Translate this page into:
Original Article
doi:
10.4103/sajc.sajc_120_18
Practical consensus recommendations regarding the management of sentinel lymph node issues in early breast cancer
1
Department of Surgical Oncology, Manipal Super Specialty Hospital, New Delhi
2
Department of Surgical Oncology, Medanta Hospital, Gurugram, Haryana
3
Department of Surgical Oncology, Mool Chand Hospital, New Delhi
4
Department of Surgical Oncology, Fortis Hospital, New Delhi
5
Department of Surgical Oncology, W Pratiksha Hospital, Gurugram, Haryana
6
Department of Surgical Oncology, DMCH Cancer Care Centre, Ludhiana, Punjab
7
Department of Surgical Oncology, Indraprastha Apollo Hospital, New Delhi
8
Department of Surgical Oncology, Jolly Grant Himalayan Institute, Dehradun, Uttarakhand
9
Department of Surgical Oncology, Amit Jaggi Memorial Hospital, Agra, Uttar Pradesh
10
Department of Surgical Oncology, Sir Ganga Ram Hospital, New Delhi
11
Department of Surgical Oncology, Sir Ganga Ram Hospital, New Delhi
12
Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi
*Corresponding author: Dr. Vedant Kabra. drvedant@gmail.com
MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)
Disclaimer:
This article was originally published by Thieme Medical and Scientific Publishers Pvt. Ltd. and was migrated to Scientific Scholar after the change of Publisher.
This article was originally published by Thieme Medical and Scientific Publishers Pvt. Ltd. and was migrated to Scientific Scholar after the change of Publisher.
Abstract
Abstract
Axillary lymph node involvement is a very important poor prognostic factor in the clinical staging and management of breast cancer patients. Traditionally, axillary lymph node dissection (ALND) has been used for determining the status of the axillary lymph nodes. More recently the sentinel lymph node biopsy (SLNB) procedure has gained wider acceptance as the standard of care, having the advantage of being less invasivewhile providing good accuracy. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at these practical consensus recommendations in regards with the use of the two different procedures and other issues in patients with early breast cancer for the benefit of community oncologists.
Keywords
References
- Faries MB, Bedrosian I, Reynolds C, Nguyen HQ, Alavi A, Czerniecki BJ, et al. Active macromolecule uptake by lymph node antigen-presenting cells: A novel mechanism in determining sentinel lymph node status. Ann Surg Oncol 2000;7:98-105.
- Harlow SP, Weaver DL. Overview of sentinel lymph node biopsy in breast cancer. UpToDate; 2017.
- Swenson KK, Nissen MJ, Ceronsky C, Swenson L, Lee MW, Tuttle TM, et al. Comparison of side effects between sentinel lymph node and axillary lymph node dissection for breast cancer. Ann Surg Oncol 2002;9:745-53.
- Mansel RE, Fallowfield L, Kissin M, Goyal A, Newcombe RG, Dixon JM, et al. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: The ALMANAC trial. J Natl Cancer Inst 2006;98:599-609.
- Veronesi U, Viale G, Paganelli G, Zurrida S, Luini A, Galimberti V, et al. Sentinel lymph node biopsy in breast cancer: Ten-year results of a randomized controlled study. Ann Surg 2010;251:595-600.
- Borgstein PJ, Pijpers R, Comans EF, van Diest PJ, Boom RP, Meijer S, et al. Sentinel lymph node biopsy in breast cancer: Guidelines and pitfalls of lymphoscintigraphy and gamma probe detection. J Am Coll Surg 1998;186:275-83.
- Le-Petross HT, Stafford RJ. The need for MRI before breast-conserving surgery. Curr Breast Cancer Rep 2009;1:98.
- Schrading S, Strobel K, Kuhl CK. Abstract S1-09: MRI screening of women at average risk of breast cancer. Cancer Res 2013;24 Suppl: S1-09. [DOI: 10.1158/0008-5472.SABCS13-S1-09].
- Brekelmans CT, Seynaeve C, Bartels CC, Tilanus-Linthorst MM, Meijers-Heijboer EJ, Crepin CM, et al. Effectiveness of breast cancer surveillance in BRCA1/2 gene mutation carriers and women with high familial risk. J Clin Oncol 2001;19:924-30.
- Kriege M, Brekelmans CT, Boetes C, Rutgers EJ, Oosterwijk JC, Tollenaar RA, et al. MRI screening for breast cancer in women with familial or genetic predisposition: Design of the Dutch National Study (MRISC). Fam Cancer 2001;1:163-8.
- Tilanus-Linthorst MM, Obdeijn IM, Bartels KC, de Koning HJ, Oudkerk M. First experiences in screening women at high risk for breast cancer with MR imaging. Breast Cancer Res Treat 2000;63:53-60.
- Kriege M, Brekelmans CT, Boetes C, Besnard PE, Zonderland HM, Obdeijn IM, et al. Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. N Engl J Med 2004;351:427-37.
- Weinstein SP, Localio AR, Conant EF, Rosen M, Thomas KM, Schnall MD, et al. Multimodality screening of high-risk women: A prospective cohort study. J Clin Oncol 2009;27:6124-8.
- Klijn JG. Early diagnosis of hereditary breast cancer by magnetic resonance imaging: What is realistic? J Clin Oncol 2010;28:1441-5.
- Leach MO, Boggis CR, Dixon AK, Easton DF, Eeles RA, Evans DG, et al. Screening with magnetic resonance imaging and mammography of a UK population at high familial risk of breast cancer: A prospective multicentre cohort study (MARIBS). Lancet 2005;365:1769-78.
- Houssami N, Turner RM, Morrow M. Meta-analysis of pre-operative magnetic resonance imaging (MRI) and surgical treatment for breast cancer. Breast Cancer Res Treat 2017;165:273-83.
- Houssami N, Hayes DF. Review of preoperative magnetic resonance imaging (MRI) in breast cancer: Should MRI be performed on all women with newly diagnosed, early stage breast cancer? CA Cancer J Clin 2009;59:290-302.
- Sardanelli F. Overview of the role of pre-operative breast MRI in the absence of evidence on patient outcomes. Breast 2010;19:3-6.
- Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002;347:1233-41.
- Blichert-Toft M, Nielsen M, Düring M, Møller S, Rank F, Overgaard M, et al. Long-term results of breast conserving surgery vs. mastectomy for early stage invasive breast cancer: 20-year follow-up of the Danish randomized DBCG-82TM protocol. Acta Oncol 2008;47:672-81.
- Turnbull L, Brown S, Harvey I, Olivier C, Drew P, Napp V, et al. Comparative effectiveness of MRI in breast cancer (COMICE) trial: A randomised controlled trial. Lancet 2010;375:563-71.
- Peters NH, van Esser S, van den Bosch MA, Storm RK, Plaisier PW, van Dalen T, et al. Preoperative MRI and surgical management in patients with nonpalpable breast cancer: The MONET – Randomised controlled trial. Eur J Cancer 2011;47:879-86.
- Vijaykumar DK, Arunlal M. Management of axilla in 2015 in Indian scenario. Indian J Surg Oncol 2015;6:435-9.
- Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW, et al. Axillary dissection vs. no axillary dissection in women with invasive breast cancer and sentinel node metastasis: A randomized clinical trial. JAMA 2011;305:569-75.
- Galimberti V, Cole BF, Zurrida S, Viale G, Luini A, Veronesi P, et al. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): A phase 3 randomised controlled trial. Lancet Oncol 2013;14:297-305.
- Solá M, Alberro JA, Fraile M, Santesteban P, Ramos M, Fabregas R, et al. Complete axillary lymph node dissection versus clinical follow-up in breast cancer patients with sentinel node micrometastasis: Final results from the multicenter clinical trial AATRM 048/13/2000. Ann Surg Oncol 2013;20:120-7.
- Sávolt A, Musonda P, Mátrai Z, Polgár C, Rényi-Vámos F, Rubovszky G, et al. Optimal treatment of the axilla after positive sentinel lymph node biopsy in early invasive breast cancer. Early results of the OTOASOR trial. Orv Hetil 2013;154:1934-42.
- Donker M, van Tienhoven G, Straver ME, Meijnen P, van de Velde CJ, Mansel RE, et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): A randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol 2014;15:1303-10.
- de Boer M, van Deurzen CH, van Dijck JA, Borm GF, van Diest PJ, Adang EM, et al. Micrometastases or isolated tumor cells and the outcome of breast cancer. N Engl J Med 2009;361:653-63.
- Somashekhar SP, Naikoo ZA, Zaveri SS, Holla S, Chandra S, Mishra S, et al. Intraoperative frozen section evaluation of sentinel lymph nodes in breast carcinoma: Single-institution Indian experience. Indian J Surg 2015;77:335-40.
- Goldhirsch A, Ingle JN, Gelber RD, Coates AS, Thürlimann B, Senn HJ, et al. Thresholds for therapies: Highlights of the St. Gallen international expert consensus on the primary therapy of early breast cancer 2009. Ann Oncol 2009;20:1319-29.
- Blair SL, Thompson K, Rococco J, Malcarne V, Beitsch PD, Ollila DW, et al. Attaining negative margins in breast-conservation operations: Is there a consensus among breast surgeons? J Am Coll Surg 2009;209:608-13.
- Houssami N, Macaskill P, Marinovich ML, Dixon JM, Irwig L, Brennan ME, et al. Meta-analysis of the impact of surgical margins on local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy. Eur J Cancer 2010;46:3219-32.
- Pleijhuis RG, Graafland M, de Vries J, Bart J, de Jong JS, van Dam GM, et al. Obtaining adequate surgical margins in breast-conserving therapy for patients with early-stage breast cancer: Current modalities and future directions. Ann Surg Oncol 2009;16:2717-30.
- Moran MS, Schnitt SJ, Giuliano AE, Harris JR, Khan SA, Horton J, et al. Society of Surgical Oncology-American Society for Radiation Oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stages I and II invasive breast cancer. J Clin Oncol 2014;32:1507-15.
- Morrow M, Van Zee KJ, Solin LJ, Houssami N, Chavez-MacGregor M, Harris JR, et al. Society of Surgical Oncology-American Society for Radiation Oncology-American Society of Clinical Oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in ductal carcinoma in situ. Ann Surg Oncol 2016;23:3801-10.
- Houvenaeghel G, Tallet A, Jalaguier-Coudray A, Cohen M, Bannier M, Jauffret-Fara C, et al. Is breast conservative surgery a reasonable option in multifocal or multicentric tumors? World J Clin Oncol 2016;7:234-42.
- Donker M, Straver ME, van Tienhoven G, van de Velde CJ, Mansel RE, Litière S, et al. Comparison of the sentinel node procedure between patients with multifocal and unifocal breast cancer in the EORTC 10981-22023 AMAROS trial: Identification rate and nodal outcome. Eur J Cancer 2013;49:2093-100.
- Yerushalmi R, Tyldesley S, Woods R, Kennecke HF, Speers C, Gelmon KA, et al. Is breast-conserving therapy a safe option for patients with tumor multicentricity and multifocality? Ann Oncol 2012;23:876-81.
- Gallager HS, Martin JE. The study of mammary carcinoma by mammography and whole organ sectioning. Early observations. Cancer 1969;23:855-73.
- Holland R, Veling SH, Mravunac M, Hendriks JH. Histologic multifocality of tis, T1-2 breast carcinomas. Implications for clinical trials of breast-conserving surgery. Cancer 1985;56:979-90.
- Coombs NJ, Boyages J. Multifocal and multicentric breast cancer: Does each focus matter? J Clin Oncol 2005;23:7497-502.
- Danoff BF, Haller DG, Glick JH, Goodman RL. Conservative surgery and irradiation in the treatment of early breast cancer. Ann Intern Med 1985;102:634-42.
- Winchester DP, Cox JD. Standards for diagnosis and management of invasive breast carcinoma. American College of Radiology. American College of Surgeons. College of American Pathologists. Society of Surgical Oncology. CA Cancer J Clin 1998;48:83-107.
- Kurtz JM, Jacquemier J, Amalric R, Brandone H, Ayme Y, Hans D, et al. Breast-conserving therapy for macroscopically multiple cancers. Ann Surg 1990;212:38-44.
- Leopold KA, Recht A, Schnitt SJ, Connolly JL, Rose MA, Silver B, et al. Results of conservative surgery and radiation therapy for multiple synchronous cancers of one breast. Int J Radiat Oncol Biol Phys 1989;16:11-6.
- Wilson LD, Beinfield M, McKhann CF, Haffty BG. Conservative surgery and radiation in the treatment of synchronous ipsilateral breast cancers. Cancer 1993;72:137-42.
- Lynch SP, Lei X, Hsu L, Meric-Bernstam F, Buchholz TA, Zhang H, et al. Breast cancer multifocality and multicentricity and locoregional recurrence. Oncologist 2013;18:1167-73.
- Wolters R, Wöckel A, Janni W, Novopashenny I, Ebner F, Kreienberg R, et al. Comparing the outcome between multicentric and multifocal breast cancer: What is the impact on survival, and is there a role for guideline-adherent adjuvant therapy? A retrospective multicenter cohort study of 8,935 patients. Breast Cancer Res Treat 2013;142:579-90.
- Haffty BG, Wilson LD, Smith R, Fischer D, Beinfield M, Ward B, et al. Subareolar breast cancer: Long-term results with conservative surgery and radiation therapy. Int J Radiat Oncol Biol Phys 1995;33:53-7.
- Gajdos C, Tartter PI, Bleiweiss IJ. Subareolar breast cancers. Am J Surg 2000;180:167-70.
- Fisher ER, Gregorio R, Redmond C, Vellios F, Sommers SC, Fisher B, et al. Pathologic findings from the national surgical adjuvant breast project (protocol no 4). I. Observations concerning the multicentricity of mammary cancer. Cancer 1975;35:247-54.
- Lagios MD, Gates EA, Westdahl PR, Richards V, Alpert BS. A guide to the frequency of nipple involvement in breast cancer. A study of 149 consecutive mastectomies using a serial subgross and correlated radiographic technique. Am J Surg 1979;138:135-42.
- Rosen PP, Fracchia AA, Urban JA, Schottenfeld D, Robbins GF. “Residual” mammary carcinoma following simulated partial mastectomy. Cancer 1975;35:739-47.
- Andersen JA, Pallesen RM. Spread to the nipple and areola in carcinoma of the breast. Ann Surg 1979;189:367-72.
- Suehiro S, Inai K, Tokuoka S, Hamada Y, Toi M, Niimoto M, et al. Involvement of the nipple in early carcinoma of the breast. Surg Gynecol Obstet 1989;168:244-8.
- Santini D, Taffurelli M, Gelli MC, Grassigli A, Giosa F, Marrano D, et al. Neoplastic involvement of nipple-areolar complex in invasive breast cancer. Am J Surg 1989;158:399-403.
- Parry R, Cochran T, Wolfert F. When is there nipple involvement in cancer of the breast? Plast Reconstr Surg 1977;59:535-7.
- Vyas JJ, Chinoy RF, Vaidya JS. Prediction of nipple and areola involvement in breast cancer. Eur J Surg Oncol 1998;24:15-6.
- Tausch C, Hintringer T, Kugler F, Schmidhammer C, Bauer M, Aufschnaiter M, et al. Breast-conserving surgery with resection of the nipple-areola complex for subareolar breast carcinoma. Br J Surg 2005;92:1368-71.
- Pezzi CM, Kukora JS, Audet IM, Herbert SH, Horvick D, Richter MP, et al. Breast conservation surgery using nipple-areolar resection for central breast cancers. Arch Surg 2004;139:32-7.
- Maaskant-Braat AJ, Roumen RM, Voogd AC, Pijpers R, Luiten EJ, Rutgers EJ, et al. Sentinel node and recurrent breast cancer (SNARB): Results of a nationwide registration study. Ann Surg Oncol 2013;20:620-6.
- Vugts G, Maaskant-Braat AJ, Voogd AC, van Riet YE, Luiten EJ, Rutgers EJ, et al. Repeat sentinel node biopsy should be considered in patients with locally recurrent breast cancer. Breast Cancer Res Treat 2015;153:549-56.