Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct 1;19(4):318-324.
doi: 10.4274/ejbh.galenos.2023.2023-6-4. eCollection 2023 Oct.

Axillary Surgical Attitude Changing with Retrospective Application of ACOSOG Z0011 Eligible Criteria: An Institutional Evaluation

C Florin Pop  1 , Lea Datin Nziki  1 , Etienne El Helou  1 , Michel Moreau  2 , Magali Radermecker  3 , Denis Larsimont  4 , Isabelle Veys  1 , Filip De Neubourg  1
Affiliations

Axillary Surgical Attitude Changing with Retrospective Application of ACOSOG Z0011 Eligible Criteria: An Institutional Evaluation

C Florin Pop et al. Eur J Breast Health. .

Abstract

Objective: Sentinel lymph node biopsy (SLNB) represents the gold standard for axillary surgical staging. The aim of this study was to assess the proportion of axillary lymph node dissection (ALND) that could be avoided after retrospective application of the ACOSOG Z0011 criteria and to evaluate the shortterm complications associated with axillary surgery.

Materials and methods: We reviewed breast cancer (BC) patients treated by primary breast-conserving surgery from 2012 to 2015. The percentage of SLNB vs ALND performed before and after the application of the ACOSOG Z0011 criteria was calculated. Complications were analyzed using crosstabs, with p<0.05 considered significant.

Results: Two hundred fifty one patients with a median age of 59.3 years were included. BC tumors had a median size of 13 mm and were mostly unifocal (83.9%). There were 30.3% with 1-2 metastatic lymph nodes (MLN). ALND was performed in 44.2%. The patients with 1-2 MLN, had only SLNB in 14.5% of cases. By applying the ACOSOG Z0011 criteria, ALND would have been avoided in 40.2% of patients. At least one postoperative complication was reported after SLNB or ALND for 45.7% and 74.7% of patients respectively. Seroma was the most frequent complication, and occurred in 29.3% of cases after SLNB and in 59.5% after ALND.

Conclusion: SNLB is the most commonly used axillary surgical staging procedure in this series (55.8%). With a retrospective application of the ACOSOG Z0011 criteria in our population, ALND could have been avoided for 40.2% patients. Post-operative complications rate was higher after ALND, with a seroma rate at 59.5%.

Keywords: Breast-conserving surgery; axillary lymph node dissection; axillary surgery; sentinel lymph node biopsy; seroma.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
Comparison between the type of standard axillary surgery at IJB and according to the ACOSOG Z001 criteria for cT1-2N0M0 patients. Figure 1 shows the comparison of the type of axillary surgery according to the standard procedure at the JBI during the study period and the possible effect of application of the ACOSOG Z0011 criteria. The blue colons represent the patients with a sentinel lymph node biopsy and the orange colons those with axillary lymph node dissection
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Natale G, Stouthandel MEJ, Van Hoof T, Bocci G. The Lymphatic System in Breast Cancer: Anatomical and Molecular Approaches. Medicina (Kaunas) 2021;57:1272. - PMC - PubMed
    1. Łukasiewicz S, Czeczelewski M, Forma A, Baj J, Sitarz R, Stanisławek A. Breast Cancer-Epidemiology, Risk Factors, Classification, Prognostic Markers, and Current Treatment Strategies-An Updated Review. Cancers (Basel) 2021;13:4287. - PMC - PubMed
    1. Canavese G, Catturich A, Vecchio C, Tomei D, Gipponi M, Villa G, et al. B. Sentinel node biopsy compared with complete axillary dissection for staging early breast cancer with clinically negative lymph nodes: results of randomized trial. Ann Oncol. 2009;20:1001–1007. - PubMed
    1. Costaz H, Rouffiac M, Boulle D, Arnould L, Beltjens F, Desmoulins I, et al. Stratégies en cas de positivité du ganglion sentinelle dans les cancers du sein [Strategies in case of metastatic sentinel lymph node in breast cancer] Bull Cancer. 2020;107:672–685. - PubMed
    1. Burstein HJ, Curigliano G, Thürlimann B, Weber WP, Poortmans P, Regan MM, et al. Customizing local and systemic therapies for women with early breast cancer: the St. Gallen International Consensus Guidelines for treatment of early breast cancer 2021. Ann Oncol. 2021;32:1216–1235. - PMC - PubMed

LinkOut - more resources