ArticleAnnals of surgical oncology2021
A National Survey of Breast Surgeons and Radiation Oncologists on Contemporary Axillary Management in Mastectomy Patients.
Article in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 20 citations in OpenAlex.
- Article
- Review
- Examining the false-negative rate of a negative axillary node ultrasound-guided core needle biopsy in breast cancer patients undergoing upfront surgery.American journal of surgery · 2025Article
- Predictive potential of hepatocyte growth factor and bone morphogenetic proteins in lymphatic metastasis of breast cancer.Translational breast cancer research : a journal focusing on translational research in breast cancer · 2025Article
- Should surgeons reconsider the role of intraoperative sentinel lymph node evaluation for premenopausal breast cancer patients in the era of RxPONDER?American journal of surgery · 2024Article
- Shifting neoadjuvant chemotherapy treatment paradigms for breast cancer and its impact on axillary nodal management for clinically node-negative patients.Gland surgery · 2024Article
- Does Neoadjuvant Chemotherapy in Clinical T1-T2 N0 Triple-Negative Breast Cancer Increase the Extent of Axillary Surgery?Annals of surgical oncology · 2024Article
- Intraoperative Pathology Assessment May Lead to Overtreatment of the Axilla in Clinically Node-Negative Breast Cancer Patients Undergoing Upfront Mastectomy.Annals of surgical oncology · 2023Article
- Escalating de-escalation in breast cancer treatment.Breast cancer research and treatment · 2022Article
- Postmastectomy Radiation Therapy in Patients With Minimally Involved Lymph Nodes: A Review of the Current Data and Future Directions.Journal of breast cancer · 2022Review
- 22nd Annual Virtual Meeting of the American Society of Breast Surgeons: Science, Innovation, and Practice Changes.Annals of surgical oncology · 2021Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundManagement of axillary lymph nodes in breast cancer has undergone significant change over the past decade through landmark clinical trials. This study aimed to assess national practice patterns in axillary management in patients undergoing upfront mastectomy and examines what guides provider recommendations.
methodsA national case-based survey study was performed of surgeons and radiation oncologists from July to August 2020. Surgeons were identified through the American Society of Breast Surgeons (ASBrS) after review and approval by the ASBrS Research Committee, and radiation oncologists were identified through an institutional database. Both descriptive and comparative statistical analyses were performed.
resultsOverall, 994 providers responded-680 surgeons and 314 radiation oncologists. Surgeons were older and in practice longer (p < 0.05) and treated a higher percentage of breast patients (81% vs. 40%, p < 0.001). Most surgeons were hospital-employed (43%), whereas most radiation oncologists were in private practice (40%; p < 0.001). Fifty-two percent of surgeons routinely send sentinel lymph nodes (SLNs) for frozen section (52%) during mastectomy, of which 78% proceed directly to axillary lymph node dissection (ALND) if positive. There was significant variability in treatment recommendations between the two groups among the hypothetical cases (p < 0.001). In the setting of low disease burden in the SLNs, > 30% of surgeons recommended ALND, while radiation oncologists recommend axillary radiotherapy over axillary clearance (p < 0.001).
conclusionThere is significant heterogeneity in the management of the axilla in mastectomy patients with pathologically positive SLNs, both between and among surgeons and radiation oncologists. Efforts should be made to assist both groups in identifying de-escalation opportunities to ensure that mastectomy patients with positive SLNs are treated appropriately.
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