Skip to main content
Top
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Study protocol

Clinically node negative breast cancer patients undergoing breast conserving therapy, sentinel lymph node procedure versus follow-up: a Dutch randomized controlled multicentre trial (BOOG 2013-08)

Authors: L. M. van Roozendaal, M. L. G. Vane, T. van Dalen, J. A. van der Hage, L. J. A. Strobbe, L. J. Boersma, S. C. Linn, M. B. I. Lobbes, P. M. P. Poortmans, V. C. G. Tjan-Heijnen, K. K. B. T. Van de Vijver, J. de Vries, A. H. Westenberg, A. G. H. Kessels, J. H. W. de Wilt, M. L. Smidt

Published in: BMC Cancer | Issue 1/2017

Login to get access

Abstract

Background

Studies showed that axillary lymph node dissection can be safely omitted in presence of positive sentinel lymph node(s) in breast cancer patients treated with breast conserving therapy. Since the outcome of the sentinel lymph node biopsy has no clinical consequence, the value of the procedure itself is being questioned. The aim of the BOOG 2013–08 trial is to investigate whether the sentinel lymph node biopsy can be safely omitted in clinically node negative breast cancer patients treated with breast conserving therapy.

Methods

The BOOG 2013–08 is a Dutch prospective non-inferiority randomized multicentre trial. Women with pathologically confirmed clinically node negative T1–2 invasive breast cancer undergoing breast conserving therapy will be randomized for sentinel lymph node biopsy versus no sentinel lymph node biopsy. Endpoints include regional recurrence after 5 (primary endpoint) and 10 years of follow-up, distant-disease free and overall survival, quality of life, morbidity and cost-effectiveness. Previous data indicate a 5-year regional recurrence free survival rate of 99% for the control arm and 96% for the study arm. In combination with a non-inferiority limit of 5% and probability of 0.8, this result in a sample size of 1.644 patients including a lost to follow-up rate of 10%. Primary and secondary endpoints will be reported after 5 and 10 years of follow-up.

Discussion

If the sentinel lymph node biopsy can be safely omitted in clinically node negative breast cancer patients undergoing breast conserving therapy, this study will cost-effectively lead to a decreased axillary morbidity rate and thereby improved quality of life with non-inferior regional control, distant-disease free survival and overall survival.

Trial registration

The BOOG 2013–08 study is registered in ClinicalTrials.​gov since October 20, 2014, Identifier: NCT02271828. https://​clinicaltrials.​gov/​ct2/​show/​NCT02271828
Literature
1.
go back to reference Voogd AC, Coebergh JW, Repelaer van Driel OJ, Roumen RM, van Beek MW, Vreugdenhil A, et al. The risk of nodal metastases in breast cancer patients with clinically negative lymph nodes: a population-based analysis. Breast Cancer Res Treat. 2000;62(1):63–9.CrossRefPubMed Voogd AC, Coebergh JW, Repelaer van Driel OJ, Roumen RM, van Beek MW, Vreugdenhil A, et al. The risk of nodal metastases in breast cancer patients with clinically negative lymph nodes: a population-based analysis. Breast Cancer Res Treat. 2000;62(1):63–9.CrossRefPubMed
2.
go back to reference Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Ashikaga T, et al. Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial. Lancet Oncol. 2007;8(10):881–8.CrossRefPubMed Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Ashikaga T, et al. Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial. Lancet Oncol. 2007;8(10):881–8.CrossRefPubMed
3.
go back to reference Peintinger F, Reitsamer R, Stranzl H, Ralph G. Comparison of quality of life and arm complaints after axillary lymph node dissection vs sentinel lymph node biopsy in breast cancer patients. Br J Cancer. 2003;89(4):648–52.CrossRefPubMedPubMedCentral Peintinger F, Reitsamer R, Stranzl H, Ralph G. Comparison of quality of life and arm complaints after axillary lymph node dissection vs sentinel lymph node biopsy in breast cancer patients. Br J Cancer. 2003;89(4):648–52.CrossRefPubMedPubMedCentral
4.
go back to reference Schulze T, Mucke J, Markwardt J, Schlag PM, Bembenek A. Long-term morbidity of patients with early breast cancer after sentinel lymph node biopsy compared to axillary lymph node dissection. J Surg Oncol. 2006;93(2):109–19.CrossRefPubMed Schulze T, Mucke J, Markwardt J, Schlag PM, Bembenek A. Long-term morbidity of patients with early breast cancer after sentinel lymph node biopsy compared to axillary lymph node dissection. J Surg Oncol. 2006;93(2):109–19.CrossRefPubMed
5.
go back to reference Ohsumi SK S, Takahashi M, Hara F, Takabatake D, Takashima S, Aogi K, et al. Sensory Disturbance of the Ipsilateral Upper Arm after Breast Cancer Surgery with Sentinel Node Biopsy Alone Compared with Axillary Dissection – A Prospective Study. In: 34th Annual San Antonio Breast Cancer Symposium, San Antonio Texas; 2011. Ohsumi SK S, Takahashi M, Hara F, Takabatake D, Takashima S, Aogi K, et al. Sensory Disturbance of the Ipsilateral Upper Arm after Breast Cancer Surgery with Sentinel Node Biopsy Alone Compared with Axillary Dissection – A Prospective Study. In: 34th Annual San Antonio Breast Cancer Symposium, San Antonio Texas; 2011.
6.
go back to reference Lucci A, McCall LM, Beitsch PD, Whitworth PW, Reintgen DS, Blumencranz PW, et al. Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011. J Clin Oncol. 2007;25(24):3657–63.CrossRefPubMed Lucci A, McCall LM, Beitsch PD, Whitworth PW, Reintgen DS, Blumencranz PW, et al. Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011. J Clin Oncol. 2007;25(24):3657–63.CrossRefPubMed
7.
go back to reference Ashikaga T, Krag DN, Land SR, Julian TB, Anderson SJ, Brown AM, et al. Morbidity results from the NSABP B-32 trial comparing sentinel lymph node dissection versus axillary dissection. J Surg Oncol. 2010;102(2):111–8.CrossRefPubMedPubMedCentral Ashikaga T, Krag DN, Land SR, Julian TB, Anderson SJ, Brown AM, et al. Morbidity results from the NSABP B-32 trial comparing sentinel lymph node dissection versus axillary dissection. J Surg Oncol. 2010;102(2):111–8.CrossRefPubMedPubMedCentral
8.
go back to reference Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347(16):1233–41.CrossRefPubMed Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347(16):1233–41.CrossRefPubMed
9.
go back to reference Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA. 2011;305(6):569–75.CrossRefPubMedPubMedCentral Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA. 2011;305(6):569–75.CrossRefPubMedPubMedCentral
10.
go back to reference Galimberti V, Cole BF, Zurrida S, Viale G, Luini A, Veronesi P, et al. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol. 2013;14(4):297–305.CrossRefPubMedPubMedCentral Galimberti V, Cole BF, Zurrida S, Viale G, Luini A, Veronesi P, et al. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol. 2013;14(4):297–305.CrossRefPubMedPubMedCentral
11.
go back to reference Kvistad KA, Rydland J, Smethurst HB, Lundgren S, Fjosne HE, Haraldseth O. Axillary lymph node metastases in breast cancer: preoperative detection with dynamic contrast-enhanced MRI. Eur Radiol. 2000;10(9):1464–71.CrossRefPubMed Kvistad KA, Rydland J, Smethurst HB, Lundgren S, Fjosne HE, Haraldseth O. Axillary lymph node metastases in breast cancer: preoperative detection with dynamic contrast-enhanced MRI. Eur Radiol. 2000;10(9):1464–71.CrossRefPubMed
12.
go back to reference Nori J, Vanzi E, Bazzocchi M, Bufalini FN, Distante V, Branconi F, et al. Role of axillary ultrasound examination in the selection of breast cancer patients for sentinel node biopsy. Am J Surg. 2007;193(1):16–20.CrossRefPubMed Nori J, Vanzi E, Bazzocchi M, Bufalini FN, Distante V, Branconi F, et al. Role of axillary ultrasound examination in the selection of breast cancer patients for sentinel node biopsy. Am J Surg. 2007;193(1):16–20.CrossRefPubMed
13.
go back to reference Pamilo M, Soiva M, Lavast EM. Real-time ultrasound, axillary mammography, and clinical examination in the detection of axillary lymph node metastases in breast cancer patients. J Ultrasound Med. 1989;8(3):115–20.CrossRefPubMed Pamilo M, Soiva M, Lavast EM. Real-time ultrasound, axillary mammography, and clinical examination in the detection of axillary lymph node metastases in breast cancer patients. J Ultrasound Med. 1989;8(3):115–20.CrossRefPubMed
14.
go back to reference Valente SA, Levine GM, Silverstein MJ, Rayhanabad JA, Weng-Grumley JG, Ji L, et al. Accuracy of predicting axillary lymph node positivity by physical examination, mammography, ultrasonography, and magnetic resonance imaging. Ann Surg Oncol. 2012;19(6):1825–30.CrossRefPubMed Valente SA, Levine GM, Silverstein MJ, Rayhanabad JA, Weng-Grumley JG, Ji L, et al. Accuracy of predicting axillary lymph node positivity by physical examination, mammography, ultrasonography, and magnetic resonance imaging. Ann Surg Oncol. 2012;19(6):1825–30.CrossRefPubMed
15.
go back to reference Houssami N, Ciatto S, Turner RM, Cody HS 3rd, Macaskill P. Preoperative ultrasound-guided needle biopsy of axillary nodes in invasive breast cancer: meta-analysis of its accuracy and utility in staging the axilla. Ann Surg. 2011;254(2):243–51.CrossRefPubMed Houssami N, Ciatto S, Turner RM, Cody HS 3rd, Macaskill P. Preoperative ultrasound-guided needle biopsy of axillary nodes in invasive breast cancer: meta-analysis of its accuracy and utility in staging the axilla. Ann Surg. 2011;254(2):243–51.CrossRefPubMed
16.
go back to reference Neal CH, Daly CP, Nees AV, Helvie MA. Can preoperative axillary US help exclude N2 and N3 metastatic breast cancer? Radiology. 2010;257(2):335–41.CrossRefPubMed Neal CH, Daly CP, Nees AV, Helvie MA. Can preoperative axillary US help exclude N2 and N3 metastatic breast cancer? Radiology. 2010;257(2):335–41.CrossRefPubMed
17.
go back to reference Schipper RJ, van Roozendaal LM, de Vries B, Pijnappel RM, Beets-Tan RG, Lobbes MB, et al. Axillary ultrasound for preoperative nodal staging in breast cancer patients: is it of added value? Breast. 2013;22(6):1108–13.CrossRefPubMed Schipper RJ, van Roozendaal LM, de Vries B, Pijnappel RM, Beets-Tan RG, Lobbes MB, et al. Axillary ultrasound for preoperative nodal staging in breast cancer patients: is it of added value? Breast. 2013;22(6):1108–13.CrossRefPubMed
18.
go back to reference van Wely BJ, de Wilt JH, Francissen C, Teerenstra S, Strobbe LJ. Meta-analysis of ultrasound-guided biopsy of suspicious axillary lymph nodes in the selection of patients with extensive axillary tumour burden in breast cancer. Br J Surg. 2015;102(3):159–68.CrossRefPubMed van Wely BJ, de Wilt JH, Francissen C, Teerenstra S, Strobbe LJ. Meta-analysis of ultrasound-guided biopsy of suspicious axillary lymph nodes in the selection of patients with extensive axillary tumour burden in breast cancer. Br J Surg. 2015;102(3):159–68.CrossRefPubMed
19.
go back to reference Early Breast Cancer Trialists’ Collaborative G, Darby S, McGale P, Correa C, Taylor C, Arriagada R, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011;378(9804):1707–16.CrossRef Early Breast Cancer Trialists’ Collaborative G, Darby S, McGale P, Correa C, Taylor C, Arriagada R, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011;378(9804):1707–16.CrossRef
20.
go back to reference Rastogi P, Anderson SJ, Bear HD, Geyer CE, Kahlenberg MS, Robidoux A, et al. Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27. J Clin Oncol. 2008;26(5):778–85.CrossRefPubMed Rastogi P, Anderson SJ, Bear HD, Geyer CE, Kahlenberg MS, Robidoux A, et al. Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27. J Clin Oncol. 2008;26(5):778–85.CrossRefPubMed
21.
go back to reference Straver ME, Rutgers EJ, Russell NS, Oldenburg HS, Rodenhuis S, Wesseling J, et al. Towards rational axillary treatment in relation to neoadjuvant therapy in breast cancer. Eur J Cancer. 2009;45(13):2284–92.CrossRefPubMed Straver ME, Rutgers EJ, Russell NS, Oldenburg HS, Rodenhuis S, Wesseling J, et al. Towards rational axillary treatment in relation to neoadjuvant therapy in breast cancer. Eur J Cancer. 2009;45(13):2284–92.CrossRefPubMed
22.
go back to reference Rouzier R, Extra JM, Klijanienko J, Falcou MC, Asselain B, Vincent-Salomon A, et al. Incidence and prognostic significance of complete axillary downstaging after primary chemotherapy in breast cancer patients with T1 to T3 tumors and cytologically proven axillary metastatic lymph nodes. J Clin Oncol. 2002;20(5):1304–10.CrossRefPubMed Rouzier R, Extra JM, Klijanienko J, Falcou MC, Asselain B, Vincent-Salomon A, et al. Incidence and prognostic significance of complete axillary downstaging after primary chemotherapy in breast cancer patients with T1 to T3 tumors and cytologically proven axillary metastatic lymph nodes. J Clin Oncol. 2002;20(5):1304–10.CrossRefPubMed
23.
go back to reference Alvarado R, Yi M, Le-Petross H, Gilcrease M, Mittendorf EA, Bedrosian I, et al. The role for sentinel lymph node dissection after neoadjuvant chemotherapy in patients who present with node-positive breast cancer. Ann Surg Oncol. 2012;19(10):3177–84.CrossRefPubMed Alvarado R, Yi M, Le-Petross H, Gilcrease M, Mittendorf EA, Bedrosian I, et al. The role for sentinel lymph node dissection after neoadjuvant chemotherapy in patients who present with node-positive breast cancer. Ann Surg Oncol. 2012;19(10):3177–84.CrossRefPubMed
24.
go back to reference van Roozendaal LM, Schipper RJ, Van de Vijver KK, Haekens CM, Lobbes MB, Tjan-Heijnen VC, et al. The impact of the pathological lymph node status on adjuvant systemic treatment recommendations in clinically node negative breast cancer patients. Breast Cancer Res Treat. 2014;143(3):469–76.CrossRefPubMed van Roozendaal LM, Schipper RJ, Van de Vijver KK, Haekens CM, Lobbes MB, Tjan-Heijnen VC, et al. The impact of the pathological lymph node status on adjuvant systemic treatment recommendations in clinically node negative breast cancer patients. Breast Cancer Res Treat. 2014;143(3):469–76.CrossRefPubMed
25.
go back to reference van Wely BJ, Teerenstra S, Schinagl DA, Aufenacker TJ, de Wilt JH, Strobbe LJ. Systematic review of the effect of external beam radiation therapy to the breast on axillary recurrence after negative sentinel lymph node biopsy. Br J Surg. 2011;98(3):326–33.CrossRefPubMed van Wely BJ, Teerenstra S, Schinagl DA, Aufenacker TJ, de Wilt JH, Strobbe LJ. Systematic review of the effect of external beam radiation therapy to the breast on axillary recurrence after negative sentinel lymph node biopsy. Br J Surg. 2011;98(3):326–33.CrossRefPubMed
26.
go back to reference Reed DR, Lindsley SK, Mann GN, Austin-Seymour M, Korssjoen T, Anderson BO, et al. Axillary lymph node dose with tangential breast irradiation. Int J Radiat Oncol Biol Phys. 2005;61(2):358–64.CrossRefPubMed Reed DR, Lindsley SK, Mann GN, Austin-Seymour M, Korssjoen T, Anderson BO, et al. Axillary lymph node dose with tangential breast irradiation. Int J Radiat Oncol Biol Phys. 2005;61(2):358–64.CrossRefPubMed
27.
go back to reference Chung MA, DiPetrillo T, Hernandez S, Masko G, Wazer D, Cady B. Treatment of the axilla by tangential breast radiotherapy in women with invasive breast cancer. Am J Surg. 2002;184(5):401–2.CrossRefPubMed Chung MA, DiPetrillo T, Hernandez S, Masko G, Wazer D, Cady B. Treatment of the axilla by tangential breast radiotherapy in women with invasive breast cancer. Am J Surg. 2002;184(5):401–2.CrossRefPubMed
28.
go back to reference Rabinovitch R, Ballonoff A, Newman F, Finlayson C. Evaluation of breast sentinel lymph node coverage by standard radiation therapy fields. Int J Radiat Oncol Biol Phys. 2008;70(5):1468–71.CrossRefPubMed Rabinovitch R, Ballonoff A, Newman F, Finlayson C. Evaluation of breast sentinel lymph node coverage by standard radiation therapy fields. Int J Radiat Oncol Biol Phys. 2008;70(5):1468–71.CrossRefPubMed
29.
go back to reference van Roozendaal LM, Schipper RJ, Smit LH, Brans BT, Beets-Tan RG, Lobbes MB, et al. Three-dimensional breast radiotherapy and the elective radiation dose at the sentinel lymph node site in breast cancer. Ann Surg Oncol. 2015;22(12):3824–30.CrossRefPubMedPubMedCentral van Roozendaal LM, Schipper RJ, Smit LH, Brans BT, Beets-Tan RG, Lobbes MB, et al. Three-dimensional breast radiotherapy and the elective radiation dose at the sentinel lymph node site in breast cancer. Ann Surg Oncol. 2015;22(12):3824–30.CrossRefPubMedPubMedCentral
30.
go back to reference van Roozendaal LM, de Wilt JH, van Dalen T, van der Hage JA, Strobbe LJ, Boersma LJ, et al. The value of completion axillary treatment in sentinel node positive breast cancer patients undergoing a mastectomy: a Dutch randomized controlled multicentre trial (BOOG 2013-07). BMC Cancer. 2015;15:610.CrossRefPubMedPubMedCentral van Roozendaal LM, de Wilt JH, van Dalen T, van der Hage JA, Strobbe LJ, Boersma LJ, et al. The value of completion axillary treatment in sentinel node positive breast cancer patients undergoing a mastectomy: a Dutch randomized controlled multicentre trial (BOOG 2013-07). BMC Cancer. 2015;15:610.CrossRefPubMedPubMedCentral
32.
go back to reference Abe H, Schmidt RA, Kulkarni K, Sennett CA, Mueller JS, Newstead GM. Axillary lymph nodes suspicious for breast cancer metastasis: sampling with US-guided 14-gauge core-needle biopsy--clinical experience in 100 patients. Radiology. 2009;250(1):41–9.CrossRefPubMed Abe H, Schmidt RA, Kulkarni K, Sennett CA, Mueller JS, Newstead GM. Axillary lymph nodes suspicious for breast cancer metastasis: sampling with US-guided 14-gauge core-needle biopsy--clinical experience in 100 patients. Radiology. 2009;250(1):41–9.CrossRefPubMed
33.
go back to reference Koelliker SL, Chung MA, Mainiero MB, Steinhoff MM, Cady B. Axillary lymph nodes: US-guided fine-needle aspiration for initial staging of breast cancer--correlation with primary tumor size. Radiology. 2008;246(1):81–9.CrossRefPubMed Koelliker SL, Chung MA, Mainiero MB, Steinhoff MM, Cady B. Axillary lymph nodes: US-guided fine-needle aspiration for initial staging of breast cancer--correlation with primary tumor size. Radiology. 2008;246(1):81–9.CrossRefPubMed
34.
go back to reference Offersen BV, Boersma LJ, Kirkove C, Hol S, Aznar MC, Biete Sola A, et al. ESTRO consensus guideline on target volume delineation for elective radiation therapy of early stage breast cancer. Radiother Oncol. 2015;114(1):3–10.CrossRefPubMed Offersen BV, Boersma LJ, Kirkove C, Hol S, Aznar MC, Biete Sola A, et al. ESTRO consensus guideline on target volume delineation for elective radiation therapy of early stage breast cancer. Radiother Oncol. 2015;114(1):3–10.CrossRefPubMed
35.
go back to reference Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85(5):365–76.CrossRefPubMed Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85(5):365–76.CrossRefPubMed
36.
go back to reference Sprangers MA, Groenvold M, Arraras JI, Franklin J, te Velde A, Muller M, et al. The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: first results from a three-country field study. J Clin Oncol. 1996;14(10):2756–68.CrossRefPubMed Sprangers MA, Groenvold M, Arraras JI, Franklin J, te Velde A, Muller M, et al. The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: first results from a three-country field study. J Clin Oncol. 1996;14(10):2756–68.CrossRefPubMed
37.
go back to reference Devoogdt N, Van Kampen M, Geraerts I, Coremans T, Christiaens MR. Lymphoedema functioning, disability and health questionnaire (Lymph-ICF): reliability and validity. Phys Ther. 2011;91(6):944–57.CrossRefPubMed Devoogdt N, Van Kampen M, Geraerts I, Coremans T, Christiaens MR. Lymphoedema functioning, disability and health questionnaire (Lymph-ICF): reliability and validity. Phys Ther. 2011;91(6):944–57.CrossRefPubMed
38.
go back to reference van der Bij AK, de Weerd S, Cikot RJ, Steegers EA, Braspenning JC. Validation of the dutch short form of the state scale of the Spielberger State-Trait Anxiety Inventory: considerations for usage in screening outcomes. Community Genet. 2003;6(2):84–7.PubMed van der Bij AK, de Weerd S, Cikot RJ, Steegers EA, Braspenning JC. Validation of the dutch short form of the state scale of the Spielberger State-Trait Anxiety Inventory: considerations for usage in screening outcomes. Community Genet. 2003;6(2):84–7.PubMed
39.
go back to reference van der Steeg AF, De Vries J, van der Ent FW, Roukema JA. Personality predicts quality of life six months after the diagnosis and treatment of breast disease. Ann Surg Oncol. 2007;14(2):678–85.CrossRefPubMed van der Steeg AF, De Vries J, van der Ent FW, Roukema JA. Personality predicts quality of life six months after the diagnosis and treatment of breast disease. Ann Surg Oncol. 2007;14(2):678–85.CrossRefPubMed
40.
go back to reference Moossdorff M, van Roozendaal LM, Strobbe LJ, Aebi S, Cameron DA, Dixon JM, Giuliano AE, Haffty BG, Hickey BE, Hudis CA et al. Maastricht Delphi consensus on event definitions for classification of recurrence in breast cancer research. J Natl Cancer Inst. 2014;106(12). doi:10.1093/jnci/dju288. Print 2014 Dec. Moossdorff M, van Roozendaal LM, Strobbe LJ, Aebi S, Cameron DA, Dixon JM, Giuliano AE, Haffty BG, Hickey BE, Hudis CA et al. Maastricht Delphi consensus on event definitions for classification of recurrence in breast cancer research. J Natl Cancer Inst. 2014;106(12). doi:10.​1093/​jnci/​dju288. Print 2014 Dec.
41.
go back to reference Moossdorff M, van Roozendaal LM, Schipper RJ, Strobbe LJ, Voogd AC, Tjan-Heijnen VC, et al. Inconsistent selection and definition of local and regional endpoints in breast cancer research. Br J Surg. 2014;101(13):1657–65.CrossRefPubMed Moossdorff M, van Roozendaal LM, Schipper RJ, Strobbe LJ, Voogd AC, Tjan-Heijnen VC, et al. Inconsistent selection and definition of local and regional endpoints in breast cancer research. Br J Surg. 2014;101(13):1657–65.CrossRefPubMed
Metadata
Title
Clinically node negative breast cancer patients undergoing breast conserving therapy, sentinel lymph node procedure versus follow-up: a Dutch randomized controlled multicentre trial (BOOG 2013-08)
Authors
L. M. van Roozendaal
M. L. G. Vane
T. van Dalen
J. A. van der Hage
L. J. A. Strobbe
L. J. Boersma
S. C. Linn
M. B. I. Lobbes
P. M. P. Poortmans
V. C. G. Tjan-Heijnen
K. K. B. T. Van de Vijver
J. de Vries
A. H. Westenberg
A. G. H. Kessels
J. H. W. de Wilt
M. L. Smidt
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3443-x

Other articles of this Issue 1/2017

BMC Cancer 1/2017 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine