Non-sentinel axillary tumor burden applying the ACOSOG Z0011 eligibility criteria to a large routine cohort.
Adolescent
Adult
Aged
Aged, 80 and over
Axilla
/ pathology
Biomarkers, Tumor
Breast Neoplasms
/ etiology
Clinical Decision-Making
Cohort Studies
Disease Management
Female
Humans
Lymph Node Excision
Lymphatic Metastasis
Mastectomy, Segmental
Middle Aged
Retrospective Studies
Sentinel Lymph Node
/ pathology
Sentinel Lymph Node Biopsy
Young Adult
ACOSOG Z0011
Axillary lymph node dissection
Breast cancer
Non-sentinel metastasis
Sentinel lymph node dissection
Journal
Breast cancer research and treatment
ISSN: 1573-7217
Titre abrégé: Breast Cancer Res Treat
Pays: Netherlands
ID NLM: 8111104
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
10
06
2019
accepted:
17
06
2019
pubmed:
27
6
2019
medline:
10
1
2020
entrez:
26
6
2019
Statut:
ppublish
Résumé
In the ACOSOG Z0011 trial, patients with primary breast cancer (BC) and 1-2 tumor-involved sentinel lymph nodes (SLN) undergoing breast-conserving surgery gained no benefit from completing axillary lymph node dissection (cALND). This paper reports cALND rates performed in clinical routine on patients who would meet the Z0011 criteria. Further, patients still received cALND were analyzed concerning the number of non-sentinel metastases (NSM) to estimate occult axillary tumor burden. Data were retrospectively analyzed from patients treated in 179 German breast centers between 2008 and 2015. Time-trend rates were determined for cALND regarding the presence of axillary macrometastases or micrometastases. Descriptive statistics were used to report the number of NSM depending on the number of SLN removed, tumor-involved SLN, tumor stage (pT1-2), and immunohistochemical subtype. Factors associated with NSM were identified using multivariable logistic regression. Altogether, data for 188,909 patients were available, of whom 13,741 (7.3%) were identified eligible for the Z0011 criteria. For these patients, the cALND rate for macrometastases declined from 96.4% in 2008 to 49.7% in 2015, for micrometastases from 86.7 to 5.9%. In total 9773 patients still received cALND, 33.4% of whom had NSM. The NSM rates were: 38.8% for pN(1/1sn), 28.6% for pN(1/2sn), and 50.9% for pN(2/2sn). Hormone receptor (HR) positive/HER2+ showed the highest NSM rate (41.6%), HR-/HER2- the lowest rate (29.4%). The rate of cALND for ACOSOG Z0011 eligible patients has decreased substantially in routine care in our nationwide cohort. Our data reveal a relatively high prevalence of additional axillary NSM tumor burden.
Identifiants
pubmed: 31236814
doi: 10.1007/s10549-019-05327-4
pii: 10.1007/s10549-019-05327-4
doi:
Substances chimiques
Biomarkers, Tumor
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
457-467Subventions
Organisme : Deutsche Krebshilfe
ID : 70112082
Références
Whelan TJ, Olivotto IA, Parulekar WR, Ackerman I, Chua BH, Nabid A et al (2015) Regional nodal irradiation in early-stage breast cancer. N Engl J Med 373(4):307–316
doi: 10.1056/NEJMoa1415340
pubmed: 26200977
pmcid: 4556358
Moebus V, Jackisch C, Lueck HJ, du Bois A, Thomssen C, Kurbacher C et al (2010) Intense dose-dense sequential chemotherapy with epirubicin, paclitaxel, and cyclophosphamide compared with conventionally scheduled chemotherapy in high-risk primary breast cancer: mature results of an AGO phase III study. J Clin Oncol 28(17):2874–2880
doi: 10.1200/JCO.2009.24.7643
pubmed: 20458045
Network NCC (2016) NCCN clinical practice guidelines in oncology (NCCN Guidelines). Breast Cancer 2016. 1
Perou CM, Sorlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA et al (2000) Molecular portraits of human breast tumours. Nature 406(6797):747–752
doi: 10.1038/35021093
Cardoso F, van’t Veer LJ, Bogaerts J, Slaets L, Viale G, Delaloge S et al (2016) 70-gene signature as an aid to treatment decisions in early-stage breast cancer. N Engl J Med 375(8):717–729
doi: 10.1056/NEJMoa1602253
Gluz O, Nitz UA, Christgen M, Kates RE, Shak S, Clemens M et al (2016) West German Study Group Phase III PlanB trial: first prospective outcome data for the 21-gene recurrence score assay and concordance of prognostic markers by central and local pathology assessment. J Clin Oncol 34(20):2341–2349
doi: 10.1200/JCO.2015.63.5383
pubmed: 26926676
Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V et al (2003) A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med 349(6):546–553
doi: 10.1056/NEJMoa012782
pubmed: 12904519
Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Costantino JP 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(10):927–933
doi: 10.1016/S1470-2045(10)70207-2
pubmed: 20863759
pmcid: 3041644
DiSipio T, Rye S, Newman B, Hayes S (2013) Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol 14(6):500–515
doi: 10.1016/S1470-2045(13)70076-7
pubmed: 23540561
Giuliano AE, McCall L, Beitsch P, Whitworth PW, Blumencranz P, Leitch AM et al (2010) Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons Oncology Group Z0011 randomized trial. Ann Surg 252(3):426–432 (discussion 32-3)
pubmed: 20739842
pmcid: 5593421
Giuliano AE, Ballman K, McCall L, Beitsch P, Whitworth PW, Blumencranz P et al (2016) Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: long-term follow-up from the American College of Surgeons Oncology Group (Alliance) ACOSOG Z0011 randomized trial. Ann Surg 264(3):413–420
doi: 10.1097/SLA.0000000000001863
pubmed: 27513155
pmcid: 5070540
Giuliano AE, Ballman KV, McCall L, Beitsch PD, Brennan MB, Kelemen PR et al (2017) Effect of axillary dissection vs no axillary dissection on 10-year overall survival among women with invasive breast cancer and sentinel node metastasis: the ACOSOG Z0011 (Alliance) randomized clinical trial. JAMA 318(10):918–926
doi: 10.1001/jama.2017.11470
pubmed: 28898379
pmcid: 5672806
Maguire A, Brogi E (2016) Sentinel lymph nodes for breast carcinoma: a paradigm shift. Arch Pathol Lab Med 140(8):791–798
doi: 10.5858/arpa.2015-0140-RA
pubmed: 27472237
pmcid: 5027875
Guth U, Myrick ME, Viehl CT, Schmid SM, Obermann EC, Weber WP (2012) The post ACOSOG Z0011 era: does our new understanding of breast cancer really change clinical practice? Eur J Surg Oncol 38(8):645–650
doi: 10.1016/j.ejso.2012.04.018
pubmed: 22608851
Shah-Khan M, Boughey JC (2012) Evolution of axillary nodal staging in breast cancer: clinical implications of the ACOSOG Z0011 trial. Cancer Control 19(4):267–276
doi: 10.1177/107327481201900403
pubmed: 23037494
Morrow M, Giuliano AE (2011) To cut is to cure: can we really apply Z11 in practice? Ann Surg Oncol 18(9):2413–2415
doi: 10.1245/s10434-011-1857-2
pubmed: 21717245
Galimberti V, Cole BF, Zurrida S, Viale G, Luini A, Veronesi P et al (2013) Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol 14(4):297–305
doi: 10.1016/S1470-2045(13)70035-4
pubmed: 23491275
pmcid: 3935346
Galimberti V, Cole BF, Viale G, Veronesi P, Vicini E, Intra M et al (2018) Axillary dissection versus no axillary dissection in patients with breast cancer and sentinel-node micrometastases (IBCSG 23-01): 10-year follow-up of a randomised, controlled phase 3 trial. Lancet Oncol 19(10):1385–1393
doi: 10.1016/S1470-2045(18)30380-2
pubmed: 30196031
Donker M, van Tienhoven G, Straver ME, Meijnen P, van de Velde CJ, Mansel RE et al (2014) Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol 15(12):1303–1310
doi: 10.1016/S1470-2045(14)70460-7
pubmed: 25439688
pmcid: 4291166
Savolt A, Peley G, Polgar C, Udvarhelyi N, Rubovszky G, Kovacs E et al (2017) Eight-year follow up result of the OTOASOR trial: the Optimal Treatment Of the Axilla - Surgery Or Radiotherapy after positive sentinel lymph node biopsy in early-stage breast cancer: a randomized, single centre, phase III, non-inferiority trial. Eur J Surg Oncol 43(4):672–679
doi: 10.1016/j.ejso.2016.12.011
pubmed: 28139362
Riedel F, Heil J, Golatta M, Schaefgen B, Hug S, Schott S et al (2018) Changes of breast and axillary surgery patterns in patients with primary breast cancer during the past decade. Arch Gynecol Obstet 299(4):1043–1053
doi: 10.1007/s00404-018-4982-3
pubmed: 30478667
Wockel A, Festl J, Stuber T, Brust K, Stangl S, Heuschmann PU et al (2018) Interdisciplinary screening, diagnosis, therapy and follow-up of breast cancer. Guideline of the DGGG and the DKG (S3-Level, AWMF Registry Number 032/045OL, December 2017) - Part 1 with Recommendations for the Screening, Diagnosis and Therapy of Breast Cancer. Geburtshilfe Frauenheilkd 78(10):927–948
doi: 10.1055/a-0646-4522
pubmed: 30369626
pmcid: 6202580
Gradishar WJ, Anderson BO, Balassanian R, Blair SL, Burstein HJ, Cyr A et al (2017) NCCN guidelines insights: breast cancer, version 1.2017. J Natl Compr Cancer Netw 15(4):433–451
doi: 10.6004/jnccn.2017.0044
WBC, Westdeutsches Brust-Centrum GmbH (2015) Benchmarking WBC - 2014, Jahresbericht, Kennzahlen
Hennigs A, Kopke M, Feisst M, Riedel F, Rezai M, Nitz U et al (2019) Which patients with sentinel node-positive breast cancer after breast conservation still receive completion axillary lymph node dissection in routine clinical practice? Breast Cancer Res Treat 173(2):429–438
doi: 10.1007/s10549-018-5009-2
pubmed: 30315437
Goldhirsch A, Wood WC, Coates AS, Gelber RD, Thurlimann B, Senn HJ (2011) Strategies for subtypes–dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol 22(8):1736–1747
doi: 10.1093/annonc/mdr304
pubmed: 3144634
pmcid: 3144634
Hennigs A, Riedel F, Gondos A, Sinn P, Schirmacher P, Marmé F et al (2016) Prognosis of breast cancer molecular subtypes in routine clinical care: a large prospective cohort study. BMC Cancer 16(1):1–9
doi: 10.1186/s12885-016-2766-3
Dengel LT, Van Zee KJ, King TA, Stempel M, Cody HS, El-Tamer M et al (2014) Axillary dissection can be avoided in the majority of clinically node-negative patients undergoing breast-conserving therapy. Ann Surg Oncol 21(1):22–27
doi: 10.1245/s10434-013-3200-6
pubmed: 23975314
Yao K, Liederbach E, Pesce C, Wang CH, Winchester DJ (2015) Impact of the American College of Surgeons Oncology Group Z0011 randomized trial on the number of axillary nodes removed for patients with early-stage breast cancer. J Am Coll Surg 221(1):71–81
doi: 10.1016/j.jamcollsurg.2015.02.035
pubmed: 25899731
Poodt IGM, Spronk PER, Vugts G, van Dalen T, Peeters M, Rots ML et al (2018) Trends on axillary surgery in nondistant metastatic breast cancer patients treated between 2011 and 2015: a Dutch Population-based Study in the ACOSOG-Z0011 and AMAROS Era. Ann Surg 268(6):1084–1090
doi: 10.1097/SLA.0000000000002440
pubmed: 28742702
Gondos A, Jansen L, Heil J, Schneeweiss A, Voogd AC, Frisell J et al (2016) Time trends in axilla management among early breast cancer patients: persisting major variation in clinical practice across European centers. Acta Oncol 55(6):712–719
doi: 10.3109/0284186X.2015.1136751
pubmed: 26878397
Naidoo K, Pinder SE (2017) Micro- and macro-metastasis in the axillary lymph node: a review. Surgeon 15(2):76–82
doi: 10.1016/j.surge.2016.07.002
pubmed: 27498412
Bauerfeind I, Kümmel S. (Working Group Gynecological Oncology) (2011) Diagnosis and treatment of patients with primary and metastatic breast cancer: Guidelines of the AGO Breast Commission. 03/2011
Yi M, Kuerer HM, Mittendorf EA, Hwang RF, Caudle AS, Bedrosian I et al (2013) Impact of the American College of Surgeons Oncology Group Z0011 criteria applied to a contemporary patient population. J Am Coll Surg 216(1):105–113
doi: 10.1016/j.jamcollsurg.2012.09.005
pubmed: 23122536
Tsao MW, Cornacchi SD, Hodgson N, Simunovic M, Thabane L, Cheng J et al (2016) A population-based study of the effects of a regional guideline for completion axillary lymph node dissection on axillary surgery in patients with breast cancer. Ann Surg Oncol 23(10):3354–3364
doi: 10.1245/s10434-016-5310-4
pubmed: 27342830
Freedman GM, Fowble BL, Li T, Hwang ES, Schechter N, Devarajan K et al (2014) Risk of positive nonsentinel nodes in women with 1-2 positive sentinel nodes related to age and molecular subtype approximated by receptor status. Breast J 20(4):358–363
doi: 10.1111/tbj.12276
pubmed: 24861613
pmcid: 4472437
Millar EK, Graham PH, O’Toole SA, McNeil CM, Browne L, Morey AL et al (2009) Prediction of local recurrence, distant metastases, and death after breast-conserving therapy in early-stage invasive breast cancer using a five-biomarker panel. J Clin Oncol 27(28):4701–4708
doi: 10.1200/JCO.2008.21.7075
pubmed: 19720911
Wiechmann L, Sampson M, Stempel M, Jacks LM, Patil SM, King T et al (2009) presenting features of breast cancer differ by molecular subtype. Ann Surg Oncol 16(10):2705–2710
doi: 10.1245/s10434-009-0606-2
Gangi A, Mirocha J, Leong T, Giuliano AE (2014) Triple-negative breast cancer is not associated with increased likelihood of nodal metastases. Ann Surg Oncol 21(13):4098–4103
doi: 10.1245/s10434-014-3989-7
pubmed: 25155393
Gianni L, Pienkowski T, Im YH, Tseng LM, Liu MC, Lluch A et al (2016) 5-year analysis of neoadjuvant pertuzumab and trastuzumab in patients with locally advanced, inflammatory, or early-stage HER2-positive breast cancer (NeoSphere): a multicentre, open-label, phase 2 randomised trial. Lancet Oncol 17(6):791–800
doi: 10.1016/S1470-2045(16)00163-7
Hennigs A, Riedel F, Marme F, Sinn P, Lindel K, Gondos A et al (2016) Changes in chemotherapy usage and outcome of early breast cancer patients in the last decade. Breast Cancer Res Treat 160(3):491–499
doi: 10.1007/s10549-016-4016-4
pubmed: 27744486
pmcid: 5090013
Savolt A, Polgar C, Musonda P, Matrai Z, Renyi-Vamos F, Toth L et al (2013) Does the result of completion axillary lymph node dissection influence the recommendation for adjuvant treatment in sentinel lymph node-positive patients? Clin Breast Cancer 13(5):364–370
doi: 10.1016/j.clbc.2013.04.004
pubmed: 23773380
Poodt IGM, Rots ML, Vugts G, van Dalen T, Kuijer A, Vriens BEPJ et al (2018) The administration of adjuvant chemo(-immuno) therapy in the post ACOSOG-Z0011 era; a population based study. Eur J Surg Oncol 44(8):1151–1156
doi: 10.1016/j.ejso.2018.03.003
pubmed: 29580733
Aigner J, Smetanay K, Hof H, Sinn HP, Sohn C, Schneeweiss A et al (2013) Omission of axillary dissection according to ACOSOG Z0011: impact on adjuvant treatment recommendations. Ann Surg Oncol 20(5):1538–1544
doi: 10.1245/s10434-012-2798-0
pubmed: 23389469
Lucci A, McCall LM, Beitsch PD, Whitworth PW, Reintgen DS, Blumencranz PW et al (2007) Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011. J Clin Oncol 25(24):3657–3663
doi: 10.1200/JCO.2006.07.4062
pubmed: 17485711