Axillary management for young women with breast cancer varies between patients electing breast-conservation therapy or mastectomy.

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Tytuł:: Axillary management for young women with breast cancer varies between patients electing breast-conservation therapy or mastectomy.
Autorzy:: Tadros AB; Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY, 10065, USA. .
Moo TA; Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY, 10065, USA.
Stempel M; Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY, 10065, USA.
Zabor EC; Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Khan AJ; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Morrow M; Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY, 10065, USA.
Źródło:: Breast cancer research and treatment [Breast Cancer Res Treat] 2020 Feb; Vol. 180 (1), pp. 197-205. Date of Electronic Publication: 2020 Jan 14.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: Dordrecht : Kluwer Academic
Original Publication: The Hague ; Boston : M. Nijhoff, c1981-
MeSH Terms:: Mastectomy*/adverse effects
Mastectomy*/methods
Mastectomy, Segmental*/adverse effects
Mastectomy, Segmental*/methods
Axilla/*pathology
Breast Neoplasms/*pathology
Breast Neoplasms/*surgery
Sentinel Lymph Node/*pathology
Adult ; Breast Neoplasms/etiology ; Clinical Decision-Making ; Combined Modality Therapy ; Disease Management ; Female ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Sentinel Lymph Node Biopsy
References:: Cancer. 2004 Feb 15;100(4):688-93. (PMID: 14770422)
Int J Radiat Oncol Biol Phys. 2012 Aug 1;83(5):e577-81. (PMID: 22560546)
Lancet Oncol. 2018 Oct;19(10):1385-1393. (PMID: 30196031)
Lancet Oncol. 2014 Nov;15(12):1303-10. (PMID: 25439688)
Ann Surg Oncol. 2010 Oct;17(10):2554-62. (PMID: 20461470)
Ann Surg Oncol. 2017 Jan;24(1):38-51. (PMID: 27646018)
Ann Surg. 2018 Dec;268(6):1084-1090. (PMID: 28742702)
Lancet. 2014 Jun 21;383(9935):2127-35. (PMID: 24656685)
Int J Radiat Oncol Biol Phys. 2014 Jun 1;89(2):392-8. (PMID: 24721590)
Int J Radiat Oncol Biol Phys. 2005 Apr 1;61(5):1337-47. (PMID: 15817335)
J Clin Oncol. 2007 Nov 20;25(33):5203-9. (PMID: 17954711)
J Adolesc Young Adult Oncol. 2019 Aug;8(4):463-468. (PMID: 30942651)
JAMA. 2017 Sep 12;318(10):918-926. (PMID: 28898379)
Cancer J. 2008 Jul-Aug;14(4):223-9. (PMID: 18677129)
Ann Surg Oncol. 2009 Oct;16(10):2697-704. (PMID: 19653045)
J Clin Oncol. 2002 Oct 15;20(20):4242-8. (PMID: 12377968)
J Plast Reconstr Aesthet Surg. 2017 Oct;70(10):1329-1335. (PMID: 28743588)
Br J Surg. 1986 Jul;73(7):580-4. (PMID: 3730795)
Eur J Surg Oncol. 2007 Feb;33(1):28-32. (PMID: 17123771)
Ann Surg Oncol. 2018 Nov;25(12):3527-3534. (PMID: 29868979)
J Clin Oncol. 2014 Nov 10;32(32):3600-6. (PMID: 25135994)
Ann Surg Oncol. 2018 Jul;25(7):1912-1920. (PMID: 29564588)
J Clin Oncol. 2011 Jun 1;29(16):2158-64. (PMID: 21464413)
Ann Surg Oncol. 2009 Oct;16(10):2691-6. (PMID: 19506956)
Int J Radiat Oncol Biol Phys. 2012 Aug 1;83(5):1387-93. (PMID: 22300561)
N Engl J Med. 2015 Jul 23;373(4):307-16. (PMID: 26200977)
J Natl Compr Canc Netw. 2016 Mar;14(3):324-54. (PMID: 26957618)
Curr Oncol. 2013 Dec;20(6):e585-92. (PMID: 24311960)
N Engl J Med. 1997 Oct 2;337(14):949-55. (PMID: 9395428)
Strahlenther Onkol. 2019 Apr;195(4):297-305. (PMID: 30069737)
JAMA. 2014 Sep 3;312(9):902-14. (PMID: 25182099)
Int J Radiat Oncol Biol Phys. 2010 Jun 1;77(2):516-22. (PMID: 19577858)
Grant Information:: P30 CA008748 United States CA NCI NIH HHS
Contributed Indexing:: Keywords: Axillary lymph node dissection; Breast cancer; Breast-conservation therapy; Mastectomy; Regional nodal irradiation
Entry Date(s):: Date Created: 20200116 Date Completed: 20201027 Latest Revision: 20210201
Update Code:: 20240105
PubMed Central ID:: PMC7035176
DOI:: 10.1007/s10549-019-05520-5
PMID:: 31938938
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Purpose: Axillary treatment strategies for the young woman with early-stage, clinically node-negative breast cancer undergoing upfront surgery found to have 1-3 positive sentinel lymph nodes (SLNs) differ significantly after BCT and mastectomy. Here we compare axillary lymph node dissection (ALND) and regional nodal irradiation (NRI) rates between women electing breast-conservation therapy (BCT) versus mastectomy.
Methods: From 2010 to 2016, women age < 50 years with clinical T1-T2N0 breast cancer having upfront surgery and found to have a positive SLN were identified. ALND and/or NRI receipt were compared between groups.
Results: 192 women undergoing BCT and 165 undergoing mastectomy were identified (median age: 44 years). 5.2% (10/192) of women undergoing BCT had an ALND versus 87% (144/165) of women undergoing mastectomy (p < 0.01). NRI was given to 48% (78/165) of mastectomy patients compared to 30% (57/192) of BCT patients (p < 0.01). Of the 75 mastectomy patients with 1-2 total positive lymph nodes after completion ALND, 44% received NRI. Women undergoing mastectomy were significantly more likely to receive both ALND and NRI than women undergoing BCS (45% vs 6%, p < 0.01).
Conclusion: Young cT1-2N0 breast cancer patients found to have 1-3 SLN metastases received ALND, NRI, and combined ALND/NRI more frequently if they elected mastectomy over BCT. Use of both ALND and postmastectomy radiotherapy (PMRT) in this population could be reduced in the future by omitting ALND in patients for whom the need for PMRT is clear with the finding of 1-2 SLN metastases.

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