ArticleAnnals of surgical oncology2023
Is Choosing Wisely Wise for Lobular Carcinoma in Patients Over 70 Years of Age? A National Cancer Database Analysis of Sentinel Node Practice Patterns.
Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 16 citations in OpenAlex.
- Axillary Management and Outcomes After Neoadjuvant Endocrine Therapy in the Randomized PELOPS Trial.Annals of surgical oncology · 2026Trial
- Omission of Axillary Surgery in Patients with Invasive Lobular Carcinoma of the Breast: Rates of Nodal Involvement in Clinically Node Negative Patients and Impact on Recurrence in a Single Institution Analysis.Annals of surgical oncology · 2026Article
- The Past, Present, and Future of Sentinel Lymph Node Biopsy in Breast Cancer.Annals of surgical oncology · 2026Review
- Article
- Locoregional Considerations for Invasive Lobular Carcinoma.Current breast cancer reports · 2026Review
- Evolving incidence patterns for locally advanced operable breast cancer by receptor status: SEER 2010-2021.NPJ breast cancer · 2025Article
- Racial disparities in presenting stage and surgical management among octogenarians with breast cancer: a national cancer database analysis.Breast cancer research and treatment · 2025Article
- Physician-level variation in axillary surgery in older adults with T1N0 hormone receptor-positive breast cancer: A retrospective population-based cohort study.Journal of geriatric oncology · 2024Article
- Reply to: "Is Choosing Wisely Wise for Lobular Carcinoma in Patients Over 70 Years of Age? A National Cancer Database Analysis of Sentinel Node Practice Patterns.Annals of surgical oncology · 2024Article
- Multimodal ultrasound imaging: a method to improve the accuracy of sentinel lymph node diagnosis in breast cancer.Frontiers in oncology · 2024Article
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5 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundControversy continues in the treatment of breast cancer in women over 70 years of age. In 2016, the Society of Surgical Oncology recommended against routine use of sentinel lymph node biopsy (SLNBx) as part of the 'Choosing Wisely Campaign'. This study examines the oncologic safety of avoidance of routine SLNBx in patients over 70 years of age with invasive lobular carcinoma (ILC).
methodsThe National Cancer Database was used to identify women with invasive ductal carcinoma (IDC) and ILC diagnosed between 2012 and 2020. Clinical and pathological staging, axillary staging, surgery type, and lymph node positivity between patients with IDC or ILC were compared.
resultsAmong women with T1 tumors, 85,949 (79.6%) patients with IDC and 12,761 (81.5%) patients with ILC underwent SLNBx (p < 0.001). Among patients who underwent SLNBx, those with IDC were more likely to have positive nodes (n = 7535, 8.8%) than those with ILC (n = 1041, 8.2%; p = 0.02). During the time interval of interest, for both IDC and ILC patients, the rate of axillary lymph node dissection decreased and rates of SLNBx or no axillary staging increased. On multivariate analysis, ILC histology was associated with use of SLNBx, but without nodal positivity.
conclusionA trend de-escalation of axillary staging was identified in this study, however the majority of patients meeting the 'Choosing Wisely' criteria are still undergoing SLNBx. No increased risk of nodal positivity was identified among patients with ILC, suggesting that surgeons can continue to choose wisely and limit the use of SLNBx in women over 70 years of age with T1 ILC tumors.
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