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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2010

Open Access 01-07-2010 | Breast Oncology

Sentinel Node Identification Rate and Nodal Involvement in the EORTC 10981-22023 AMAROS Trial

Authors: Marieke E. Straver, MD, PhD, Philip Meijnen, MD, PhD, Geertjan van Tienhoven, MD, PhD, Cornelis J. H. van de Velde, MD, PhD, Robert E. Mansel, MD, PhD, Jan Bogaerts, PhD, Nicole Duez, Luigi Cataliotti, MD, PhD, Jean H. G. Klinkenbijl, MD, PhD, Helen A. Westenberg, MD, PhD, Huub van der Mijle, MD, PhD, Marko Snoj, MD, PhD, Coen Hurkmans, PhD, Emiel J. T. Rutgers, MD, PhD

Published in: Annals of Surgical Oncology | Issue 7/2010

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Abstract

Background

The randomized EORTC 10981-22023 AMAROS trial investigates whether breast cancer patients with a tumor-positive sentinel node biopsy (SNB) are best treated with an axillary lymph node dissection (ALND) or axillary radiotherapy (ART). The aim of the current substudy was to evaluate the identification rate and the nodal involvement.

Methods

The first 2,000 patients participating in the AMAROS trial were evaluated. Associations between the identification rate and technical, patient-, and tumor-related factors were evaluated. The outcome of the SNB procedure and potential further nodal involvement was assessed.

Results

In 65 patients, the sentinel node could not be identified. As a result, the sentinel node identification rate was 97% (1,888 of 1,953). Variables affecting the success rate were age, pathological tumor size, histology, year of accrual, and method of detection. The SNB results of 65% of the patients (n = 1,220) were negative and the patients underwent no further axillary treatment. The SNB results were positive in 34% of the patients (n = 647), including macrometastases (n = 409, 63%), micrometastases (n = 161, 25%), and isolated tumor cells (n = 77, 12%). Further nodal involvement in patients with macrometastases, micrometastases, and isolated tumor cells undergoing an ALND was 41, 18, and 18%, respectively.

Conclusions

With a 97% detection rate in this prospective international multicenter study, the SNB procedure is highly effective, especially when the combined method is used. Further nodal involvement in patients with micrometastases and isolated tumor cells in the sentinel node was similar—both were 18%.
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Metadata
Title
Sentinel Node Identification Rate and Nodal Involvement in the EORTC 10981-22023 AMAROS Trial
Authors
Marieke E. Straver, MD, PhD
Philip Meijnen, MD, PhD
Geertjan van Tienhoven, MD, PhD
Cornelis J. H. van de Velde, MD, PhD
Robert E. Mansel, MD, PhD
Jan Bogaerts, PhD
Nicole Duez
Luigi Cataliotti, MD, PhD
Jean H. G. Klinkenbijl, MD, PhD
Helen A. Westenberg, MD, PhD
Huub van der Mijle, MD, PhD
Marko Snoj, MD, PhD
Coen Hurkmans, PhD
Emiel J. T. Rutgers, MD, PhD
Publication date
01-07-2010
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 7/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-0945-z

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