrospective analysis of patients with T1-2 breast cancer and positive sentinel lymph node biopsy (SLNB) admitted between January 2009 and December 2012. Patient demographics, tumor characteristics, and treatments were recorded. Eight hundred positive SLNBs were identified. A total of 452 (56.5%) proceeded to completion axillary lymph node dissection (cALND). cALND rate decreased from 65.1% to 49.7% from 2009-2010 to 2011-2012. cALND was performed for micrometastasis or isolated tumor cells in 39.3% in 2009-2010 and 22.2% in 2011-2012, whereas for macrometastases the rates were 83.1% and 68.6%, respectively. cALND rates diminished for both Z0011-eligible and -ineligible patients. The ACOSOG Z0011 trial presentation and publication coincided with a reduction in cALND for breast cancer with limited nodal disease. There appears equipoise regarding management of macrometastatic SN disease.

Keywords: ACOSOG Z0011 trial; axillary lymph node dissection; breast cancer; sentinel lymph node biopsy.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Antineoplastic Agents / therapeutic use
  • Australia
  • Axilla / pathology
  • Axilla / surgery
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / therapy*
  • Clinical Trials as Topic
  • Female
  • Humans
  • Lymph Node Excision / statistics & numerical data*
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis / pathology
  • Middle Aged
  • Neoplasm Micrometastasis / pathology
  • Retrospective Studies
  • Sentinel Lymph Node Biopsy / statistics & numerical data*

Substances

  • Antineoplastic Agents