Unnecessary axillary node dissections in the sentinel lymph node era

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

In the sentinel lymph node era, axillary lymph node dissection (ALND) for uninvolved axillary lymph nodes should be considered unnecessary and inappropriate. Between January 2000 and August 2005, 3487 out of 10,031 invasive breast cancer patients consecutively operated at the European Institute of Oncology were considered not suitable for sentinel lymph node biopsy (SNB) and were directly submitted to ALND ('direct ALND'). In 2875 cases (82%) a variable grade of axillary involvement was shown, while in 612 patients (18%) no evidence of metastatic spreading was documented in the axilla. In particular, the presence of suspicious nodes at pre-operative clinical evaluation of the axilla (191 patients), neoadjuvant treatment (188 patients), large tumour >2 cm (88 patients), multifocality of disease (76 patients), previous excisional biopsy (49 patients), were considered the most frequent contraindications to SNB and led to an 'unnecessary ALND'. According to the wider extension of the indications for SNB over the time, the number of 'unnecessary ALNDs' progressively decreased from 26% (in 2000) to 9% of the 'direct ALNDs' (in 2005). As the clinical indications to SNB are progressively extending to encompass most breast cancer patients with non-metastatic disease who were previously excluded, great effort should be made to avoid 'unnecessary ALNDs'.

Original languageEnglish
Pages (from-to)2664-2668
Number of pages5
JournalEuropean Journal of Cancer
Volume43
Issue number18
DOIs
Publication statusPublished - Dec 2007

Fingerprint

Dissection
Sentinel Lymph Node Biopsy
Lymph Node Excision
Axilla
Breast Neoplasms
Neoadjuvant Therapy
Sentinel Lymph Node
Lymph Nodes
Biopsy
Neoplasms

Keywords

  • Breast cancer
  • Complete axillary dissection
  • Non-metastatic lymph nodes
  • Sentinel lymph node biopsy
  • Uninvolved axillary nodes
  • Unnecessary dissection

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

Cite this

Unnecessary axillary node dissections in the sentinel lymph node era. / Intra, Mattia; Rotmensz, Nicole; Mattar, Denise; Gentilini, Oreste D.; Vento, Annarita; Veronesi, Paolo; Colleoni, Marco; De Cicco, Concetta; Cassano, Enrico; Luini, Alberto; Veronesi, Umberto.

In: European Journal of Cancer, Vol. 43, No. 18, 12.2007, p. 2664-2668.

Research output: Contribution to journalArticle

@article{c45ba4c230f1408cbf80875b94c63357,
title = "Unnecessary axillary node dissections in the sentinel lymph node era",
abstract = "In the sentinel lymph node era, axillary lymph node dissection (ALND) for uninvolved axillary lymph nodes should be considered unnecessary and inappropriate. Between January 2000 and August 2005, 3487 out of 10,031 invasive breast cancer patients consecutively operated at the European Institute of Oncology were considered not suitable for sentinel lymph node biopsy (SNB) and were directly submitted to ALND ('direct ALND'). In 2875 cases (82{\%}) a variable grade of axillary involvement was shown, while in 612 patients (18{\%}) no evidence of metastatic spreading was documented in the axilla. In particular, the presence of suspicious nodes at pre-operative clinical evaluation of the axilla (191 patients), neoadjuvant treatment (188 patients), large tumour >2 cm (88 patients), multifocality of disease (76 patients), previous excisional biopsy (49 patients), were considered the most frequent contraindications to SNB and led to an 'unnecessary ALND'. According to the wider extension of the indications for SNB over the time, the number of 'unnecessary ALNDs' progressively decreased from 26{\%} (in 2000) to 9{\%} of the 'direct ALNDs' (in 2005). As the clinical indications to SNB are progressively extending to encompass most breast cancer patients with non-metastatic disease who were previously excluded, great effort should be made to avoid 'unnecessary ALNDs'.",
keywords = "Breast cancer, Complete axillary dissection, Non-metastatic lymph nodes, Sentinel lymph node biopsy, Uninvolved axillary nodes, Unnecessary dissection",
author = "Mattia Intra and Nicole Rotmensz and Denise Mattar and Gentilini, {Oreste D.} and Annarita Vento and Paolo Veronesi and Marco Colleoni and {De Cicco}, Concetta and Enrico Cassano and Alberto Luini and Umberto Veronesi",
year = "2007",
month = "12",
doi = "10.1016/j.ejca.2007.09.001",
language = "English",
volume = "43",
pages = "2664--2668",
journal = "European Journal of Cancer",
issn = "0959-8049",
publisher = "Elsevier Ltd",
number = "18",

}

TY - JOUR

T1 - Unnecessary axillary node dissections in the sentinel lymph node era

AU - Intra, Mattia

AU - Rotmensz, Nicole

AU - Mattar, Denise

AU - Gentilini, Oreste D.

AU - Vento, Annarita

AU - Veronesi, Paolo

AU - Colleoni, Marco

AU - De Cicco, Concetta

AU - Cassano, Enrico

AU - Luini, Alberto

AU - Veronesi, Umberto

PY - 2007/12

Y1 - 2007/12

N2 - In the sentinel lymph node era, axillary lymph node dissection (ALND) for uninvolved axillary lymph nodes should be considered unnecessary and inappropriate. Between January 2000 and August 2005, 3487 out of 10,031 invasive breast cancer patients consecutively operated at the European Institute of Oncology were considered not suitable for sentinel lymph node biopsy (SNB) and were directly submitted to ALND ('direct ALND'). In 2875 cases (82%) a variable grade of axillary involvement was shown, while in 612 patients (18%) no evidence of metastatic spreading was documented in the axilla. In particular, the presence of suspicious nodes at pre-operative clinical evaluation of the axilla (191 patients), neoadjuvant treatment (188 patients), large tumour >2 cm (88 patients), multifocality of disease (76 patients), previous excisional biopsy (49 patients), were considered the most frequent contraindications to SNB and led to an 'unnecessary ALND'. According to the wider extension of the indications for SNB over the time, the number of 'unnecessary ALNDs' progressively decreased from 26% (in 2000) to 9% of the 'direct ALNDs' (in 2005). As the clinical indications to SNB are progressively extending to encompass most breast cancer patients with non-metastatic disease who were previously excluded, great effort should be made to avoid 'unnecessary ALNDs'.

AB - In the sentinel lymph node era, axillary lymph node dissection (ALND) for uninvolved axillary lymph nodes should be considered unnecessary and inappropriate. Between January 2000 and August 2005, 3487 out of 10,031 invasive breast cancer patients consecutively operated at the European Institute of Oncology were considered not suitable for sentinel lymph node biopsy (SNB) and were directly submitted to ALND ('direct ALND'). In 2875 cases (82%) a variable grade of axillary involvement was shown, while in 612 patients (18%) no evidence of metastatic spreading was documented in the axilla. In particular, the presence of suspicious nodes at pre-operative clinical evaluation of the axilla (191 patients), neoadjuvant treatment (188 patients), large tumour >2 cm (88 patients), multifocality of disease (76 patients), previous excisional biopsy (49 patients), were considered the most frequent contraindications to SNB and led to an 'unnecessary ALND'. According to the wider extension of the indications for SNB over the time, the number of 'unnecessary ALNDs' progressively decreased from 26% (in 2000) to 9% of the 'direct ALNDs' (in 2005). As the clinical indications to SNB are progressively extending to encompass most breast cancer patients with non-metastatic disease who were previously excluded, great effort should be made to avoid 'unnecessary ALNDs'.

KW - Breast cancer

KW - Complete axillary dissection

KW - Non-metastatic lymph nodes

KW - Sentinel lymph node biopsy

KW - Uninvolved axillary nodes

KW - Unnecessary dissection

UR - http://www.scopus.com/inward/record.url?scp=36348970049&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=36348970049&partnerID=8YFLogxK

U2 - 10.1016/j.ejca.2007.09.001

DO - 10.1016/j.ejca.2007.09.001

M3 - Article

C2 - 17931853

AN - SCOPUS:36348970049

VL - 43

SP - 2664

EP - 2668

JO - European Journal of Cancer

JF - European Journal of Cancer

SN - 0959-8049

IS - 18

ER -