The decline of axillary lymph node dissection in breast cancer. Evolution of its indication over the last 20 years
| Autor: | Alejandra García-Novoa, Isabel Casal-Beloy, Benigno Acea-Nebril, Joaquín Mosquera-Oses, Alba Gómez-Dovigo, Alberto Bouzón-Alejandro, Paz Santiago, Sergio Builes-Ramírez, Carmen Cereijo Garea |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Sentinel lymph node Breast Neoplasms 030230 surgery Conservative Treatment 03 medical and health sciences 0302 clinical medicine Breast cancer Biopsy medicine Humans Prospective Studies Lymph node Aged Neoplasm Staging medicine.diagnostic_test business.industry Sentinel Lymph Node Biopsy General Engineering Axillary Lymph Node Dissection Middle Aged medicine.disease Survival Analysis Surgery Clinical trial Dissection medicine.anatomical_structure Lymphatic Metastasis Lymph Node Excision Lymphadenectomy Female Lymph Nodes business Carcinoma in Situ |
| Zdroj: | Cirugia espanola. 97(4) |
| ISSN: | 2173-5077 |
| Popis: | Introduction In last 20 years, lymph node staging procedures in breast cancer have been modified. The objective of this study is to describe the evolution of these procedures at our hospital. Methods A prospective observational study that included women with breast cancer who were treated surgically between 2001 and 2017. Four groups were identified according to the therapeutic regimen and 3 study periods defined by the lymph node dissection. Results 1319 patients met the inclusion criteria. Primary conservative surgery was the most frequent therapy (54.13%), and 615 (46.62%) axillary lymph node dissections (ALND) were performed in the 20-year study period. The percentage of ALND decreased progressively over time, going from 91% in the first period to 34% in the last period. The futile ALND fell to 6.6% in the last year. In the primary conservative surgery, no futile ALND was performed in the last two years. Conclusion The introduction of sentinel lymph node biopsy and the ACOSOG Z0011 criteria have modified the indication for ALND. Thus, ALND without involvement have been reduced, thereby avoiding the associated morbidity. The study demonstrates the progressive decrease in the indication of lymphadenectomy in the different study groups, similar to reports by other authors. Several clinical trials have described that these changes have not negatively impacted survival. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect