Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2012

01-11-2012 | Breast Oncology

Does the Rapid Acceptance of ACOSOG Z0011 Compromise Selection of Systemic Therapy?

Author: Hiram S. Cody III, MD

Published in: Annals of Surgical Oncology | Issue 12/2012

Login to get access

Excerpt

The acceptance of sentinel lymph node (SLN) biopsy as standard care in cN0 breast cancer is one of the great success stories in contemporary surgical oncology and is supported by the results of at least 69 observational studies, 7 randomized trials, and extensive literature covering all aspects of the procedure.1,2 The logical next question in the evolution of axillary staging is to ask whether all SLN-positive patients require axillary lymph node dissection (ALND), and it is clear that for many American surgeons they do not. In a retrospective study from the National Cancer Data Base, Bilimoria et al. report on 97,314 SLN-positive patients treated nationwide between 1998 and 2006.3 They show 23 % of patients with SLN macrometastases (>2 mm, pN1) and 55 % with SLN micrometastases (0.2–2 mm, pN1mi) did not have ALND, yet for both pN1 and pN1mi SLN disease, axillary local recurrence and 5-year relative survival were the same with or without ALND. …
Literature
1.
Kim T, Giuliano AE, Lyman GH. Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma. Cancer. 2006;106:4–16.PubMedCrossRef
2.
Kell MR, Burke JP, Barry M, Morrow M. Outcome of axillary staging in early breast cancer: a meta-analysis. Breast Cancer Res Treat. 2010;120:441–7.PubMedCrossRef
3.
Bilimoria KY, Bentrem DJ, Hansen NM, Bethke KP, Rademaker AW, Ko CY, et al. Comparison of sentinel lymph node biopsy alone and completion axillary lymph node dissection for node-positive breast cancer. J Clin Oncol. 2009;27:2946–53.PubMedCrossRef
4.
Giuliano AE, McCall LM, Beitsch PD, Whitworth PW, Morrow M, Blumencranz PW, et al. ACOSOG Z0011: A randomized trial of axillary node dissection in women with clinical T1-2 N0 M0 breast cancer who have a positive sentinel node. J Clin Oncol (Meeting Abstracts). 2010;28:CRA506.
5.
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;305:569–75.PubMedCrossRef
6.
Montemurro F, Maggiorotto F, Valabrega G, Kubatzki F, Rossi V, Magistris A, et al. Omission of axillary dissection after a positive sentinel node dissection may influence adjuvant chemotherapy indications in operable breast cancer patients. Ann Surg Oncol. doi:10.​1245/​s10434-012-2505-1.
7.
Goldhirsch A, Wood WC, Coates AS, Gelber RD, Thürlimann B, Senn HJ, et al. Strategies for subtypes–dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol. 2011;22:1736–47.PubMedCrossRef
8.
Carlson RW, Allred DC, Anderson BO, Burstein HJ, Edge SB, Farrar WB, et al. NCCN Clinical Practice Guidelines in Oncology: Breast Cancer Version 1.2012. 2012. Accessed June 7, 2012.
9.
Early Breast Cancer Trialists’ Collaborative Group. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;365:1687–717.CrossRef
10.
Early Breast Cancer Trialists’ Collaborative Group. Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. Lancet. 2012;379:432–44.
11.
Giuliano AE, McCall L, Beitsch P, Whitworth PW, Blumencranz P, Leitch AM, et al. Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons Oncology Group Z0011 randomized trial. Ann Surg. 2010;252:426–33.PubMed
12.
Straver ME, Meijnen P, van TG, van de Velde CJ, Mansel RE, Bogaerts J, et al. Role of axillary clearance after a tumor-positive sentinel node in the administration of adjuvant therapy in early breast cancer. J Clin Oncol. 2010;28:731–7.PubMedCrossRef
13.
Paik S, Shak S, Tang G, Kim C, Baker J, Cronin M, et al. A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. New Engl J Med. 2004;351:2817–26.PubMedCrossRef
14.
Paik S, Tang G, Shak S, Kim C, Baker J, Kim W, et al. Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer. J Clin Oncol. 2006;24:3726–34.PubMedCrossRef
15.
Albain KS, Barlow WE, Shak S, Hortobagyi GN, Livingston RB, Yeh IT, et al. Prognostic and predictive value of the 21-gene recurrence score assay in postmenopausal women with node-positive, oestrogen-receptor-positive breast cancer on chemotherapy: a retrospective analysis of a randomised trial. Lancet Oncol. 2010;11:55–65.PubMedCrossRef
16.
Sparano JA. TAILORx: trial assigning individualized options for treatment (Rx). Clin Breast Cancer. 2006;7:347–50.PubMedCrossRef
Metadata
Title
Does the Rapid Acceptance of ACOSOG Z0011 Compromise Selection of Systemic Therapy?
Author
Hiram S. Cody III, MD
Publication date
01-11-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 12/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2508-y

Other articles of this Issue 12/2012

Annals of Surgical Oncology 12/2012 Go to the issue

Pancreatic Tumors

Cost Effectiveness of Treatment Strategies for Primary Operable Pancreatic Head Adenocarcinoma: Do We Have More Scientific Evidence to Call for Further Centralization of Care?

Melanomas

The Unique Clinical Characteristics of Melanoma Diagnosed in Children

Hepatobiliary Tumors

Teach Your Children Well: Stage IV Colorectal Cancer and Variability in Practice Patterns

Breast Oncology

A Randomized, Controlled Trial Comparing Acetaminophen Plus Ibuprofen versus Acetaminophen Plus Codeine Plus Caffeine (Tylenol 3) after Outpatient Breast Surgery

Gastrointestinal Oncology

Duodenal Duplication Cyst: A Potentially Malignant Disease

Breast Oncology

Biology, Treatment, and Outcome in Very Young and Older Women with DCIS