title: Axillary Dissection in the Case of Positive Sentinel Lymph Nodes: Results of the Innsbruck Consensus Conference.
abstract: The prognosis of breast cancer is most heavily influenced by the status of the axillary nodes. Until a few years ago, this knowledge was gained through radical axillary lymph node clearance. In the meantime, sentinel lymph node clearance has become an established part of the surgical treatment of breast cancer. With the development of this procedure, the morbidity caused by axillary dissection has been reduced significantly. Although comprehensive prospective, randomised data regarding the safe use of the sentinel concept are only now available, the focus currently, however, is on the question of whether in the case of positive sentinel lymph nodes, an axillary dissection can be done away with altogether without having any negative impact on the risk of loco-regional recurrence or on progression-free survival and overall survival. The results of the American ACOSOG-Z001 study have changed the fundamental perspective of this. In this study on the advantages of axillary dissection following the confirmation of tumour tissue in the sentinel lymph nodes, there were no statistically significant advantages from axillary dissection for women with a favourable overall risk profile who had received radiotherapy and systemic therapy. If this concept takes hold, the surgical treatment of node-positive breast cancer, at least in the axilla, would be reduced to a minimum, and the focus of treatment would in future lie more on the systemic treatment of this condition. As part of an interdisciplinary consensus meeting, a standardised approach for Austria with regard to this question was decided upon.
authors.affiliation: Department of Women's Health, Clin. Dept. of Gynaecology and Obstetrics, Innsbruck, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Hubalek
authors.affiliation: University Department of Internal Medicine I, Breast Health Centre MUW/AKH, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Bartsch
authors.affiliation: University Department of Surgery, Breast Health Centre MUW/AKH, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Gnant
authors.affiliation: University Department of Radiotherapy/Radio-Oncology, Graz, Austria.
authors.forename: K S
authors.initials: KS
authors.lastname: Kapp
authors.affiliation: Feldkirch State Hospital, Dept. of Internal Medicine, Haematology and Medical Oncology, Feldkirch, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Lang
authors.affiliation: Graz West State Hospital, Institute of Pathology, Graz, Austria.
authors.forename: S
authors.initials: S
authors.lastname: Lax
authors.affiliation: University Department of Radiotherapy/Radio-Oncology, Innsbruck, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Lukas
authors.affiliation: Dornbirn Hospital, Department of Gynaecology and Obstetrics, Dornbirn, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Neunteufel
authors.affiliation: University Department of Gynaecology and Obstetrics, Clinical Department of Gynaecology, Graz, Austria.
authors.forename: G
authors.initials: G
authors.lastname: Pristauz
authors.affiliation: St. Johanns-Spital/State Women's Hospital, University Department of Specialist Gynaecology, Salzburg, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Reitsamer
authors.affiliation: St.Vinzenz Hospital, Department of Surgery, Zams, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Sandbichler
authors.affiliation: Linz City Hospital, Dept. of Surgery II, Breast Competence Centre, Linz, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Schrenk
authors.affiliation: Clinical Department of General Gynaecology and Gynaecological Oncology, Medical University of Vienna, Vienna, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Singer
authors.affiliation: University Department of Gynaecology and Obstetrics, Clinical Department of Gynaecology, Graz, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Tamussino
authors.affiliation: Hospital of the Merciful Brothers, Surgical Department, St. Veit/Glan, Austria.
authors.forename: J
authors.initials: J
authors.lastname: Tschmelitsch
authors.affiliation: Department of Women's Health, Clin. Dept. of Gynaecology and Obstetrics, Innsbruck, Austria.
authors.forename: A G
authors.initials: AG
authors.lastname: Zeimet
authors.affiliation: Department of Women's Health, Clin. Dept. of Gynaecology and Obstetrics, Innsbruck, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Marth
keywords: ACOSOG-Z0011; axillary dissection; breast cancer; sentinel lymph node