Moving Away From Axillary Lymph Node Dissection Indicates Practice-Changing Trials
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Axillary lymph node dissection (ALND) during breast-conserving surgery (BCS) or mastectomy has been the standard practice for the surgical treatment of breast cancer. To reduce side effects of ALND, sentinel lymph node dissection (SLND) has been developed and standardized for early-stage breast cancer. Until recently, micrometastases or metastases in one or more sentinel nodes was considered as indication for ALND. However, recent, large-scale, randomized trials have showed no survival benefit or improved locoregional control of ALND compared with no ALND when micrometastatic or metastatic disease is detected in sentinel lymph nodes (SLN).1,2 Therefore, ALND can be considered an overtreatment in selected patients. Under these new practice-changing results, new recommendations for multidisciplinary treatment of early breast cancer also require modification.
To highlight potential consequences by omitting complete ALND (cALND) after the publication of the American College of Surgeons Onco ...
- Weaver DL, Ashikaga T, Krag DN, et al. 2011 Effect of occult metastases on survival in node-negative breast cancer. N Engl J Mecancerd. 2011;364(5):412–21 CrossRef
- Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW, Leitch AM, Saha S, McCall LM, Morrow M. Axillary dissection vs. no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA. 2011;305(6):569–75.
- Caudle AS, Hunt KK, Kuerer HM, et al. Multidisciplinary considerations in the implementation of the findings from the American College of Surgeons Oncology Group (ACOSOG) Z0011 study: a practice-changing trial. Ann Surg Oncol. 2011 Feb 15 [Epub ahead of print].
- King TA, Sakr R, Patil S, Gurevich I, Stempel M, Sampson M, Morrow M. Clinical management factors contribute to the decision for contralateral prophylactic mastectomy. J Clin Oncol. 2011 Apr 4 [Epub ahead of print].
- Green ED, Guyer MS; National Human Genome Research Institute. Charting a course for genomic medicine from base pairs to bedside. Nature. 2011;470(7333):204–13. CrossRef
- Katsios C, Roukos DH. Individual genomes and personalized medicine: life diversity and complexity. Per Med. 2010;7(4):347–50. CrossRef
- Roukos DH. Trastuzumab and beyond: sequencing cancer genomes and predicting molecular networks. Pharmacogenomics J. 2011;11(2):81–92. CrossRef
- Roukos DH. Next-generation, genome sequencing-based biomarkers: concerns and challenges for medical practice. Biomark Med. 2010;4(4):583–6. CrossRef
- Roukos DH. Networks medicine: from reductionism to evidence of complex dynamic biomolecular interactions. Pharmacogenomics. 2011;12(5):695–8. CrossRef
- Roukos DH. Measurable evidence of miRNAs as regulators of cancer networks and therapeutic targets. Expert Rev Med Devices. 2011;8(2):123–6. CrossRef
- Roukos DH. Cancer genome explosion and systems biology: impact on surgical oncology? Ann Surg Oncol. 2011;18(1):12–5. CrossRef
- Katsios C, Roukos DH. Missing heritability, next-generation genome-wide association studies and primary cancer prevention: an Atlantean illusion? Future Oncol. 2011;7(4):477–80. CrossRef
- Moving Away From Axillary Lymph Node Dissection Indicates Practice-Changing Trials
Annals of Surgical Oncology
Volume 18, Issue 3 Supplement, pp 281-282
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. Department of Surgery, University Hospital of Ioannina, School of Medicine, Ioannina, Greece
- 2. Department of General Surgery, University Hospital of Heraklion, Medical School, University of Crete Heraklion, Crete, Greece