Impact of nodal status on indication for adjuvant treatment in clinically node negative breast cancer

Citation
M. Greco et al., Impact of nodal status on indication for adjuvant treatment in clinically node negative breast cancer, ANN ONCOL, 11(9), 2000, pp. 1137-1140
Citations number
22
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
ANNALS OF ONCOLOGY
ISSN journal
0923-7534 → ACNP
Volume
11
Issue
9
Year of publication
2000
Pages
1137 - 1140
Database
ISI
SICI code
0923-7534(200009)11:9<1137:IONSOI>2.0.ZU;2-0
Abstract
We addressed the problem of the need for axillary dissection in clinically node-negative breast cancer by determining how the information provided by the dissection suggests a different treatment to that indicated by primary tumour characteristics and age alone. We examined retrospectively 260 cases of clinically node negative early breast cancer all of whom underwent brea st surgery, radiotherapy and axillary dissection. We assigned adjuvant ther apy according to accepted guidelines with and without consideration of path ological node status and compared the difference. Fifty-six patients had in volved axillary nodes. There was no change in adjuvant chemotherapy indicat ion for the 44 cases over 65 years. The change in indication for the remain ing 216 cases was 18.5% to 6%, depending on whether none or all of the inte rmediate risk patients were originally assigned chemotherapy (all were orig inally assigned tamoxifen). Since the trend is for most intermediate risk patients is to be assigned ad juvant chemotherapy, and since tamoxifen is anyway considered effective the rapy for low and intermediate risk patients, we conclude that the informati on provided by axillary dissection is probably not necessary if guidelines recommending wide application of systemic adjuvant chemotherapy are applied . Satisfactory prognostic information can be obtained by consideration of p rimary tumour characteristics, while new prognostic markers are likely to f urther refine prognostic precision in the near future.