Ontology highlight
ABSTRACT: Background
Tailored axillary surgery (TAS) is a novel surgical concept for clinical node-positive breast cancer. It consists of the removal of the sentinel lymph nodes (LNs), as well as palpably suspicious nodes. The TAS technique can be utilized in both the upfront and neoadjuvant chemotherapy (NACT) setting. This study assessed whether/how imaging-guided localization (IGL) influenced TAS.Patients and methods
This was a prospective observational cohort study preplanned in the randomized phase-III OPBC-03/TAXIS trial. IGL was performed at the surgeon's discretion for targeted removal of LNs during TAS. Immediate back-up axillary lymph node dissection (ALND) followed TAS according to TAXIS randomization.Results
Five-hundred patients were included from 44 breast centers in six countries, 151 (30.2%) of whom underwent NACT. IGL was performed in 84.4% of all patients, with significant variation by country (77.6-100%, p < 0.001). No difference in the median number of removed (5 vs. 4, p = 0.3) and positive (2 vs. 2, p = 0.6) LNs by use of IGL was noted. The number of LNs removed during TAS with IGL remained stable over time (p = 0.8), but decreased significantly without IGL, from six (IQR 4-6) in 2019 to four (IQR 3-4) in 2022 (p = 0.015). An ALND was performed in 249 patients, removing another 12 (IQR 9-17) LNs, in which a median number of 1 (IQR 0-4) was positive. There was no significant difference in residual nodal disease after TAS with or without IGL (68.0% vs. 57.6%, p = 0.2).Conclusions
IGL did not significantly change either the performance of TAS or the volume of residual nodal tumor burden.Trial registration
ClinicalTrials.gov Identifier: NCT03513614.
SUBMITTER: Weber WP
PROVIDER: S-EPMC10695869 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
Weber Walter P WP Heidinger Martin M Hayoz Stefanie S Matrai Zoltan Z Tausch Christoph C Henke Guido G Zwahlen Daniel R DR Gruber Günther G Zimmermann Frank F Montagna Giacomo G Andreozzi Mariacarla M Goldschmidt Maite M Schulz Alexandra A Mueller Andreas A Ackerknecht Markus M Tampaki Ekaterini Christina EC Bjelic-Radisic Vesna V Kurzeder Christian C Sávolt Ákos Á Smanykó Viktor V Hagen Daniela D Müller Dieter J DJ Gnant Michael M Loibl Sibylle S Fitzal Florian F Markellou Pagona P Bekes Inga I Egle Daniel D Heil Jörg J Knauer Michael M
Annals of surgical oncology 20231030 1
<h4>Background</h4>Tailored axillary surgery (TAS) is a novel surgical concept for clinical node-positive breast cancer. It consists of the removal of the sentinel lymph nodes (LNs), as well as palpably suspicious nodes. The TAS technique can be utilized in both the upfront and neoadjuvant chemotherapy (NACT) setting. This study assessed whether/how imaging-guided localization (IGL) influenced TAS.<h4>Patients and methods</h4>This was a prospective observational cohort study preplanned in the ra ...[more]