Clinical Breast Cancer, Journal Year: 2025, Volume and Issue: unknown
Published: April 1, 2025
Language: Английский
Journal of Clinical Oncology, Journal Year: 2025, Volume and Issue: unknown
Published: April 10, 2025
ASCO Guidelines provide recommendations with comprehensive review and analyses of the relevant literature for each recommendation, following guideline development process as outlined in Methodology Manual . follow Conflict Interest Policy Clinical Practice other guidance (“Guidance”) provided by is not a or definitive guide to treatment options. It intended voluntary use clinicians should be used conjunction independent professional judgment. Guidance may applicable all patients, interventions, diseases stages diseases. based on analysis literature, statement standard care. does endorse third-party drugs, devices, services, therapies assumes no responsibility any harm arising from related this information. See complete disclaimer Appendix 1 2 (online only) more. PURPOSE To update evidence-based sentinel lymph node biopsy (SLNB) patients early-stage breast cancer treated initial surgery. METHODS convened an Expert Panel develop updated systematic (January 2016-May 2024). RESULTS Eleven randomized clinical trials (14 publications), eight meta-analyses and/or reviews, one prospective cohort study met inclusion criteria review. members available evidence informal consensus practice recommendations. RECOMMENDATIONS Clinicians recommend routine SLNB select who are postmenopausal ≥50 years age negative findings preoperative axillary ultrasound grade 1-2, small (≤2 cm), hormone receptor–positive, human epidermal growth factor receptor 2–negative undergo breast-conserving therapy. offer postmastectomy radiation (RT) regional nodal irradiation (RNI) omit dissection (ALND) clinically node-negative invasive ≤5 cm receive mastectomy have two positive nodes. cT3-T4c multicentric tumors (clinically node-negative) ductal carcinoma situ mastectomy, obese, male, pregnant, had prior ALND do metastases, metastases will surgery whole-breast RT without RNI. Additional information at www.asco.org/breast-cancer-guidelines This has been endorsed American Society Radiation Oncology (ASTRO).
Language: Английский
Citations
1
Archives of Gynecology and Obstetrics, Journal Year: 2025, Volume and Issue: unknown
Published: April 22, 2025
Language: Английский
Citations
1
npj Breast Cancer, Journal Year: 2024, Volume and Issue: 10(1)
Published: March 12, 2024
Abstract This study aimed to develop and validate a deep learning radiomics nomogram (DLRN) for the preoperative evaluation of axillary lymph node (ALN) metastasis status in patients with newly diagnosed unifocal breast cancer. A total 883 eligible cancer who underwent ultrasound were retrospectively enrolled between April 1, 2016, June 30, 2022. The training cohort comprised 621 from Hospital I; external validation cohorts 112, 87, 63 Hospitals II, III, IV, respectively. DLR signature was created based on handcrafted features, DLRN then developed four independent clinical parameters. exhibited good performance, yielding areas under receiver operating characteristic curve (AUC) 0.914, 0.929, 0.952 three cohorts, Decision calibration analyses demonstrated favorable value nomogram. In addition, outperformed five experienced radiologists all cohorts. has potential guide appropriate management axilla cancer, including avoiding overtreatment.
Language: Английский
Citations
8
Clinical Breast Cancer, Journal Year: 2024, Volume and Issue: 24(4), P. 310 - 318
Published: Feb. 1, 2024
Language: Английский
Citations
6
Cancers, Journal Year: 2024, Volume and Issue: 16(9), P. 1623 - 1623
Published: April 23, 2024
Axillary surgery for patients with breast cancer (BC) in 2024 is becoming increasingly specific, moving away from the previous ‘one size fits all’ radical approach. The goal to spare morbidity whilst maintaining oncologic safety. In upfront setting, a first landmark randomized controlled trial (RCT) on omission of any surgical axillary staging unremarkable clinical examination and ultrasound showed non-inferiority sentinel lymph node (SLN) biopsy (SLNB). study population consisted 87.8% postmenopausal estrogen receptor-positive, human epidermal growth factor receptor 2-negative BC. Patients clinically node-negative up two positive SLNs can safely be spared dissection (ALND) even context mastectomy or extranodal extension. enrolled TAXIS trial, adjuvant systemic treatment was shown similar without ALND despite loss information. After neoadjuvant chemotherapy (NACT), targeted removal SLNB lower false-negative rate determine nodal pathological complete response (pCR) compared alone. However, outcomes do not appear differ pCR determined by either one concepts, according recently published global, retrospective, real-world study. Real-world studies generally have level evidence than RCTs, but they are feasible quickly large sample size. Another global provides that residual isolated tumor cells ALND. general, few indications remain. Three trials ongoing node-positive BC setting disease after NACT. Pending results these trials, remains indicated patients.
Language: Английский
Citations
6
European Journal of Surgical Oncology, Journal Year: 2024, Volume and Issue: 50(2), P. 107954 - 107954
Published: Jan. 6, 2024
Background De-escalation of axillary surgery in breast cancer (BC) management began when sentinel lymph node biopsy (SLNB) replaced dissection (ALND) as standard care patients with node-negative BC. The second step consolidated ALND omission selected subgroups BC up to two macrometastases and recognized molecular genomic implication predicting prognosis planning adjuvant treatment. Outcomes from the recent RxPONDER monarchE trials have come challenge previous cut-off SLN order inform decisions on systemic therapies for hormone receptor-positive (HR+), human epidermal growth factor receptor type-2 (HER2) negative BC, criteria included a respectively three four SLNs. In view controversy that this may lift surgical practice, Italian National Association Breast Surgeons (Associazione Nazionale Italiana Senologi Chirurghi, ANISC) reviewed data regarding latest topic proposes an implementation clinical practice. Material methods We available literature offering pathological nodal status cN0 patients. Results rates pN2 ranges 3.5 % 16 %; pre-surgical diagnostic definition by ultrasound could be useful about possible involvement ≥4 nodes specific sub-groups women. Conclusions (ANISC) considers HR + HER2-/cN0-pN1(sn) undergoing conserving treatment preoperative workup should optimized more detailed assessment axilla technique SLNB optimized, if considered appropriate surgeon, not considering routine always indicated determine recommendations according eligibility monarch-E trials.
Language: Английский
Citations
5
Annals of Surgical Oncology, Journal Year: 2024, Volume and Issue: 31(5), P. 3160 - 3167
Published: Feb. 12, 2024
Abstract Background National guidelines recommend omitting SNB in older patients with favorable invasive breast cancer. However, there is a lack of prospective data specifically addressing this issue. This study evaluates recurrence and survival estrogen receptor-positive/Her2− (ER+) cancer patients, aged ≥ 65 years who have breast-conserving surgery (BCS) without SNB. Methods prospective, observational at single institution where 125 clinical T1-2N0 ER+ undergoing BCS were enrolled. Patients treated Primary outcome measure was axillary recurrence. Secondary measures include recurrence-free (RFS), disease-free (DFS), cancer-specific (BCSS), overall (OS). Results From January 2016 to July 2022, enrolled median follow-up 36.7 months [95% confidence interval (CI) 35.0–38.0]. Median age 77.0 (range 65–93). tumor size 1 cm 0.1–5.0). Most tumors ductal (95/124, 77.0%), intermediate grade (60/116, 51.7%), PR-positive (117/123, 91.7%). Radiation therapy performed 37 (29.6%). Only 60 (48.0%) recommended hormonal compliant 2 years. Chemotherapy administered six (4.8%) patients. There two (1.6%) recurrences. Estimated 3-years rates regional RFS, DFS, OS 98.2%, 91.2%, 94.8%, respectively. Univariate Cox regression identified noncompliance be significantly associated ( p = 0.02). Conclusions Axillary extremely low cohort. These results provide support omission patient population Trial Registration ClinicalTrials.gov ID NCT02564848.
Language: Английский
Citations
5
British journal of surgery, Journal Year: 2024, Volume and Issue: 111(4)
Published: March 14, 2024
Trials have demonstrated the safety of omitting completion axillary lymph node dissection in patients with cT1-2 N0 breast cancer operated breast-conserving surgery who limited metastatic burden sentinel node. The aim this registry study was to provide insight into oncological treatment mastectomy limited-volume metastasis.
Language: Английский
Citations
5
Clinical Breast Cancer, Journal Year: 2024, Volume and Issue: 24(6), P. 510 - 518.e4
Published: May 7, 2024
Language: Английский
Citations
5
Clinical Breast Cancer, Journal Year: 2024, Volume and Issue: unknown
Published: June 1, 2024
Language: Английский
Citations
5