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Donker, M., van Tienhoven, G., Straver, M.E., Meijnen, P., van de Velde, C.J., Mansel, R.E., et al. (2014) Radiotherapy or Surgery of the Axilla after a Positive Sentinel Node in Breast Cancer (EORTC 10981-22023 AMAROS): A Randomized, Multicenter, Open-Label, Phase 3 Non-Inferiority Trial. The Lancet Oncology, 15, 1303-1310.
https://doi.org/10.1016/S1470-2045(14)70460-7
has been cited by the following article:
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TITLE:
Usefulness of Breast MRI for Safe Omission of Axillary Lymph Nodes Dissection in Sentinel Node-Positive Breast Cancer Patients
AUTHORS:
Hiromi Fuchikami, Naoko Takeda, Kazuhiko Sato
KEYWORDS:
Breast Cancer, Sentinel Node, Axillary Lymph Node Dissection, Breast MRI
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.8 No.11,
November
28,
2017
ABSTRACT: Background: Preoperative identification of patients with extensive lymph node metastasis (LNM) is important for safe omission of axillary lymph
node dissection (ALND) in sentinel node (SN)-positive
(SN+) breast cancer patients. Methods: We evaluated retrospectively the
collected data of 758 breast cancer patients who underwent axillary surgery
between 2008 and 2017, excluding those who received neoadjuvant chemotherapy. Results: Of the 758 patients, 607 were not suspicious to have LNM by axillary ultrasound
(AUS-), but 38 suspicious cases were found by
breast magnetic resonance imaging (MRI). Of 15 patients undergoing axillary
fine needle biopsy (AFNA) due to second-look axillary ultrasound (AUS), 9
underwent ALND because of a positive AFNA (AFNA+). Among 81 (10.9%)
patients undergoing ALND due to SN+ findings,
6 (7.4%) had extensive LNM (LNM ≥ 4). If MRI was not performed, among the 90 of 673 patients
undergoing ALND who had SN+ findings, 12 (13.3%) had LNM ≥ 4. Conclusions: The proportion of
cases with LNM ≥ 4 was reduced
from 13.3% to 7.4% among patients undergoing SN biopsies combined with breast
MRI. ALND might be omitted safely in SN+ cases according to detailed
preoperative evaluations using additional breast MRI to ultrasound.