Loco-regional morbidity after breast conservation and axillary lymph node dissection for early breast cancer with or without regional nodes radiotherapy, perspectives in modern breast cancer treatment:the Skagen Trial 1 is active
| Autor: | Rasmus Blechingberg Friis, Søren Linnet, Birgitte Vrou Offersen, Hanne Melgaard Nielsen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Oncology
medicine.medical_treatment Mastectomy Segmental BODY-IMAGE 0302 clinical medicine Antineoplastic Combined Chemotherapy Protocols Breast-conserving surgery 030212 general & internal medicine Range of Motion Articular TARGET VOLUME DELINEATION Hematology General Medicine Middle Aged Prognosis Combined Modality Therapy COOPERATIVE GROUP Lymphedema medicine.anatomical_structure Chemotherapy Adjuvant 030220 oncology & carcinogenesis Lymphatic Metastasis UK STANDARDIZATION Female Mastectomy Adult medicine.medical_specialty Shoulder Breast Neoplasms 03 medical and health sciences Breast cancer Whole Breast Irradiation Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Aged ELECTIVE RADIATION-THERAPY business.industry Sentinel Lymph Node Biopsy Axillary Lymph Node Dissection INTERNAL MAMMARY medicine.disease RANDOMIZED-TRIAL Radiation therapy Axilla Cross-Sectional Studies SENTINEL NODE ARM-LYMPHEDEMA Radiotherapy Adjuvant Morbidity business ESTRO CONSENSUS GUIDELINE Follow-Up Studies |
| Zdroj: | Nielsen, H M, Friis, R B, Linnet, S & Offersen, B V 2017, ' Loco-regional morbidity after breast conservation and axillary lymph node dissection for early breast cancer with or without regional nodes radiotherapy, perspectives in modern breast cancer treatment : the Skagen Trial 1 is active ', Acta Oncologica, vol. 56, no. 5, pp. 713-718 . https://doi.org/10.1080/0284186X.2016.1277261 |
| Popis: | Background: Axillary lymph node dissection (ALND) and adjuvant radiotherapy (RT) in early breast cancer are associated with a risk of morbidity, including lymphedema and impaired shoulder mobility. The aim of this study was to evaluate loco-regional morbidity after breast conserving surgery (BCS), ALND, taxane-based chemotherapy and whole breast irradiation (WBI) with or without regional nodes RT.Material and methods: Eligible patients had BCS and ALND from 2007 to 2012 followed by adjuvant taxane-based chemotherapy and if indicated, trastuzumab and endocrine treatment. The RT consisted of WBI and regional nodes RT in case of pN1 disease (group 1) and WBI only in case of pN0-1(mic) disease (group 2). The dose was 50Gy in 25 fractions. The patients were invited to participate in a cross-sectional study evaluating morbidity.Results: Of the 347 eligible patients, 277 patients (79%) accepted the invitation. Of these, 185 patients (67%) belonged to group 1 and 92 patients (33%) to group 2. The median time from RT to evaluation of morbidity was 3.3 years (group 1) and 4.3 years (group 2). In group 1, 34 patients (18%) and in group 2, 15 patients (16%) had 2cm enlargement in circumference of ipsilateral upper or lower arm (p=.67). The frequence of impairment of ipsilateral shoulder abduction to 120 degrees was 3% in both groups and of shoulder flexion to 120 degrees was 1% and 2% (group 1 versus 2). No difference in patient reported outcome measure (PROM) data regarding heaviness or enlargement of ipsilateral upper and lower arm or mobility and sensory disturbances.Conclusion: The risk of lymphedema was low in patients after ALND and not related to use of regional nodes RT. Impairment of shoulder function was rare, and no differences in PROM were detected regarding use or not of regional nodes RT. |
| Databáze: | OpenAIRE |
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