Omission of axillary dissection after a positive sentinel node dissection may influence adjuvant chemotherapy indications in operable breast cancer patients

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Abstract

Background. This study was designed to evaluate how the omission of axillary dissection would have altered the indication for adjuvant chemotherapy (ACT) in patients with early breast cancer submitted to conservative surgery with one or two positive sentinel lymph nodes (SLNs). Methods. We identified 321 women in our institutional database who fulfilled the characteristics. All underwent completion axillary lymph node dissection (AD). Each case was blindly reviewed by our breast team in two rounds, and the total number of positive lymph nodes was disclosed only in the second. At each round, the panel chose between: (1) recommend, (2) discuss, (3) do not recommend ACT. Changes between round 1 and 2 were studied by the marginal homogeneity test. Exploratory logistic regression analyses were performed to study predictors of non-SLN involvement and of changes in the indication for ACT. Results. AD revealed non-SLNs metastases in 96 patients (30 %). Fifty-two patients (16 %) had their initial indication changed at round 2 (p

Original languageEnglish
Pages (from-to)3755-3761
Number of pages7
JournalAnnals of Surgical Oncology
Volume19
Issue number12
DOIs
Publication statusPublished - Nov 2012

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Adjuvant Chemotherapy
Dissection
Lymph Nodes
Breast Neoplasms
Lymph Node Excision
Breast
Logistic Models
Regression Analysis
Databases
Neoplasm Metastasis
cyhalothrin

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

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title = "Omission of axillary dissection after a positive sentinel node dissection may influence adjuvant chemotherapy indications in operable breast cancer patients",
abstract = "Background. This study was designed to evaluate how the omission of axillary dissection would have altered the indication for adjuvant chemotherapy (ACT) in patients with early breast cancer submitted to conservative surgery with one or two positive sentinel lymph nodes (SLNs). Methods. We identified 321 women in our institutional database who fulfilled the characteristics. All underwent completion axillary lymph node dissection (AD). Each case was blindly reviewed by our breast team in two rounds, and the total number of positive lymph nodes was disclosed only in the second. At each round, the panel chose between: (1) recommend, (2) discuss, (3) do not recommend ACT. Changes between round 1 and 2 were studied by the marginal homogeneity test. Exploratory logistic regression analyses were performed to study predictors of non-SLN involvement and of changes in the indication for ACT. Results. AD revealed non-SLNs metastases in 96 patients (30 {\%}). Fifty-two patients (16 {\%}) had their initial indication changed at round 2 (p",
author = "Filippo Montemurro and Furio Maggiorotto and Giorgio Valabrega and Franziska Kubatzki and Valentina Rossi and Alessandra Magistris and Francesco Marocco and Marco Gatti and Ivana Sarotto and Massimo Aglietta and Riccardo Ponzone",
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T1 - Omission of axillary dissection after a positive sentinel node dissection may influence adjuvant chemotherapy indications in operable breast cancer patients

AU - Montemurro, Filippo

AU - Maggiorotto, Furio

AU - Valabrega, Giorgio

AU - Kubatzki, Franziska

AU - Rossi, Valentina

AU - Magistris, Alessandra

AU - Marocco, Francesco

AU - Gatti, Marco

AU - Sarotto, Ivana

AU - Aglietta, Massimo

AU - Ponzone, Riccardo

PY - 2012/11

Y1 - 2012/11

N2 - Background. This study was designed to evaluate how the omission of axillary dissection would have altered the indication for adjuvant chemotherapy (ACT) in patients with early breast cancer submitted to conservative surgery with one or two positive sentinel lymph nodes (SLNs). Methods. We identified 321 women in our institutional database who fulfilled the characteristics. All underwent completion axillary lymph node dissection (AD). Each case was blindly reviewed by our breast team in two rounds, and the total number of positive lymph nodes was disclosed only in the second. At each round, the panel chose between: (1) recommend, (2) discuss, (3) do not recommend ACT. Changes between round 1 and 2 were studied by the marginal homogeneity test. Exploratory logistic regression analyses were performed to study predictors of non-SLN involvement and of changes in the indication for ACT. Results. AD revealed non-SLNs metastases in 96 patients (30 %). Fifty-two patients (16 %) had their initial indication changed at round 2 (p

AB - Background. This study was designed to evaluate how the omission of axillary dissection would have altered the indication for adjuvant chemotherapy (ACT) in patients with early breast cancer submitted to conservative surgery with one or two positive sentinel lymph nodes (SLNs). Methods. We identified 321 women in our institutional database who fulfilled the characteristics. All underwent completion axillary lymph node dissection (AD). Each case was blindly reviewed by our breast team in two rounds, and the total number of positive lymph nodes was disclosed only in the second. At each round, the panel chose between: (1) recommend, (2) discuss, (3) do not recommend ACT. Changes between round 1 and 2 were studied by the marginal homogeneity test. Exploratory logistic regression analyses were performed to study predictors of non-SLN involvement and of changes in the indication for ACT. Results. AD revealed non-SLNs metastases in 96 patients (30 %). Fifty-two patients (16 %) had their initial indication changed at round 2 (p

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