Outcomes of Clinically Node-Negative Breast Cancer Without Axillary Dissection: Can Preserved Axilla Be Safely Treated with Radiation after a Positive Sentinel Node Biopsy?

Naoko Sanuki, Atsuya Takeda, Atsushi Amemiya, Toru Ofuchi, Masashi Ono, Haruki Ogata, Ryo Yamagami, Jun Hatayama, Takahisa Eriguchi, Etsuo Kunieda

研究成果: Article

15 引用 (Scopus)

抄録

Purpose: We analyzed whether axillary nodal irradiation could control clinically node-negative disease, including those patients with a positive sentinel lymph node biopsy (SLNB), most of whom received regional nodal irradiation. We also evaluated toxicity profiles that resulted from nodal irradiation. Patients and Methods: From 1988 to 2011, 2107 patients with cT1-T2N0M0 breast cancer underwent breast conservation therapy in the absence of axillary dissection: nx group (n = 1548), without any axillary surgery; the sn- group (n = 518), with a negative SLNB; and sn+ group (n = 104), with a positive SLNB. Results: The median follow-up times were 88, 56, and 55 months for the nx, sn-, and sn+ groups, respectively. The nx group had more risk factors than did the other 2 groups in terms of age, grade, or T stage. Ninety-eight percent of the sn-group received only tangent irradiation, and 100% and 83% of the sn+ and nx group, respectively, received additional regional nodal irradiation. The 5-year cumulative incidences of axillary failure and regional nodal failure were 34, 3, and 0 (2.7%, 0.7%, and 0%; P =.02, log-rank test) and 57, 4, and 0 (4.4, 1%, and 0; P =.04), respectively. Overall survival rates in 5 years were 96.4%, 98.9%, and 97.6% (P =.03), respectively. Symptomatic but transient radiation pneumonitis developed in 31, 16, and 6 (2.0%, 3.1%, and 5.7%). Mild arm edema was observed in 1, 4, and 0 (0.06%, 0.8%, and 0%) in the nx, sn-, sn+ groups, respectively. Conclusions: Treatment without axillary dissection showed excellent outcomes with negligible toxicity for patients with clinically node negative, including those with a positive SLNB. Regional nodal irradiation after a positive SLNB is a reasonable alternative to axillary dissection.

元の言語English
ページ(範囲)69-76
ページ数8
ジャーナルClinical Breast Cancer
13
発行部数1
DOI
出版物ステータスPublished - 2013
外部発表Yes

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Sentinel Lymph Node Biopsy
Axilla
Dissection
Radiation
Breast Neoplasms
Biopsy
Radiation Pneumonitis
Segmental Mastectomy
Edema
Survival Rate
cyhalothrin
Incidence

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

これを引用

Outcomes of Clinically Node-Negative Breast Cancer Without Axillary Dissection : Can Preserved Axilla Be Safely Treated with Radiation after a Positive Sentinel Node Biopsy? / Sanuki, Naoko; Takeda, Atsuya; Amemiya, Atsushi; Ofuchi, Toru; Ono, Masashi; Ogata, Haruki; Yamagami, Ryo; Hatayama, Jun; Eriguchi, Takahisa; Kunieda, Etsuo.

:: Clinical Breast Cancer, 巻 13, 番号 1, 2013, p. 69-76.

研究成果: Article

Sanuki, Naoko ; Takeda, Atsuya ; Amemiya, Atsushi ; Ofuchi, Toru ; Ono, Masashi ; Ogata, Haruki ; Yamagami, Ryo ; Hatayama, Jun ; Eriguchi, Takahisa ; Kunieda, Etsuo. / Outcomes of Clinically Node-Negative Breast Cancer Without Axillary Dissection : Can Preserved Axilla Be Safely Treated with Radiation after a Positive Sentinel Node Biopsy?. :: Clinical Breast Cancer. 2013 ; 巻 13, 番号 1. pp. 69-76.
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title = "Outcomes of Clinically Node-Negative Breast Cancer Without Axillary Dissection: Can Preserved Axilla Be Safely Treated with Radiation after a Positive Sentinel Node Biopsy?",
abstract = "Purpose: We analyzed whether axillary nodal irradiation could control clinically node-negative disease, including those patients with a positive sentinel lymph node biopsy (SLNB), most of whom received regional nodal irradiation. We also evaluated toxicity profiles that resulted from nodal irradiation. Patients and Methods: From 1988 to 2011, 2107 patients with cT1-T2N0M0 breast cancer underwent breast conservation therapy in the absence of axillary dissection: nx group (n = 1548), without any axillary surgery; the sn- group (n = 518), with a negative SLNB; and sn+ group (n = 104), with a positive SLNB. Results: The median follow-up times were 88, 56, and 55 months for the nx, sn-, and sn+ groups, respectively. The nx group had more risk factors than did the other 2 groups in terms of age, grade, or T stage. Ninety-eight percent of the sn-group received only tangent irradiation, and 100{\%} and 83{\%} of the sn+ and nx group, respectively, received additional regional nodal irradiation. The 5-year cumulative incidences of axillary failure and regional nodal failure were 34, 3, and 0 (2.7{\%}, 0.7{\%}, and 0{\%}; P =.02, log-rank test) and 57, 4, and 0 (4.4, 1{\%}, and 0; P =.04), respectively. Overall survival rates in 5 years were 96.4{\%}, 98.9{\%}, and 97.6{\%} (P =.03), respectively. Symptomatic but transient radiation pneumonitis developed in 31, 16, and 6 (2.0{\%}, 3.1{\%}, and 5.7{\%}). Mild arm edema was observed in 1, 4, and 0 (0.06{\%}, 0.8{\%}, and 0{\%}) in the nx, sn-, sn+ groups, respectively. Conclusions: Treatment without axillary dissection showed excellent outcomes with negligible toxicity for patients with clinically node negative, including those with a positive SLNB. Regional nodal irradiation after a positive SLNB is a reasonable alternative to axillary dissection.",
keywords = "Axillary dissection, Axillary radiotherapy, Breast cancer, Regional node irradiation, Sentinel lymph node biopsy",
author = "Naoko Sanuki and Atsuya Takeda and Atsushi Amemiya and Toru Ofuchi and Masashi Ono and Haruki Ogata and Ryo Yamagami and Jun Hatayama and Takahisa Eriguchi and Etsuo Kunieda",
year = "2013",
doi = "10.1016/j.clbc.2012.09.005",
language = "English",
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pages = "69--76",
journal = "Clinical Breast Cancer",
issn = "1526-8209",
publisher = "Elsevier",
number = "1",

}

TY - JOUR

T1 - Outcomes of Clinically Node-Negative Breast Cancer Without Axillary Dissection

T2 - Can Preserved Axilla Be Safely Treated with Radiation after a Positive Sentinel Node Biopsy?

AU - Sanuki, Naoko

AU - Takeda, Atsuya

AU - Amemiya, Atsushi

AU - Ofuchi, Toru

AU - Ono, Masashi

AU - Ogata, Haruki

AU - Yamagami, Ryo

AU - Hatayama, Jun

AU - Eriguchi, Takahisa

AU - Kunieda, Etsuo

PY - 2013

Y1 - 2013

N2 - Purpose: We analyzed whether axillary nodal irradiation could control clinically node-negative disease, including those patients with a positive sentinel lymph node biopsy (SLNB), most of whom received regional nodal irradiation. We also evaluated toxicity profiles that resulted from nodal irradiation. Patients and Methods: From 1988 to 2011, 2107 patients with cT1-T2N0M0 breast cancer underwent breast conservation therapy in the absence of axillary dissection: nx group (n = 1548), without any axillary surgery; the sn- group (n = 518), with a negative SLNB; and sn+ group (n = 104), with a positive SLNB. Results: The median follow-up times were 88, 56, and 55 months for the nx, sn-, and sn+ groups, respectively. The nx group had more risk factors than did the other 2 groups in terms of age, grade, or T stage. Ninety-eight percent of the sn-group received only tangent irradiation, and 100% and 83% of the sn+ and nx group, respectively, received additional regional nodal irradiation. The 5-year cumulative incidences of axillary failure and regional nodal failure were 34, 3, and 0 (2.7%, 0.7%, and 0%; P =.02, log-rank test) and 57, 4, and 0 (4.4, 1%, and 0; P =.04), respectively. Overall survival rates in 5 years were 96.4%, 98.9%, and 97.6% (P =.03), respectively. Symptomatic but transient radiation pneumonitis developed in 31, 16, and 6 (2.0%, 3.1%, and 5.7%). Mild arm edema was observed in 1, 4, and 0 (0.06%, 0.8%, and 0%) in the nx, sn-, sn+ groups, respectively. Conclusions: Treatment without axillary dissection showed excellent outcomes with negligible toxicity for patients with clinically node negative, including those with a positive SLNB. Regional nodal irradiation after a positive SLNB is a reasonable alternative to axillary dissection.

AB - Purpose: We analyzed whether axillary nodal irradiation could control clinically node-negative disease, including those patients with a positive sentinel lymph node biopsy (SLNB), most of whom received regional nodal irradiation. We also evaluated toxicity profiles that resulted from nodal irradiation. Patients and Methods: From 1988 to 2011, 2107 patients with cT1-T2N0M0 breast cancer underwent breast conservation therapy in the absence of axillary dissection: nx group (n = 1548), without any axillary surgery; the sn- group (n = 518), with a negative SLNB; and sn+ group (n = 104), with a positive SLNB. Results: The median follow-up times were 88, 56, and 55 months for the nx, sn-, and sn+ groups, respectively. The nx group had more risk factors than did the other 2 groups in terms of age, grade, or T stage. Ninety-eight percent of the sn-group received only tangent irradiation, and 100% and 83% of the sn+ and nx group, respectively, received additional regional nodal irradiation. The 5-year cumulative incidences of axillary failure and regional nodal failure were 34, 3, and 0 (2.7%, 0.7%, and 0%; P =.02, log-rank test) and 57, 4, and 0 (4.4, 1%, and 0; P =.04), respectively. Overall survival rates in 5 years were 96.4%, 98.9%, and 97.6% (P =.03), respectively. Symptomatic but transient radiation pneumonitis developed in 31, 16, and 6 (2.0%, 3.1%, and 5.7%). Mild arm edema was observed in 1, 4, and 0 (0.06%, 0.8%, and 0%) in the nx, sn-, sn+ groups, respectively. Conclusions: Treatment without axillary dissection showed excellent outcomes with negligible toxicity for patients with clinically node negative, including those with a positive SLNB. Regional nodal irradiation after a positive SLNB is a reasonable alternative to axillary dissection.

KW - Axillary dissection

KW - Axillary radiotherapy

KW - Breast cancer

KW - Regional node irradiation

KW - Sentinel lymph node biopsy

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U2 - 10.1016/j.clbc.2012.09.005

DO - 10.1016/j.clbc.2012.09.005

M3 - Article

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AN - SCOPUS:84872340803

VL - 13

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JO - Clinical Breast Cancer

JF - Clinical Breast Cancer

SN - 1526-8209

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