Management of Early Node-Positive Breast Cancer in Australia: A Multicentre Study.
To examine practice patterns for breast cancer patients with limited sentinel node (SN) disease in light of the ACOSOG Z0011 results. Retrospective analysis of patients with T1-2 breast cancer and positive sentinel lymph node biopsy (SLNB) admitted between January 2009 and December 2012. Patient demographics, tumor characteristics, and treatments were recorded. Eight hundred positive SLNBs were identified. A total of 452 (56.5%) proceeded to completion axillary lymph node dissection (cALND). cALND rate decreased from 65.1% to 49.7% from 2009-2010 to 2011-2012. cALND was performed for micrometastasis or isolated tumor cells in 39.3% in 2009-2010 and 22.2% in 2011-2012, whereas for macrometastases the rates were 83.1% and 68.6%, respectively. cALND rates diminished for both Z0011-eligible and -ineligible patients. The ACOSOG Z0011 trial presentation and publication coincided with a reduction in cALND for breast cancer with limited nodal disease. There appears equipoise regarding management of macrometastatic SN disease.
The Breast Service, The Royal Melbourne Hospital & The Royal Women's Hospital, Parkville, Victoria, Australia.|Department of Surgery, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
Emma
E
Gannan
Focus Pathology, East Melbourne, Victoria, Australia.
Jeremy
J
Khoo
Department of Surgery, The Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.
Sophie
S
Nightingale
Department of Surgery, Monash Medical Centre, Clayton, Victoria, Australia.
Thomas Surya
TS
Suhardja
Department of Surgery, The Austin Hospital, Heidelberg, Victoria, Australia.
Jocelyn
J
Lippey
Department of Surgery, The Alfred Hospital, Melbourne, Victoria, Australia.
Holly
H
Keane
Department of Surgery, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
Kian Jin
KJ
Tan
Focus Pathology, East Melbourne, Victoria, Australia.
David
D
Clouston
Melbourne EpiCentre, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.
Alexandra
A
Gorelik
The Breast Service, The Royal Melbourne Hospital & The Royal Women's Hospital, Parkville, Victoria, Australia.|Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia.
Gregory Bruce
GB
Mann
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001315:Australia; D001365:Axilla / Q000473:pathology / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy*; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000706:statistics & numerical data*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008875:Middle Aged; D061206:Neoplasm Micrometastasis / Q000473:pathology; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000706:statistics & numerical data*
D000970:Antineoplastic Agents
ACOSOG Z0011 trial; axillary lymph node dissection; breast cancer; sentinel lymph node biopsy