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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2012

01-10-2012 | Breast Oncology

Changing Behavior in Clinical Practice in Response to the ACOSOG Z0011 Trial: A Survey of the American Society of Breast Surgeons

Authors: Sarah M. Gainer, MD, Kelly K. Hunt, MD, Peter Beitsch, MD, Abigail S. Caudle, MD, Elizabeth A. Mittendorf, MD, Anthony Lucci, MD

Published in: Annals of Surgical Oncology | Issue 10/2012

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Abstract

Background

The American College of Surgeons Oncology Group (ACOSOG) Z0011 trial demonstrated no difference in overall survival or local–regional recurrence rates between patients planned for breast conservation therapy including whole breast irradiation (WBI) with one or two positive sentinel lymph nodes (SLNs) randomly selected to undergo axillary lymph node dissection (ALND) versus no further surgery. The current study was undertaken to evaluate the impact of Z0011 on surgical practice nationally.

Methods

A survey was sent by e-mail to 2,759 members of the American Society of Breast Surgeons (ASBrS). Questions assessed the respondents’ practice, familiarity with Z0011, and preferences for treating patients with one or two positive SLNs.

Results

Of those surveyed, 849 (30.8 %) responded. The majority (97 %) indicated familiarity with the data. Of those respondents, 468 (56.9 %) would not routinely perform ALND in patients planned to receive WBI, while 279 (36.0 %) would consider omission of completion ALND in patients planned to receive accelerated partial breast irradiation (APBI), and 218 (26.6 %) would consider omission of ALND in patients not planned to receive radiation. Academic and private practice surgeons were equally likely to incorporate Z0011 into practice.

Conclusions

ACOSOG Z0011 has changed surgical practice. ASBrS respondents have embraced Z0011 and have changed their practice, omitting ALND in patients with one or two positive SLNs who will undergo WBI. However, many also omit ALND in patients undergoing surgery without radiation or with APBI. As these clinical scenarios were not studied in Z0011, further evaluation is required prior to changing clinical practice.
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Metadata
Title
Changing Behavior in Clinical Practice in Response to the ACOSOG Z0011 Trial: A Survey of the American Society of Breast Surgeons
Authors
Sarah M. Gainer, MD
Kelly K. Hunt, MD
Peter Beitsch, MD
Abigail S. Caudle, MD
Elizabeth A. Mittendorf, MD
Anthony Lucci, MD
Publication date
01-10-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2523-z

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