ArticleAnnals of surgical oncology2014
Axillary dissection can be avoided in the majority of clinically node-negative patients undergoing breast-conserving therapy.
Article in Annals of surgical oncology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.
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44 citing papers in PubMed, 1 synthesis or guideline pooled it, 113 citations in OpenAlex.
- Axilla lymph node dissection can be safely omitted in patients with 1-2 positive sentinel nodes receiving mastectomy: a large multi-institutional study and a systemic meta-analysis.Breast cancer research and treatment · 2022Pooled it
- The feasibility of the ACOSOG Z0011 Criteria to Chinese Breast Cancer Patients: A Multicenter Study.Scientific reports · 2015Trial
- Radiomics-based signature of breast cancer on preoperative contrast-enhanced MRI to predict axillary metastasis.Future oncology (London, England) · 2026Article
- Is sentinel lymph node frozen section analysis necessary in hormone receptor-positive, HER2-negative, clinically node-negative breast cancer patients undergoing upfront mastectomy?Frontiers in oncology · 2026Article
- Article
- A systematic study of molecular targets of cannabidiol in Alzheimer's disease.Journal of Alzheimer's disease reports · 2024Review
- Extremely Low Incidence of Local-Regional Recurrences Observed Among T1-2 N1 (1 or 2 Positive SLNs) Breast Cancer Patients Receiving Upfront Mastectomy Without Completion Axillary Node Dissection.Annals of surgical oncology · 2023Article
- Axillary lymph node dissection: Dead or still alive?Breast (Edinburgh, Scotland) · 2023Article
- Inequalities in the omission of axillary dissection in sentinel lymph node positive patients in the Netherlands: Innovative hospitals are early adopters of a de-escalating approach.International journal of cancer · 2023Article
- The effect of omitting axillary dissection and the impact of radiotherapy on patients with breast cancer sentinel node macrometastases: a cohort study following the ACOSOG Z0011 and AMAROS trials.Breast cancer research and treatment · 2021Article
- Can We Avoid Axillary Lymph Node Dissection (ALND) in Patients with 1-2 Positive Sentinel/Low Axillary Lymph Nodes (SLN/LAS+) in the Indian Setting?Indian journal of surgical oncology · 2021Article
- Application of the ACOSOG Z0011 criteria to Chinese patients with breast cancer: a prospective study.World journal of surgical oncology · 2021Article
- Outcomes After Sentinel Lymph Node Biopsy and Radiotherapy in Older Women With Early-Stage, Estrogen Receptor-Positive Breast Cancer.JAMA network open · 2021Article
- De-escalation of axillary surgery in breast cancer patients treated in the neoadjuvant setting: a Dutch population-based study.Breast cancer research and treatment · 2020Article
- The Adventure of Axillary Treatment in Early Stage Breast Cancer.European journal of breast health · 2020Review
- Lobular Histology Does Not Predict the Need for Axillary Dissection Among ACOSOG Z0011-Eligible Breast Cancers.Annals of surgical oncology · 2019Article
- MRI evaluation of axillary and intramammary lymph nodes in the postoperative period.The breast journal · 2019Article
- Non-sentinel axillary tumor burden applying the ACOSOG Z0011 eligibility criteria to a large routine cohort.Breast cancer research and treatment · 2019Article
- Determining Whether High Nodal Burden in Early Breast Cancer Patients Can Be Predicted Preoperatively to Avoid Sentinel Lymph Node Biopsy.Journal of breast cancer · 2019Article
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Abstract
backgroundThe extent to which ACOSOG Z0011 findings are applicable to patients undergoing breast-conserving therapy (BCT) is uncertain. We prospectively assessed how often axillary dissection (ALND) was avoided in an unselected, consecutive patient cohort meeting Z0011 eligibility criteria and whether subgroups requiring ALND could be identified preoperatively.
methodsPatients with cT1,2cN0 breast cancer undergoing BCT were managed without ALND for metastases in <3 sentinel nodes (SNs) and no gross extracapsular extension (ECE). Patients with and without indications for ALND were compared using Fisher's exact and Wilcoxon rank sum tests.
resultsFrom August 2010 to November 2012, 2,157 invasive cancer patients had BCT. A total of 380 had histologic nodal metastasis; 93 did not meet Z0011 criteria. Of 287 with ≥1 H&E-positive SN (209 macrometastases), 242 (84 %) had indications for SN only. ALND was indicated in 45 for ≥3 positive SNs (n = 29) or ECE (n = 16). The median number of SNs removed in the SN group was 3 versus 5 in the ALND group (p < 0.0001). Age, hormone receptor and HER2 status, and grade did not differ between groups; tumors were larger in the ALND group (p < 0.0001). Of ALND patients, 72 % had additional positive nodes (median = 1; range 1-19). No axillary recurrences have occurred (median follow-up, 13 months).
conclusionsALND was avoided in 84 % of a consecutive series of patients having BCT, suggesting that most patients meeting ACOSOG Z0011 eligibility have a low axillary tumor burden. Age, ER, and HER2 status were not predictive of ALND, and the criteria used for ALND (≥3 SNs, ECE) reliably identified patients at high risk for residual axillary disease.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.