Which sentinel lymph-node (SLN) positive breast cancer patient needs an axillary lymph-node dissection (ALND) - ACOSOG Z0011 results and beyond

Wolfgang Gatzemeier, G. Bruce Mann

Research output: Contribution to journalArticle

Abstract

Axillary management has evolved from routine axillary lymph node dissection (ALND) for most patients to a selective approach based on the assessment of the sentinel node (SN). Validation of this approach for staging the axilla is based on observational studies and multiple randomized trials with near general consensus that in case of negative SN completion ALND is not required and if the SN contained metastatic disease, a completion ALND is recommended.Multiple observations have challenged the need for routine completion ALND and growing evidence from institutional series have indicated that selective omission of ALND in patients with positive SN was safe. Unfortunately, the main randomized study addressing the question of the need for a completion axillary dissection closed early having failed to meet its accrual targets. The presentation and publication of the American College of Surgeons Oncology Group (ACOSOG) Z0011 study has provoked controversy around the world regarding the extent to which this is a practice-changing study. The aim of this review was to critically re-appraise Z0011 results and assess available evidence which should be used to support the decision of which SN positive breast cancer patient needs an ALND.

Original languageEnglish
Pages (from-to)211-216
Number of pages6
JournalBreast
Volume22
Issue number3
DOIs
Publication statusPublished - Jun 2013

Keywords

  • ACOSOG Z0011 trial
  • Axillary lymph node dissection
  • Axillary nodal staging
  • Breast cancer
  • Positive sentinel lymph node management

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Which sentinel lymph-node (SLN) positive breast cancer patient needs an axillary lymph-node dissection (ALND) - ACOSOG Z0011 results and beyond'. Together they form a unique fingerprint.

  • Cite this