Trends in axillary treatment for breast cancer patients undergoing sentinel lymph node biopsy as determined by a questionnaire from the Japanese Breast Cancer Society

Shigeru Imoto, Chikako Yamauchi, Yoshifumi Komoike, Koichiro Tsugawa, Daisuke Yotsumoto, Noriaki Wada, Takayuki Ueno, Mari S. Oba, Tadahiko Shien, Sadatoshi Sugae, Hitoshi Tsuda, Kimiyasu Yoneyama

Research output: Contribution to journalArticle

Abstract

Background: Sentinel lymph node biopsy (SLNB) alone has been compared with SLNB followed by axillary lymph node dissection (ALND) in sentinel lymph node (SLN)-positive breast cancer patients in randomized phase III trials: the addition of ALND did not further improve the patient’s outcome. However, there is still some controversy, regarding the clinical application of SLNB alone. To identify the optimal axillary treatment in the era of SLNB, the Japanese Breast Cancer Society conducted a group study of SLNB in 2014. Methods: A questionnaire on axillary surgery and radiation therapy was sent to 432 Japanese institutes in December 2014, and 309 (72 %) completed the questionnaire. Results: SLNB was performed at 98 % of the institutes, and 77 % offered irradiation for cancer treatment. Regarding breast-conserving surgery (BCS), SLNB alone was indicated at 41 % of the institutes in the cases of SLN with micrometastases. However, in the cases of SLN with macrometastases, ALND was performed at 64 %. The proportion of ALND seemed to be higher in total mastectomy than in BCS regardless of the SLN-positive status. In the cases of SLN with micrometastases, the radiation field was localized in the conserved breast at about half of the institutes. On the other hand, in the cases of SLN with macrometastases, it was extended to axillary and/or supraclavicular lesions beyond the conserved breast at about 70 % of the institutes. Conclusions: Japanese breast physicians were conservative with respect to the omission of ALND in SLN-positive breast cancer, especially in the cases of SLN with macrometastases.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalBreast Cancer
DOIs
Publication statusAccepted/In press - Aug 23 2016

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Sentinel Lymph Node Biopsy
Breast Neoplasms
Lymph Node Excision
Neoplasm Micrometastasis
Breast
Segmental Mastectomy
Therapeutics
Simple Mastectomy
Sentinel Lymph Node
Surveys and Questionnaires
Radiotherapy
Radiation
Physicians

Keywords

  • Axillary lymph node dissection
  • Breast-conserving surgery
  • Micrometastases
  • Regional node irradiation
  • Sentinel lymph node biopsy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Pharmacology (medical)

Cite this

Trends in axillary treatment for breast cancer patients undergoing sentinel lymph node biopsy as determined by a questionnaire from the Japanese Breast Cancer Society. / Imoto, Shigeru; Yamauchi, Chikako; Komoike, Yoshifumi; Tsugawa, Koichiro; Yotsumoto, Daisuke; Wada, Noriaki; Ueno, Takayuki; Oba, Mari S.; Shien, Tadahiko; Sugae, Sadatoshi; Tsuda, Hitoshi; Yoneyama, Kimiyasu.

In: Breast Cancer, 23.08.2016, p. 1-6.

Research output: Contribution to journalArticle

Imoto, Shigeru ; Yamauchi, Chikako ; Komoike, Yoshifumi ; Tsugawa, Koichiro ; Yotsumoto, Daisuke ; Wada, Noriaki ; Ueno, Takayuki ; Oba, Mari S. ; Shien, Tadahiko ; Sugae, Sadatoshi ; Tsuda, Hitoshi ; Yoneyama, Kimiyasu. / Trends in axillary treatment for breast cancer patients undergoing sentinel lymph node biopsy as determined by a questionnaire from the Japanese Breast Cancer Society. In: Breast Cancer. 2016 ; pp. 1-6.
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abstract = "Background: Sentinel lymph node biopsy (SLNB) alone has been compared with SLNB followed by axillary lymph node dissection (ALND) in sentinel lymph node (SLN)-positive breast cancer patients in randomized phase III trials: the addition of ALND did not further improve the patient’s outcome. However, there is still some controversy, regarding the clinical application of SLNB alone. To identify the optimal axillary treatment in the era of SLNB, the Japanese Breast Cancer Society conducted a group study of SLNB in 2014. Methods: A questionnaire on axillary surgery and radiation therapy was sent to 432 Japanese institutes in December 2014, and 309 (72 {\%}) completed the questionnaire. Results: SLNB was performed at 98 {\%} of the institutes, and 77 {\%} offered irradiation for cancer treatment. Regarding breast-conserving surgery (BCS), SLNB alone was indicated at 41 {\%} of the institutes in the cases of SLN with micrometastases. However, in the cases of SLN with macrometastases, ALND was performed at 64 {\%}. The proportion of ALND seemed to be higher in total mastectomy than in BCS regardless of the SLN-positive status. In the cases of SLN with micrometastases, the radiation field was localized in the conserved breast at about half of the institutes. On the other hand, in the cases of SLN with macrometastases, it was extended to axillary and/or supraclavicular lesions beyond the conserved breast at about 70 {\%} of the institutes. Conclusions: Japanese breast physicians were conservative with respect to the omission of ALND in SLN-positive breast cancer, especially in the cases of SLN with macrometastases.",
keywords = "Axillary lymph node dissection, Breast-conserving surgery, Micrometastases, Regional node irradiation, Sentinel lymph node biopsy",
author = "Shigeru Imoto and Chikako Yamauchi and Yoshifumi Komoike and Koichiro Tsugawa and Daisuke Yotsumoto and Noriaki Wada and Takayuki Ueno and Oba, {Mari S.} and Tadahiko Shien and Sadatoshi Sugae and Hitoshi Tsuda and Kimiyasu Yoneyama",
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T1 - Trends in axillary treatment for breast cancer patients undergoing sentinel lymph node biopsy as determined by a questionnaire from the Japanese Breast Cancer Society

AU - Imoto, Shigeru

AU - Yamauchi, Chikako

AU - Komoike, Yoshifumi

AU - Tsugawa, Koichiro

AU - Yotsumoto, Daisuke

AU - Wada, Noriaki

AU - Ueno, Takayuki

AU - Oba, Mari S.

AU - Shien, Tadahiko

AU - Sugae, Sadatoshi

AU - Tsuda, Hitoshi

AU - Yoneyama, Kimiyasu

PY - 2016/8/23

Y1 - 2016/8/23

N2 - Background: Sentinel lymph node biopsy (SLNB) alone has been compared with SLNB followed by axillary lymph node dissection (ALND) in sentinel lymph node (SLN)-positive breast cancer patients in randomized phase III trials: the addition of ALND did not further improve the patient’s outcome. However, there is still some controversy, regarding the clinical application of SLNB alone. To identify the optimal axillary treatment in the era of SLNB, the Japanese Breast Cancer Society conducted a group study of SLNB in 2014. Methods: A questionnaire on axillary surgery and radiation therapy was sent to 432 Japanese institutes in December 2014, and 309 (72 %) completed the questionnaire. Results: SLNB was performed at 98 % of the institutes, and 77 % offered irradiation for cancer treatment. Regarding breast-conserving surgery (BCS), SLNB alone was indicated at 41 % of the institutes in the cases of SLN with micrometastases. However, in the cases of SLN with macrometastases, ALND was performed at 64 %. The proportion of ALND seemed to be higher in total mastectomy than in BCS regardless of the SLN-positive status. In the cases of SLN with micrometastases, the radiation field was localized in the conserved breast at about half of the institutes. On the other hand, in the cases of SLN with macrometastases, it was extended to axillary and/or supraclavicular lesions beyond the conserved breast at about 70 % of the institutes. Conclusions: Japanese breast physicians were conservative with respect to the omission of ALND in SLN-positive breast cancer, especially in the cases of SLN with macrometastases.

AB - Background: Sentinel lymph node biopsy (SLNB) alone has been compared with SLNB followed by axillary lymph node dissection (ALND) in sentinel lymph node (SLN)-positive breast cancer patients in randomized phase III trials: the addition of ALND did not further improve the patient’s outcome. However, there is still some controversy, regarding the clinical application of SLNB alone. To identify the optimal axillary treatment in the era of SLNB, the Japanese Breast Cancer Society conducted a group study of SLNB in 2014. Methods: A questionnaire on axillary surgery and radiation therapy was sent to 432 Japanese institutes in December 2014, and 309 (72 %) completed the questionnaire. Results: SLNB was performed at 98 % of the institutes, and 77 % offered irradiation for cancer treatment. Regarding breast-conserving surgery (BCS), SLNB alone was indicated at 41 % of the institutes in the cases of SLN with micrometastases. However, in the cases of SLN with macrometastases, ALND was performed at 64 %. The proportion of ALND seemed to be higher in total mastectomy than in BCS regardless of the SLN-positive status. In the cases of SLN with micrometastases, the radiation field was localized in the conserved breast at about half of the institutes. On the other hand, in the cases of SLN with macrometastases, it was extended to axillary and/or supraclavicular lesions beyond the conserved breast at about 70 % of the institutes. Conclusions: Japanese breast physicians were conservative with respect to the omission of ALND in SLN-positive breast cancer, especially in the cases of SLN with macrometastases.

KW - Axillary lymph node dissection

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KW - Micrometastases

KW - Regional node irradiation

KW - Sentinel lymph node biopsy

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