Tailored axillary surgery in patients with clinically node-positive breast cancer: Pre-planned feasibility substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101)
Aim: We developed tailored axillary surgery (TAS) to reduce the axillary tumor volume in patients with clinically node-positive breast cancer to the point where radiotherapy can control it. The aim of this study was to quantify the extent of tumor load reduction achieved by TAS. Methods: Internation...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Walter P. Weber [verfasserIn] Zoltan Matrai [verfasserIn] Stefanie Hayoz [verfasserIn] Christoph Tausch [verfasserIn] Guido Henke [verfasserIn] Daniel R. Zwahlen [verfasserIn] Günther Gruber [verfasserIn] Frank Zimmermann [verfasserIn] Stefanie Seiler [verfasserIn] Charlotte Maddox [verfasserIn] Thomas Ruhstaller [verfasserIn] Simone Muenst [verfasserIn] Markus Ackerknecht [verfasserIn] Sherko Kuemmel [verfasserIn] Vesna Bjelic-Radisic [verfasserIn] Christian Kurzeder [verfasserIn] Mihály Újhelyi [verfasserIn] Conny Vrieling [verfasserIn] Rok Satler [verfasserIn] Inna Meyer [verfasserIn] Charles Becciolini [verfasserIn] Susanne Bucher [verfasserIn] Colin Simonson [verfasserIn] Peter M. Fehr [verfasserIn] Natalie Gabriel [verfasserIn] Robert Maráz [verfasserIn] Dimitri Sarlos [verfasserIn] Konstantin J. Dedes [verfasserIn] Cornelia Leo [verfasserIn] Gilles Berclaz [verfasserIn] Peter Dubsky [verfasserIn] Ruth Exner [verfasserIn] Hisham Fansa [verfasserIn] Christopher Hager [verfasserIn] Klaus Reisenberger [verfasserIn] Christian F. Singer [verfasserIn] Roland Reitsamer [verfasserIn] Mattea Reinisch [verfasserIn] Jelena Winkler [verfasserIn] Giang Thanh Lam [verfasserIn] Mathias K. Fehr [verfasserIn] Tatiana Naydina [verfasserIn] Magdalena Kohlik [verfasserIn] Karine Clerc [verfasserIn] Valerijus Ostapenko [verfasserIn] Florian Fitzal [verfasserIn] Rahel Nussbaumer [verfasserIn] Nadia Maggi [verfasserIn] Alexandra Schulz [verfasserIn] Pagona Markellou [verfasserIn] Loïc Lelièvre [verfasserIn] Daniel Egle [verfasserIn] Jörg Heil [verfasserIn] Michael Knauer [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2021 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
In: Breast - Elsevier, 2020, 60(2021), Seite 98-110 |
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| Übergeordnetes Werk: |
volume:60 ; year:2021 ; pages:98-110 |
| Links: |
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| DOI / URN: |
10.1016/j.breast.2021.09.004 |
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| Katalog-ID: |
DOAJ003130584 |
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| 100 | 0 | |a Walter P. Weber |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Tailored axillary surgery in patients with clinically node-positive breast cancer: Pre-planned feasibility substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101) |
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| 520 | |a Aim: We developed tailored axillary surgery (TAS) to reduce the axillary tumor volume in patients with clinically node-positive breast cancer to the point where radiotherapy can control it. The aim of this study was to quantify the extent of tumor load reduction achieved by TAS. Methods: International multicenter prospective study embedded in a randomized trial. TAS is a novel pragmatic concept for axillary surgery de-escalation that combines palpation-guided removal of suspicious nodes with the sentinel procedure and, optionally, imaging-guided localization. Pre-specified study endpoints quantified surgical extent and reduction of tumor load. Results: A total of 296 patients were included at 28 sites in four European countries, 125 (42.2%) of whom underwent neoadjuvant chemotherapy (NACT) and 71 (24.0%) achieved nodal pathologic complete response. Axillary metastases were detectable only by imaging in 145 (49.0%) patients. They were palpable in 151 (51.0%) patients, of whom 63 underwent NACT and 21 had residual palpable disease after NACT. TAS removed the biopsied and clipped node in 279 (94.3%) patients. In 225 patients with nodal disease at the time of surgery, TAS removed a median of five (IQR 3–7) nodes, two (IQR 1–4) of which were positive. Of these 225 patients, 100 underwent ALND after TAS, which removed a median of 14 (IQR 10–17) additional nodes and revealed additional positive nodes in 70/100 (70%) of patients. False-negative rate of TAS in patients who underwent subsequent ALND was 2.6%. Conclusions: TAS selectively reduced the tumor load in the axilla and remained much less radical than ALND. | ||
| 650 | 4 | |a Breast cancer | |
| 650 | 4 | |a Breast surgery | |
| 650 | 4 | |a Axillary dissection | |
| 650 | 4 | |a Sentinel lymph node procedure | |
| 650 | 4 | |a Axillary staging | |
| 653 | 0 | |a Neoplasms. Tumors. Oncology. Including cancer and carcinogens | |
| 700 | 0 | |a Zoltan Matrai |e verfasserin |4 aut | |
| 700 | 0 | |a Stefanie Hayoz |e verfasserin |4 aut | |
| 700 | 0 | |a Christoph Tausch |e verfasserin |4 aut | |
| 700 | 0 | |a Guido Henke |e verfasserin |4 aut | |
| 700 | 0 | |a Daniel R. Zwahlen |e verfasserin |4 aut | |
| 700 | 0 | |a Günther Gruber |e verfasserin |4 aut | |
| 700 | 0 | |a Frank Zimmermann |e verfasserin |4 aut | |
| 700 | 0 | |a Stefanie Seiler |e verfasserin |4 aut | |
| 700 | 0 | |a Charlotte Maddox |e verfasserin |4 aut | |
| 700 | 0 | |a Thomas Ruhstaller |e verfasserin |4 aut | |
| 700 | 0 | |a Simone Muenst |e verfasserin |4 aut | |
| 700 | 0 | |a Markus Ackerknecht |e verfasserin |4 aut | |
| 700 | 0 | |a Sherko Kuemmel |e verfasserin |4 aut | |
| 700 | 0 | |a Vesna Bjelic-Radisic |e verfasserin |4 aut | |
| 700 | 0 | |a Christian Kurzeder |e verfasserin |4 aut | |
| 700 | 0 | |a Mihály Újhelyi |e verfasserin |4 aut | |
| 700 | 0 | |a Conny Vrieling |e verfasserin |4 aut | |
| 700 | 0 | |a Rok Satler |e verfasserin |4 aut | |
| 700 | 0 | |a Inna Meyer |e verfasserin |4 aut | |
| 700 | 0 | |a Charles Becciolini |e verfasserin |4 aut | |
| 700 | 0 | |a Susanne Bucher |e verfasserin |4 aut | |
| 700 | 0 | |a Colin Simonson |e verfasserin |4 aut | |
| 700 | 0 | |a Peter M. Fehr |e verfasserin |4 aut | |
| 700 | 0 | |a Natalie Gabriel |e verfasserin |4 aut | |
| 700 | 0 | |a Robert Maráz |e verfasserin |4 aut | |
| 700 | 0 | |a Dimitri Sarlos |e verfasserin |4 aut | |
| 700 | 0 | |a Konstantin J. Dedes |e verfasserin |4 aut | |
| 700 | 0 | |a Cornelia Leo |e verfasserin |4 aut | |
| 700 | 0 | |a Gilles Berclaz |e verfasserin |4 aut | |
| 700 | 0 | |a Peter Dubsky |e verfasserin |4 aut | |
| 700 | 0 | |a Ruth Exner |e verfasserin |4 aut | |
| 700 | 0 | |a Hisham Fansa |e verfasserin |4 aut | |
| 700 | 0 | |a Christopher Hager |e verfasserin |4 aut | |
| 700 | 0 | |a Klaus Reisenberger |e verfasserin |4 aut | |
| 700 | 0 | |a Christian F. Singer |e verfasserin |4 aut | |
| 700 | 0 | |a Roland Reitsamer |e verfasserin |4 aut | |
| 700 | 0 | |a Mattea Reinisch |e verfasserin |4 aut | |
| 700 | 0 | |a Jelena Winkler |e verfasserin |4 aut | |
| 700 | 0 | |a Giang Thanh Lam |e verfasserin |4 aut | |
| 700 | 0 | |a Mathias K. Fehr |e verfasserin |4 aut | |
| 700 | 0 | |a Tatiana Naydina |e verfasserin |4 aut | |
| 700 | 0 | |a Magdalena Kohlik |e verfasserin |4 aut | |
| 700 | 0 | |a Karine Clerc |e verfasserin |4 aut | |
| 700 | 0 | |a Valerijus Ostapenko |e verfasserin |4 aut | |
| 700 | 0 | |a Florian Fitzal |e verfasserin |4 aut | |
| 700 | 0 | |a Rahel Nussbaumer |e verfasserin |4 aut | |
| 700 | 0 | |a Nadia Maggi |e verfasserin |4 aut | |
| 700 | 0 | |a Alexandra Schulz |e verfasserin |4 aut | |
| 700 | 0 | |a Pagona Markellou |e verfasserin |4 aut | |
| 700 | 0 | |a Loïc Lelièvre |e verfasserin |4 aut | |
| 700 | 0 | |a Daniel Egle |e verfasserin |4 aut | |
| 700 | 0 | |a Jörg Heil |e verfasserin |4 aut | |
| 700 | 0 | |a Michael Knauer |e verfasserin |4 aut | |
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10.1016/j.breast.2021.09.004 doi (DE-627)DOAJ003130584 (DE-599)DOAJa6afce6f79f449a0a15b5200378bb924 DE-627 ger DE-627 rakwb eng RC254-282 Walter P. Weber verfasserin aut Tailored axillary surgery in patients with clinically node-positive breast cancer: Pre-planned feasibility substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101) 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Aim: We developed tailored axillary surgery (TAS) to reduce the axillary tumor volume in patients with clinically node-positive breast cancer to the point where radiotherapy can control it. The aim of this study was to quantify the extent of tumor load reduction achieved by TAS. Methods: International multicenter prospective study embedded in a randomized trial. TAS is a novel pragmatic concept for axillary surgery de-escalation that combines palpation-guided removal of suspicious nodes with the sentinel procedure and, optionally, imaging-guided localization. Pre-specified study endpoints quantified surgical extent and reduction of tumor load. Results: A total of 296 patients were included at 28 sites in four European countries, 125 (42.2%) of whom underwent neoadjuvant chemotherapy (NACT) and 71 (24.0%) achieved nodal pathologic complete response. Axillary metastases were detectable only by imaging in 145 (49.0%) patients. They were palpable in 151 (51.0%) patients, of whom 63 underwent NACT and 21 had residual palpable disease after NACT. TAS removed the biopsied and clipped node in 279 (94.3%) patients. In 225 patients with nodal disease at the time of surgery, TAS removed a median of five (IQR 3–7) nodes, two (IQR 1–4) of which were positive. Of these 225 patients, 100 underwent ALND after TAS, which removed a median of 14 (IQR 10–17) additional nodes and revealed additional positive nodes in 70/100 (70%) of patients. False-negative rate of TAS in patients who underwent subsequent ALND was 2.6%. Conclusions: TAS selectively reduced the tumor load in the axilla and remained much less radical than ALND. Breast cancer Breast surgery Axillary dissection Sentinel lymph node procedure Axillary staging Neoplasms. Tumors. Oncology. Including cancer and carcinogens Zoltan Matrai verfasserin aut Stefanie Hayoz verfasserin aut Christoph Tausch verfasserin aut Guido Henke verfasserin aut Daniel R. Zwahlen verfasserin aut Günther Gruber verfasserin aut Frank Zimmermann verfasserin aut Stefanie Seiler verfasserin aut Charlotte Maddox verfasserin aut Thomas Ruhstaller verfasserin aut Simone Muenst verfasserin aut Markus Ackerknecht verfasserin aut Sherko Kuemmel verfasserin aut Vesna Bjelic-Radisic verfasserin aut Christian Kurzeder verfasserin aut Mihály Újhelyi verfasserin aut Conny Vrieling verfasserin aut Rok Satler verfasserin aut Inna Meyer verfasserin aut Charles Becciolini verfasserin aut Susanne Bucher verfasserin aut Colin Simonson verfasserin aut Peter M. Fehr verfasserin aut Natalie Gabriel verfasserin aut Robert Maráz verfasserin aut Dimitri Sarlos verfasserin aut Konstantin J. Dedes verfasserin aut Cornelia Leo verfasserin aut Gilles Berclaz verfasserin aut Peter Dubsky verfasserin aut Ruth Exner verfasserin aut Hisham Fansa verfasserin aut Christopher Hager verfasserin aut Klaus Reisenberger verfasserin aut Christian F. Singer verfasserin aut Roland Reitsamer verfasserin aut Mattea Reinisch verfasserin aut Jelena Winkler verfasserin aut Giang Thanh Lam verfasserin aut Mathias K. Fehr verfasserin aut Tatiana Naydina verfasserin aut Magdalena Kohlik verfasserin aut Karine Clerc verfasserin aut Valerijus Ostapenko verfasserin aut Florian Fitzal verfasserin aut Rahel Nussbaumer verfasserin aut Nadia Maggi verfasserin aut Alexandra Schulz verfasserin aut Pagona Markellou verfasserin aut Loïc Lelièvre verfasserin aut Daniel Egle verfasserin aut Jörg Heil verfasserin aut Michael Knauer verfasserin aut In Breast Elsevier, 2020 60(2021), Seite 98-110 (DE-627)320475042 (DE-600)2009043-2 15323080 nnns volume:60 year:2021 pages:98-110 https://doi.org/10.1016/j.breast.2021.09.004 kostenfrei https://doaj.org/article/a6afce6f79f449a0a15b5200378bb924 kostenfrei http://www.sciencedirect.com/science/article/pii/S0960977621004586 kostenfrei https://doaj.org/toc/1532-3080 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2008 GBV_ILN_2014 GBV_ILN_2025 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2064 GBV_ILN_2106 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 60 2021 98-110 |
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10.1016/j.breast.2021.09.004 doi (DE-627)DOAJ003130584 (DE-599)DOAJa6afce6f79f449a0a15b5200378bb924 DE-627 ger DE-627 rakwb eng RC254-282 Walter P. Weber verfasserin aut Tailored axillary surgery in patients with clinically node-positive breast cancer: Pre-planned feasibility substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101) 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Aim: We developed tailored axillary surgery (TAS) to reduce the axillary tumor volume in patients with clinically node-positive breast cancer to the point where radiotherapy can control it. The aim of this study was to quantify the extent of tumor load reduction achieved by TAS. Methods: International multicenter prospective study embedded in a randomized trial. TAS is a novel pragmatic concept for axillary surgery de-escalation that combines palpation-guided removal of suspicious nodes with the sentinel procedure and, optionally, imaging-guided localization. Pre-specified study endpoints quantified surgical extent and reduction of tumor load. Results: A total of 296 patients were included at 28 sites in four European countries, 125 (42.2%) of whom underwent neoadjuvant chemotherapy (NACT) and 71 (24.0%) achieved nodal pathologic complete response. Axillary metastases were detectable only by imaging in 145 (49.0%) patients. They were palpable in 151 (51.0%) patients, of whom 63 underwent NACT and 21 had residual palpable disease after NACT. TAS removed the biopsied and clipped node in 279 (94.3%) patients. In 225 patients with nodal disease at the time of surgery, TAS removed a median of five (IQR 3–7) nodes, two (IQR 1–4) of which were positive. Of these 225 patients, 100 underwent ALND after TAS, which removed a median of 14 (IQR 10–17) additional nodes and revealed additional positive nodes in 70/100 (70%) of patients. False-negative rate of TAS in patients who underwent subsequent ALND was 2.6%. Conclusions: TAS selectively reduced the tumor load in the axilla and remained much less radical than ALND. Breast cancer Breast surgery Axillary dissection Sentinel lymph node procedure Axillary staging Neoplasms. Tumors. Oncology. Including cancer and carcinogens Zoltan Matrai verfasserin aut Stefanie Hayoz verfasserin aut Christoph Tausch verfasserin aut Guido Henke verfasserin aut Daniel R. Zwahlen verfasserin aut Günther Gruber verfasserin aut Frank Zimmermann verfasserin aut Stefanie Seiler verfasserin aut Charlotte Maddox verfasserin aut Thomas Ruhstaller verfasserin aut Simone Muenst verfasserin aut Markus Ackerknecht verfasserin aut Sherko Kuemmel verfasserin aut Vesna Bjelic-Radisic verfasserin aut Christian Kurzeder verfasserin aut Mihály Újhelyi verfasserin aut Conny Vrieling verfasserin aut Rok Satler verfasserin aut Inna Meyer verfasserin aut Charles Becciolini verfasserin aut Susanne Bucher verfasserin aut Colin Simonson verfasserin aut Peter M. Fehr verfasserin aut Natalie Gabriel verfasserin aut Robert Maráz verfasserin aut Dimitri Sarlos verfasserin aut Konstantin J. Dedes verfasserin aut Cornelia Leo verfasserin aut Gilles Berclaz verfasserin aut Peter Dubsky verfasserin aut Ruth Exner verfasserin aut Hisham Fansa verfasserin aut Christopher Hager verfasserin aut Klaus Reisenberger verfasserin aut Christian F. Singer verfasserin aut Roland Reitsamer verfasserin aut Mattea Reinisch verfasserin aut Jelena Winkler verfasserin aut Giang Thanh Lam verfasserin aut Mathias K. Fehr verfasserin aut Tatiana Naydina verfasserin aut Magdalena Kohlik verfasserin aut Karine Clerc verfasserin aut Valerijus Ostapenko verfasserin aut Florian Fitzal verfasserin aut Rahel Nussbaumer verfasserin aut Nadia Maggi verfasserin aut Alexandra Schulz verfasserin aut Pagona Markellou verfasserin aut Loïc Lelièvre verfasserin aut Daniel Egle verfasserin aut Jörg Heil verfasserin aut Michael Knauer verfasserin aut In Breast Elsevier, 2020 60(2021), Seite 98-110 (DE-627)320475042 (DE-600)2009043-2 15323080 nnns volume:60 year:2021 pages:98-110 https://doi.org/10.1016/j.breast.2021.09.004 kostenfrei https://doaj.org/article/a6afce6f79f449a0a15b5200378bb924 kostenfrei http://www.sciencedirect.com/science/article/pii/S0960977621004586 kostenfrei https://doaj.org/toc/1532-3080 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2008 GBV_ILN_2014 GBV_ILN_2025 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2064 GBV_ILN_2106 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 60 2021 98-110 |
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10.1016/j.breast.2021.09.004 doi (DE-627)DOAJ003130584 (DE-599)DOAJa6afce6f79f449a0a15b5200378bb924 DE-627 ger DE-627 rakwb eng RC254-282 Walter P. Weber verfasserin aut Tailored axillary surgery in patients with clinically node-positive breast cancer: Pre-planned feasibility substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101) 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Aim: We developed tailored axillary surgery (TAS) to reduce the axillary tumor volume in patients with clinically node-positive breast cancer to the point where radiotherapy can control it. The aim of this study was to quantify the extent of tumor load reduction achieved by TAS. Methods: International multicenter prospective study embedded in a randomized trial. TAS is a novel pragmatic concept for axillary surgery de-escalation that combines palpation-guided removal of suspicious nodes with the sentinel procedure and, optionally, imaging-guided localization. Pre-specified study endpoints quantified surgical extent and reduction of tumor load. Results: A total of 296 patients were included at 28 sites in four European countries, 125 (42.2%) of whom underwent neoadjuvant chemotherapy (NACT) and 71 (24.0%) achieved nodal pathologic complete response. Axillary metastases were detectable only by imaging in 145 (49.0%) patients. They were palpable in 151 (51.0%) patients, of whom 63 underwent NACT and 21 had residual palpable disease after NACT. TAS removed the biopsied and clipped node in 279 (94.3%) patients. In 225 patients with nodal disease at the time of surgery, TAS removed a median of five (IQR 3–7) nodes, two (IQR 1–4) of which were positive. Of these 225 patients, 100 underwent ALND after TAS, which removed a median of 14 (IQR 10–17) additional nodes and revealed additional positive nodes in 70/100 (70%) of patients. False-negative rate of TAS in patients who underwent subsequent ALND was 2.6%. Conclusions: TAS selectively reduced the tumor load in the axilla and remained much less radical than ALND. Breast cancer Breast surgery Axillary dissection Sentinel lymph node procedure Axillary staging Neoplasms. Tumors. Oncology. Including cancer and carcinogens Zoltan Matrai verfasserin aut Stefanie Hayoz verfasserin aut Christoph Tausch verfasserin aut Guido Henke verfasserin aut Daniel R. Zwahlen verfasserin aut Günther Gruber verfasserin aut Frank Zimmermann verfasserin aut Stefanie Seiler verfasserin aut Charlotte Maddox verfasserin aut Thomas Ruhstaller verfasserin aut Simone Muenst verfasserin aut Markus Ackerknecht verfasserin aut Sherko Kuemmel verfasserin aut Vesna Bjelic-Radisic verfasserin aut Christian Kurzeder verfasserin aut Mihály Újhelyi verfasserin aut Conny Vrieling verfasserin aut Rok Satler verfasserin aut Inna Meyer verfasserin aut Charles Becciolini verfasserin aut Susanne Bucher verfasserin aut Colin Simonson verfasserin aut Peter M. Fehr verfasserin aut Natalie Gabriel verfasserin aut Robert Maráz verfasserin aut Dimitri Sarlos verfasserin aut Konstantin J. Dedes verfasserin aut Cornelia Leo verfasserin aut Gilles Berclaz verfasserin aut Peter Dubsky verfasserin aut Ruth Exner verfasserin aut Hisham Fansa verfasserin aut Christopher Hager verfasserin aut Klaus Reisenberger verfasserin aut Christian F. Singer verfasserin aut Roland Reitsamer verfasserin aut Mattea Reinisch verfasserin aut Jelena Winkler verfasserin aut Giang Thanh Lam verfasserin aut Mathias K. Fehr verfasserin aut Tatiana Naydina verfasserin aut Magdalena Kohlik verfasserin aut Karine Clerc verfasserin aut Valerijus Ostapenko verfasserin aut Florian Fitzal verfasserin aut Rahel Nussbaumer verfasserin aut Nadia Maggi verfasserin aut Alexandra Schulz verfasserin aut Pagona Markellou verfasserin aut Loïc Lelièvre verfasserin aut Daniel Egle verfasserin aut Jörg Heil verfasserin aut Michael Knauer verfasserin aut In Breast Elsevier, 2020 60(2021), Seite 98-110 (DE-627)320475042 (DE-600)2009043-2 15323080 nnns volume:60 year:2021 pages:98-110 https://doi.org/10.1016/j.breast.2021.09.004 kostenfrei https://doaj.org/article/a6afce6f79f449a0a15b5200378bb924 kostenfrei http://www.sciencedirect.com/science/article/pii/S0960977621004586 kostenfrei https://doaj.org/toc/1532-3080 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2008 GBV_ILN_2014 GBV_ILN_2025 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2064 GBV_ILN_2106 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 60 2021 98-110 |
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10.1016/j.breast.2021.09.004 doi (DE-627)DOAJ003130584 (DE-599)DOAJa6afce6f79f449a0a15b5200378bb924 DE-627 ger DE-627 rakwb eng RC254-282 Walter P. Weber verfasserin aut Tailored axillary surgery in patients with clinically node-positive breast cancer: Pre-planned feasibility substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101) 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Aim: We developed tailored axillary surgery (TAS) to reduce the axillary tumor volume in patients with clinically node-positive breast cancer to the point where radiotherapy can control it. The aim of this study was to quantify the extent of tumor load reduction achieved by TAS. Methods: International multicenter prospective study embedded in a randomized trial. TAS is a novel pragmatic concept for axillary surgery de-escalation that combines palpation-guided removal of suspicious nodes with the sentinel procedure and, optionally, imaging-guided localization. Pre-specified study endpoints quantified surgical extent and reduction of tumor load. Results: A total of 296 patients were included at 28 sites in four European countries, 125 (42.2%) of whom underwent neoadjuvant chemotherapy (NACT) and 71 (24.0%) achieved nodal pathologic complete response. Axillary metastases were detectable only by imaging in 145 (49.0%) patients. They were palpable in 151 (51.0%) patients, of whom 63 underwent NACT and 21 had residual palpable disease after NACT. TAS removed the biopsied and clipped node in 279 (94.3%) patients. In 225 patients with nodal disease at the time of surgery, TAS removed a median of five (IQR 3–7) nodes, two (IQR 1–4) of which were positive. Of these 225 patients, 100 underwent ALND after TAS, which removed a median of 14 (IQR 10–17) additional nodes and revealed additional positive nodes in 70/100 (70%) of patients. False-negative rate of TAS in patients who underwent subsequent ALND was 2.6%. Conclusions: TAS selectively reduced the tumor load in the axilla and remained much less radical than ALND. Breast cancer Breast surgery Axillary dissection Sentinel lymph node procedure Axillary staging Neoplasms. Tumors. Oncology. Including cancer and carcinogens Zoltan Matrai verfasserin aut Stefanie Hayoz verfasserin aut Christoph Tausch verfasserin aut Guido Henke verfasserin aut Daniel R. Zwahlen verfasserin aut Günther Gruber verfasserin aut Frank Zimmermann verfasserin aut Stefanie Seiler verfasserin aut Charlotte Maddox verfasserin aut Thomas Ruhstaller verfasserin aut Simone Muenst verfasserin aut Markus Ackerknecht verfasserin aut Sherko Kuemmel verfasserin aut Vesna Bjelic-Radisic verfasserin aut Christian Kurzeder verfasserin aut Mihály Újhelyi verfasserin aut Conny Vrieling verfasserin aut Rok Satler verfasserin aut Inna Meyer verfasserin aut Charles Becciolini verfasserin aut Susanne Bucher verfasserin aut Colin Simonson verfasserin aut Peter M. Fehr verfasserin aut Natalie Gabriel verfasserin aut Robert Maráz verfasserin aut Dimitri Sarlos verfasserin aut Konstantin J. Dedes verfasserin aut Cornelia Leo verfasserin aut Gilles Berclaz verfasserin aut Peter Dubsky verfasserin aut Ruth Exner verfasserin aut Hisham Fansa verfasserin aut Christopher Hager verfasserin aut Klaus Reisenberger verfasserin aut Christian F. Singer verfasserin aut Roland Reitsamer verfasserin aut Mattea Reinisch verfasserin aut Jelena Winkler verfasserin aut Giang Thanh Lam verfasserin aut Mathias K. Fehr verfasserin aut Tatiana Naydina verfasserin aut Magdalena Kohlik verfasserin aut Karine Clerc verfasserin aut Valerijus Ostapenko verfasserin aut Florian Fitzal verfasserin aut Rahel Nussbaumer verfasserin aut Nadia Maggi verfasserin aut Alexandra Schulz verfasserin aut Pagona Markellou verfasserin aut Loïc Lelièvre verfasserin aut Daniel Egle verfasserin aut Jörg Heil verfasserin aut Michael Knauer verfasserin aut In Breast Elsevier, 2020 60(2021), Seite 98-110 (DE-627)320475042 (DE-600)2009043-2 15323080 nnns volume:60 year:2021 pages:98-110 https://doi.org/10.1016/j.breast.2021.09.004 kostenfrei https://doaj.org/article/a6afce6f79f449a0a15b5200378bb924 kostenfrei http://www.sciencedirect.com/science/article/pii/S0960977621004586 kostenfrei https://doaj.org/toc/1532-3080 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2008 GBV_ILN_2014 GBV_ILN_2025 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2064 GBV_ILN_2106 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 60 2021 98-110 |
| allfieldsSound |
10.1016/j.breast.2021.09.004 doi (DE-627)DOAJ003130584 (DE-599)DOAJa6afce6f79f449a0a15b5200378bb924 DE-627 ger DE-627 rakwb eng RC254-282 Walter P. Weber verfasserin aut Tailored axillary surgery in patients with clinically node-positive breast cancer: Pre-planned feasibility substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101) 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Aim: We developed tailored axillary surgery (TAS) to reduce the axillary tumor volume in patients with clinically node-positive breast cancer to the point where radiotherapy can control it. The aim of this study was to quantify the extent of tumor load reduction achieved by TAS. Methods: International multicenter prospective study embedded in a randomized trial. TAS is a novel pragmatic concept for axillary surgery de-escalation that combines palpation-guided removal of suspicious nodes with the sentinel procedure and, optionally, imaging-guided localization. Pre-specified study endpoints quantified surgical extent and reduction of tumor load. Results: A total of 296 patients were included at 28 sites in four European countries, 125 (42.2%) of whom underwent neoadjuvant chemotherapy (NACT) and 71 (24.0%) achieved nodal pathologic complete response. Axillary metastases were detectable only by imaging in 145 (49.0%) patients. They were palpable in 151 (51.0%) patients, of whom 63 underwent NACT and 21 had residual palpable disease after NACT. TAS removed the biopsied and clipped node in 279 (94.3%) patients. In 225 patients with nodal disease at the time of surgery, TAS removed a median of five (IQR 3–7) nodes, two (IQR 1–4) of which were positive. Of these 225 patients, 100 underwent ALND after TAS, which removed a median of 14 (IQR 10–17) additional nodes and revealed additional positive nodes in 70/100 (70%) of patients. False-negative rate of TAS in patients who underwent subsequent ALND was 2.6%. Conclusions: TAS selectively reduced the tumor load in the axilla and remained much less radical than ALND. Breast cancer Breast surgery Axillary dissection Sentinel lymph node procedure Axillary staging Neoplasms. Tumors. Oncology. Including cancer and carcinogens Zoltan Matrai verfasserin aut Stefanie Hayoz verfasserin aut Christoph Tausch verfasserin aut Guido Henke verfasserin aut Daniel R. Zwahlen verfasserin aut Günther Gruber verfasserin aut Frank Zimmermann verfasserin aut Stefanie Seiler verfasserin aut Charlotte Maddox verfasserin aut Thomas Ruhstaller verfasserin aut Simone Muenst verfasserin aut Markus Ackerknecht verfasserin aut Sherko Kuemmel verfasserin aut Vesna Bjelic-Radisic verfasserin aut Christian Kurzeder verfasserin aut Mihály Újhelyi verfasserin aut Conny Vrieling verfasserin aut Rok Satler verfasserin aut Inna Meyer verfasserin aut Charles Becciolini verfasserin aut Susanne Bucher verfasserin aut Colin Simonson verfasserin aut Peter M. Fehr verfasserin aut Natalie Gabriel verfasserin aut Robert Maráz verfasserin aut Dimitri Sarlos verfasserin aut Konstantin J. Dedes verfasserin aut Cornelia Leo verfasserin aut Gilles Berclaz verfasserin aut Peter Dubsky verfasserin aut Ruth Exner verfasserin aut Hisham Fansa verfasserin aut Christopher Hager verfasserin aut Klaus Reisenberger verfasserin aut Christian F. Singer verfasserin aut Roland Reitsamer verfasserin aut Mattea Reinisch verfasserin aut Jelena Winkler verfasserin aut Giang Thanh Lam verfasserin aut Mathias K. Fehr verfasserin aut Tatiana Naydina verfasserin aut Magdalena Kohlik verfasserin aut Karine Clerc verfasserin aut Valerijus Ostapenko verfasserin aut Florian Fitzal verfasserin aut Rahel Nussbaumer verfasserin aut Nadia Maggi verfasserin aut Alexandra Schulz verfasserin aut Pagona Markellou verfasserin aut Loïc Lelièvre verfasserin aut Daniel Egle verfasserin aut Jörg Heil verfasserin aut Michael Knauer verfasserin aut In Breast Elsevier, 2020 60(2021), Seite 98-110 (DE-627)320475042 (DE-600)2009043-2 15323080 nnns volume:60 year:2021 pages:98-110 https://doi.org/10.1016/j.breast.2021.09.004 kostenfrei https://doaj.org/article/a6afce6f79f449a0a15b5200378bb924 kostenfrei http://www.sciencedirect.com/science/article/pii/S0960977621004586 kostenfrei https://doaj.org/toc/1532-3080 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2008 GBV_ILN_2014 GBV_ILN_2025 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2064 GBV_ILN_2106 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 60 2021 98-110 |
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Walter P. Weber @@aut@@ Zoltan Matrai @@aut@@ Stefanie Hayoz @@aut@@ Christoph Tausch @@aut@@ Guido Henke @@aut@@ Daniel R. Zwahlen @@aut@@ Günther Gruber @@aut@@ Frank Zimmermann @@aut@@ Stefanie Seiler @@aut@@ Charlotte Maddox @@aut@@ Thomas Ruhstaller @@aut@@ Simone Muenst @@aut@@ Markus Ackerknecht @@aut@@ Sherko Kuemmel @@aut@@ Vesna Bjelic-Radisic @@aut@@ Christian Kurzeder @@aut@@ Mihály Újhelyi @@aut@@ Conny Vrieling @@aut@@ Rok Satler @@aut@@ Inna Meyer @@aut@@ Charles Becciolini @@aut@@ Susanne Bucher @@aut@@ Colin Simonson @@aut@@ Peter M. Fehr @@aut@@ Natalie Gabriel @@aut@@ Robert Maráz @@aut@@ Dimitri Sarlos @@aut@@ Konstantin J. Dedes @@aut@@ Cornelia Leo @@aut@@ Gilles Berclaz @@aut@@ Peter Dubsky @@aut@@ Ruth Exner @@aut@@ Hisham Fansa @@aut@@ Christopher Hager @@aut@@ Klaus Reisenberger @@aut@@ Christian F. Singer @@aut@@ Roland Reitsamer @@aut@@ Mattea Reinisch @@aut@@ Jelena Winkler @@aut@@ Giang Thanh Lam @@aut@@ Mathias K. Fehr @@aut@@ Tatiana Naydina @@aut@@ Magdalena Kohlik @@aut@@ Karine Clerc @@aut@@ Valerijus Ostapenko @@aut@@ Florian Fitzal @@aut@@ Rahel Nussbaumer @@aut@@ Nadia Maggi @@aut@@ Alexandra Schulz @@aut@@ Pagona Markellou @@aut@@ Loïc Lelièvre @@aut@@ Daniel Egle @@aut@@ Jörg Heil @@aut@@ Michael Knauer @@aut@@ |
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Weber</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Tailored axillary surgery in patients with clinically node-positive breast cancer: Pre-planned feasibility substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101)</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2021</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Aim: We developed tailored axillary surgery (TAS) to reduce the axillary tumor volume in patients with clinically node-positive breast cancer to the point where radiotherapy can control it. The aim of this study was to quantify the extent of tumor load reduction achieved by TAS. Methods: International multicenter prospective study embedded in a randomized trial. TAS is a novel pragmatic concept for axillary surgery de-escalation that combines palpation-guided removal of suspicious nodes with the sentinel procedure and, optionally, imaging-guided localization. Pre-specified study endpoints quantified surgical extent and reduction of tumor load. Results: A total of 296 patients were included at 28 sites in four European countries, 125 (42.2%) of whom underwent neoadjuvant chemotherapy (NACT) and 71 (24.0%) achieved nodal pathologic complete response. Axillary metastases were detectable only by imaging in 145 (49.0%) patients. They were palpable in 151 (51.0%) patients, of whom 63 underwent NACT and 21 had residual palpable disease after NACT. TAS removed the biopsied and clipped node in 279 (94.3%) patients. In 225 patients with nodal disease at the time of surgery, TAS removed a median of five (IQR 3–7) nodes, two (IQR 1–4) of which were positive. Of these 225 patients, 100 underwent ALND after TAS, which removed a median of 14 (IQR 10–17) additional nodes and revealed additional positive nodes in 70/100 (70%) of patients. False-negative rate of TAS in patients who underwent subsequent ALND was 2.6%. Conclusions: TAS selectively reduced the tumor load in the axilla and remained much less radical than ALND.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Breast cancer</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Breast surgery</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Axillary dissection</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Sentinel lymph node procedure</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Axillary staging</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Neoplasms. Tumors. Oncology. 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RC254-282 Tailored axillary surgery in patients with clinically node-positive breast cancer: Pre-planned feasibility substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101) Breast cancer Breast surgery Axillary dissection Sentinel lymph node procedure Axillary staging |
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Tailored axillary surgery in patients with clinically node-positive breast cancer: Pre-planned feasibility substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101) |
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Walter P. Weber Zoltan Matrai Stefanie Hayoz Christoph Tausch Guido Henke Daniel R. Zwahlen Günther Gruber Frank Zimmermann Stefanie Seiler Charlotte Maddox Thomas Ruhstaller Simone Muenst Markus Ackerknecht Sherko Kuemmel Vesna Bjelic-Radisic Christian Kurzeder Mihály Újhelyi Conny Vrieling Rok Satler Inna Meyer Charles Becciolini Susanne Bucher Colin Simonson Peter M. Fehr Natalie Gabriel Robert Maráz Dimitri Sarlos Konstantin J. Dedes Cornelia Leo Gilles Berclaz Peter Dubsky Ruth Exner Hisham Fansa Christopher Hager Klaus Reisenberger Christian F. Singer Roland Reitsamer Mattea Reinisch Jelena Winkler Giang Thanh Lam Mathias K. Fehr Tatiana Naydina Magdalena Kohlik Karine Clerc Valerijus Ostapenko Florian Fitzal Rahel Nussbaumer Nadia Maggi Alexandra Schulz Pagona Markellou Loïc Lelièvre Daniel Egle Jörg Heil Michael Knauer |
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Walter P. Weber |
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tailored axillary surgery in patients with clinically node-positive breast cancer: pre-planned feasibility substudy of taxis (opbc-03, sakk 23/16, ibcsg 57-18, abcsg-53, gbg 101) |
| callnumber |
RC254-282 |
| title_auth |
Tailored axillary surgery in patients with clinically node-positive breast cancer: Pre-planned feasibility substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101) |
| abstract |
Aim: We developed tailored axillary surgery (TAS) to reduce the axillary tumor volume in patients with clinically node-positive breast cancer to the point where radiotherapy can control it. The aim of this study was to quantify the extent of tumor load reduction achieved by TAS. Methods: International multicenter prospective study embedded in a randomized trial. TAS is a novel pragmatic concept for axillary surgery de-escalation that combines palpation-guided removal of suspicious nodes with the sentinel procedure and, optionally, imaging-guided localization. Pre-specified study endpoints quantified surgical extent and reduction of tumor load. Results: A total of 296 patients were included at 28 sites in four European countries, 125 (42.2%) of whom underwent neoadjuvant chemotherapy (NACT) and 71 (24.0%) achieved nodal pathologic complete response. Axillary metastases were detectable only by imaging in 145 (49.0%) patients. They were palpable in 151 (51.0%) patients, of whom 63 underwent NACT and 21 had residual palpable disease after NACT. TAS removed the biopsied and clipped node in 279 (94.3%) patients. In 225 patients with nodal disease at the time of surgery, TAS removed a median of five (IQR 3–7) nodes, two (IQR 1–4) of which were positive. Of these 225 patients, 100 underwent ALND after TAS, which removed a median of 14 (IQR 10–17) additional nodes and revealed additional positive nodes in 70/100 (70%) of patients. False-negative rate of TAS in patients who underwent subsequent ALND was 2.6%. Conclusions: TAS selectively reduced the tumor load in the axilla and remained much less radical than ALND. |
| abstractGer |
Aim: We developed tailored axillary surgery (TAS) to reduce the axillary tumor volume in patients with clinically node-positive breast cancer to the point where radiotherapy can control it. The aim of this study was to quantify the extent of tumor load reduction achieved by TAS. Methods: International multicenter prospective study embedded in a randomized trial. TAS is a novel pragmatic concept for axillary surgery de-escalation that combines palpation-guided removal of suspicious nodes with the sentinel procedure and, optionally, imaging-guided localization. Pre-specified study endpoints quantified surgical extent and reduction of tumor load. Results: A total of 296 patients were included at 28 sites in four European countries, 125 (42.2%) of whom underwent neoadjuvant chemotherapy (NACT) and 71 (24.0%) achieved nodal pathologic complete response. Axillary metastases were detectable only by imaging in 145 (49.0%) patients. They were palpable in 151 (51.0%) patients, of whom 63 underwent NACT and 21 had residual palpable disease after NACT. TAS removed the biopsied and clipped node in 279 (94.3%) patients. In 225 patients with nodal disease at the time of surgery, TAS removed a median of five (IQR 3–7) nodes, two (IQR 1–4) of which were positive. Of these 225 patients, 100 underwent ALND after TAS, which removed a median of 14 (IQR 10–17) additional nodes and revealed additional positive nodes in 70/100 (70%) of patients. False-negative rate of TAS in patients who underwent subsequent ALND was 2.6%. Conclusions: TAS selectively reduced the tumor load in the axilla and remained much less radical than ALND. |
| abstract_unstemmed |
Aim: We developed tailored axillary surgery (TAS) to reduce the axillary tumor volume in patients with clinically node-positive breast cancer to the point where radiotherapy can control it. The aim of this study was to quantify the extent of tumor load reduction achieved by TAS. Methods: International multicenter prospective study embedded in a randomized trial. TAS is a novel pragmatic concept for axillary surgery de-escalation that combines palpation-guided removal of suspicious nodes with the sentinel procedure and, optionally, imaging-guided localization. Pre-specified study endpoints quantified surgical extent and reduction of tumor load. Results: A total of 296 patients were included at 28 sites in four European countries, 125 (42.2%) of whom underwent neoadjuvant chemotherapy (NACT) and 71 (24.0%) achieved nodal pathologic complete response. Axillary metastases were detectable only by imaging in 145 (49.0%) patients. They were palpable in 151 (51.0%) patients, of whom 63 underwent NACT and 21 had residual palpable disease after NACT. TAS removed the biopsied and clipped node in 279 (94.3%) patients. In 225 patients with nodal disease at the time of surgery, TAS removed a median of five (IQR 3–7) nodes, two (IQR 1–4) of which were positive. Of these 225 patients, 100 underwent ALND after TAS, which removed a median of 14 (IQR 10–17) additional nodes and revealed additional positive nodes in 70/100 (70%) of patients. False-negative rate of TAS in patients who underwent subsequent ALND was 2.6%. Conclusions: TAS selectively reduced the tumor load in the axilla and remained much less radical than ALND. |
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| title_short |
Tailored axillary surgery in patients with clinically node-positive breast cancer: Pre-planned feasibility substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101) |
| url |
https://doi.org/10.1016/j.breast.2021.09.004 https://doaj.org/article/a6afce6f79f449a0a15b5200378bb924 http://www.sciencedirect.com/science/article/pii/S0960977621004586 https://doaj.org/toc/1532-3080 |
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Zoltan Matrai Stefanie Hayoz Christoph Tausch Guido Henke Daniel R. Zwahlen Günther Gruber Frank Zimmermann Stefanie Seiler Charlotte Maddox Thomas Ruhstaller Simone Muenst Markus Ackerknecht Sherko Kuemmel Vesna Bjelic-Radisic Christian Kurzeder Mihály Újhelyi Conny Vrieling Rok Satler Inna Meyer Charles Becciolini Susanne Bucher Colin Simonson Peter M. Fehr Natalie Gabriel Robert Maráz Dimitri Sarlos Konstantin J. Dedes Cornelia Leo Gilles Berclaz Peter Dubsky Ruth Exner Hisham Fansa Christopher Hager Klaus Reisenberger Christian F. Singer Roland Reitsamer Mattea Reinisch Jelena Winkler Giang Thanh Lam Mathias K. Fehr Tatiana Naydina Magdalena Kohlik Karine Clerc Valerijus Ostapenko Florian Fitzal Rahel Nussbaumer Nadia Maggi Alexandra Schulz Pagona Markellou Loïc Lelièvre Daniel Egle Jörg Heil Michael Knauer |
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Zoltan Matrai Stefanie Hayoz Christoph Tausch Guido Henke Daniel R. Zwahlen Günther Gruber Frank Zimmermann Stefanie Seiler Charlotte Maddox Thomas Ruhstaller Simone Muenst Markus Ackerknecht Sherko Kuemmel Vesna Bjelic-Radisic Christian Kurzeder Mihály Újhelyi Conny Vrieling Rok Satler Inna Meyer Charles Becciolini Susanne Bucher Colin Simonson Peter M. Fehr Natalie Gabriel Robert Maráz Dimitri Sarlos Konstantin J. Dedes Cornelia Leo Gilles Berclaz Peter Dubsky Ruth Exner Hisham Fansa Christopher Hager Klaus Reisenberger Christian F. Singer Roland Reitsamer Mattea Reinisch Jelena Winkler Giang Thanh Lam Mathias K. Fehr Tatiana Naydina Magdalena Kohlik Karine Clerc Valerijus Ostapenko Florian Fitzal Rahel Nussbaumer Nadia Maggi Alexandra Schulz Pagona Markellou Loïc Lelièvre Daniel Egle Jörg Heil Michael Knauer |
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