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Acquis et limites dans l’exploration de l’aisselle

Axillary surgery for breast cancer patients: state of the art

  • Conference paper
Acquis et limites en sénologie / Assets and limits in breast diseases

  • 232 Accesses

Résumé

L’exploration chirurgicale de l’aisselle répond au double objectif de recueil d’information sur le statut des ganglions et de contrôle local en cas de ganglions métastatiques. Environ 30 % des cancers du sein T1 ou T2 sans adénopathie cliniquement palpable présentent un envahissement ganglionnaire [1], [2]. L’impact direct de ce geste axillaire sur la survie globale reste hypothétique. Jusque dans les années 1990, cette exploration chirurgicale était réalisée par curage axillaire limité aux étages I–II de BERG [3]. Depuis, il existe une désescalade thérapeutique avec d’une part l’avènement de la technique du ganglion axillaire sentinelle (GAS), d’autre part la mise en place d’outils d’aide à la décision de curage complémentaire chez les patientes dont le GAS est métastatique et enfin, plus récemment, la remise en question de l’intérêt du curage axillaire complémentaire en cas de GAS métastatique.

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Références

  1. Krag DN, Anderson SJ, Julian TB et al. (2010) Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncol 11: 927–933

    Article  PubMed  Google Scholar 

  2. Veronesi U, Paganelli G, Viale G et al. (2003) A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med 349: 546–553

    Article  PubMed  Google Scholar 

  3. Berg JW (1955) The significance of axillary node levels in the study of breast carcinoma. Cancer 8: 776–778

    Article  PubMed  CAS  Google Scholar 

  4. Thierrin L, Steiger D, Zuber JP et al. (2008) Severe anaphylactic shock to Patent Blue V with cardiac arrest during breast carcinoma surgery with lymphatic mapping. Eur J Obstet Gynecol Reprod Biol 140: 140–141

    Article  PubMed  Google Scholar 

  5. Krag DN, Anderson SJ, Julian TB et al. (2007) Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial. Lancet Oncol 8: 881–888

    Article  PubMed  CAS  Google Scholar 

  6. Mansel RE, Fallowfield L, Kissin M et al. (2006) Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst 98: 599–609

    Article  PubMed  Google Scholar 

  7. Martin RC, 2nd, Chagpar A, Scoggins CR et al. (2005) Clinicopathologic factors associated with false-negative sentinel lymph-node biopsy in breast cancer. Ann Surg 241: 1005–1012; discussion 1012–15

    Article  PubMed  Google Scholar 

  8. Giard S, Chauvet MP, Penel N et al. (2010) Feasibility of sentinel lymph node biopsy in multiple unilateral synchronous breast cancer: results of a French prospective multi-institutional study (IGASSU 0502). Ann Oncol 21: 1630–1635

    Article  PubMed  CAS  Google Scholar 

  9. Classe JM, Bordes V, Campion L et al. (2009) Sentinel lymph node biopsy after neoadjuvant chemotherapy for advanced breast cancer: results of Ganglion Sentinelle et Chimiotherapie Neoadjuvante, a French prospective multicentric study. J Clin Oncol 27: 726–732

    Article  PubMed  Google Scholar 

  10. O’Leary DP, O’Brien O, Relihan N et al. (2012) Rapid on-site evaluation of axillary fine-needle aspiration cytology in breast cancer. Br J Surg 99: 807–812

    Article  CAS  Google Scholar 

  11. Tunon-de-Lara C, Giard S, Buttarelli M et al. (2008) Sentinel node procedure is warranted in ductal carcinoma in situ with high risk of occult invasive carcinoma and microinvasive carcinoma treated by mastectomy. Breast J 14: 135–140

    Article  PubMed  Google Scholar 

  12. Layfield DM, Agrawal A, Roche H, Cutress RI (2011) Intraoperative assessment of sentinel lymph nodes in breast cancer. Br J Surg 98: 4–17

    Article  PubMed  CAS  Google Scholar 

  13. Cserni G (2012) Intraoperative analysis of sentinel lymph nodes in breast cancer by one-step nucleic acid amplification. J Clin Pathol 65: 193–199

    Article  PubMed  CAS  Google Scholar 

  14. Classe JM, Baffert S, Sigal-Zafrani B et al. (2011) Cost comparison of axillary sentinel lymph node detection and axillary lymphadenectomy in early breast cancer. A national study based on a prospective multi-institutional series of 985 patients ‘on behalf of the Group of Surgeons from the French Unicancer Federation’. Ann Oncol 23: 1170–1177

    Article  PubMed  Google Scholar 

  15. Avril A, Le Bouedec G, Lorimier G et al. (2011) Phase III randomized equivalence trial of early breast cancer treatments with or without axillary clearance in post-menopausal patients results after 5 years of follow-up. Eur J Surg Oncol 37: 563–570

    Article  PubMed  CAS  Google Scholar 

  16. Coutant C, Olivier C, Lambaudie E et al. (2009) Comparison of models to predict nonsentinel lymph node status in breast cancer patients with metastatic sentinel lymph nodes: a prospective multicenter study. J Clin Oncol 27: 2800–2808

    Article  PubMed  Google Scholar 

  17. Houvenaeghel G, Bannier M, Nos C et al. (2012) Non sentinel node involvement prediction for sentinel node micrometastases in breast cancer: nomogram validation and comparison with other models. Breast 21: 204–209

    Article  PubMed  Google Scholar 

  18. Hwang RF, Gonzalez-Angulo AM, Yi M et al. (2007) Low locoregional failure rates in selected breast cancer patients with tumor-positive sentinel lymph nodes who do not undergo completion axillary dissection. Cancer 110: 723–730

    Article  PubMed  Google Scholar 

  19. Naik AM, Fey J, Gemignani M et al. (2004) The risk of axillary relapse after sentinel lymph node biopsy for breast cancer is comparable with that of axillary lymph node dissection: a follow-up study of 4008 procedures. Ann Surg 240: 462–468; discussion 468–71

    Article  PubMed  Google Scholar 

  20. Weaver DL, Ashikaga T, Krag DN et al. (2011) Effect of occult metastases on survival in node-negative breast cancer. N Engl J Med 364: 412–421

    Article  PubMed  CAS  Google Scholar 

  21. Houvenaeghel G, Nos C, Mignotte H et al. (2006) Micrometastases in sentinel lymph node in a multicentric study: predictive factors of nonsentinel lymph node involvement—Groupe des Chirurgiens de la Federation des Centres de Lutte Contre le Cancer. J Clin Oncol 24: 1814–1822

    Article  PubMed  Google Scholar 

  22. Giuliano AE, Hunt KK, Ballman KV et al. (2011) Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. Jama 305: 569–575

    Article  PubMed  CAS  Google Scholar 

  23. Hurkmans CW, Borger JH, Rutgers EJ, van Tienhoven G (2003) Quality assurance of axillary radiotherapy in the EORTC AMAROS trial 10981/22023: the dummy run. Radiother Oncol 68: 233–240

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Institut de Cancérologie de l’Ouest — René Gauducheau, 44805, Saint-Herblain, France

    J.-M. Classe, S. Giard, G. Houvenaeghel, K. Clough, C. Nos & E. Barranger

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  1. J.-M. Classe
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  2. S. Giard
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  3. G. Houvenaeghel
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  4. K. Clough
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  5. C. Nos
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  6. E. Barranger
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© 2013 Springer-Verlag France, Paris

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Classe, JM., Giard, S., Houvenaeghel, G., Clough, K., Nos, C., Barranger, E. (2013). Acquis et limites dans l’exploration de l’aisselle. In: Acquis et limites en sénologie / Assets and limits in breast diseases. Springer, Paris. https://doi.org/10.1007/978-2-8178-0396-8_14

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  • DOI: https://doi.org/10.1007/978-2-8178-0396-8_14

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0395-1

  • Online ISBN: 978-2-8178-0396-8

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