Sentinel lymph node biopsy vs no axillary surgery in early breast cancer clinically and ultrasonographically node negative: A prospective randomized controlled trial—VENUS trial

2020 ◽  
Vol 26 (10) ◽  
pp. 2087-2089
Author(s):  
Danielle Cristina Miyamoto Araújo ◽  
Giuliano Mendes Duarte ◽  
Rodrigo Menezes Jales ◽  
Julia Yoriko Shinzato ◽  
Cassio Cardoso Filho ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Controlled Trial ◽  
Lymph Node ◽  
Controlled Trial ◽  
Lymph Node Biopsy ◽  
Node Negative ◽  
Axillary Surgery ◽  
Randomized Controlled ◽  
Node Biopsy ◽  
Prospective Randomized Controlled Trial

Morbidity After Sentinel Lymph Node Biopsy in Primary Breast Cancer: Results From a Randomized Controlled Trial

2005 ◽  
Vol 23 (19) ◽  
pp. 4312-4321 ◽  
Author(s):  
Anand David Purushotham ◽  
Sara Upponi ◽  
Manfred Borislav Klevesath ◽  
Lynda Bobrow ◽  
Keith Millar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Controlled Trial ◽  
Lymph Node ◽  
Controlled Trial ◽  
Lymph Node Biopsy ◽  
Psychological Morbidity ◽  
Study Group ◽  
Node Negative ◽  
Randomized Controlled ◽  
Node Biopsy

Purpose Axillary lymph node dissection (ALND) as part of surgical treatment for patients with breast cancer is associated with significant morbidity. Sentinel lymph node biopsy (SLNB) is a newly developed method of staging the axilla and has the potential to avoid an ALND in lymph node–negative patients, thereby minimizing morbidity. The aim of this study was to investigate physical and psychological morbidity after SLNB in the treatment of early breast cancer in a randomized controlled trial. Patients and Methods Between November 1999 and February 2003, 298 patients with early breast cancer (tumors 3 cm or less on ultrasound examination) who were clinically node negative were randomly allocated to undergo ALND (control group) or SLNB followed by ALND if subsequently found to be lymph node positive (study group). A detailed assessment of physical and psychological morbidity was performed during a 1-year period postoperatively. Results A significant reduction in postoperative arm swelling, rate of seroma formation, numbness, loss of sensitivity to light touch and pinprick was observed in the study group. Although shoulder mobility was less impaired on average in the study group, this was significant only for abduction at 1 month and flexion at 3 months. Scores reflecting quality of life and psychological morbidity were significantly better in the study group in the immediate postoperative period, with fewer long-term differences. Conclusion SLNB in patients undergoing surgery for breast cancer results in a significant reduction in physical and psychological morbidity.

scholarly journals Avoiding Axillary Sentinel Lymph Node Biopsy after Neoadjuvant Systemic Therapy in Breast Cancer: Rationale for the Prospective, Multicentric EUBREAST-01 Trial

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3698
Author(s):  
Toralf Reimer ◽  
Aenne Glass ◽  
Edoardo Botteri ◽  
Sibylle Loibl ◽  
Oreste D. Gentilini
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Systemic Therapy ◽  
Lymph Node Biopsy ◽  
Biological Behavior ◽  
Axillary Surgery ◽  
Node Biopsy ◽  
Neoadjuvant Systemic Therapy

Currently, axillary surgery for breast cancer is considered only as staging procedure, since the risk of developing metastasis depends on the biological behavior of the primary. The postsurgical therapy should be considered on the basis of biologic tumor characteristics rather than nodal involvement. Improvements in systemic treatments for breast cancer have increased the rates of pathologic complete response (pCR) in patients receiving neoadjuvant systemic therapy (NAST), offering the opportunity to de-escalate surgery in patients who have a pCR. European Breast Cancer Research Association of Surgical Trialists (EUBREAST)-01 is a clinical trial in which only patients with the highest likelihood of having a pCR after NAST (triple-negative or HER2-positive breast cancer) will be included and type of surgery will be defined according to the response to NAST rather than on the classical T (for tumor size in the breast) and N (for axillary lymph node involvement) status. In the discussed trial, axillary surgery will be eliminated completely (no axillary sentinel lymph node biopsy) for initially clinical node-negative (cN0) patients with radiologic complete remission and a breast pCR in the lumpectomy specimen. The trial design is a multicenter single-arm study with a limited number of patients (n = 267), which might give practice-changing results in a short period of time, sparing the time and the costs of a randomized comparison.

Single-Injection Depot Progesterone Before Surgery and Survival in Women With Operable Breast Cancer: A Randomized Controlled Trial

2011 ◽  
Vol 29 (21) ◽  
pp. 2845-2851 ◽  
Author(s):  
Rajendra Badwe ◽  
Rohini Hawaldar ◽  
Vani Parmar ◽  
Mandar Nadkarni ◽  
Tanuja Shet ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Controlled Trial ◽  
Lymph Node ◽  
Single Injection ◽  
Controlled Trial ◽  
Group Versus ◽  
Operable Breast Cancer ◽  
Control Group ◽  
Node Positive ◽  
Randomized Controlled

Purpose Many nonrandomized studies have suggested better outcome for patients with breast cancer who undergo surgery during the luteal (progestogenic) phase of their menstrual cycle, but this is controversial. We investigated the effect of a single preoperative injection of hydroxyprogesterone in women with operable breast cancer (OBC) in a randomized controlled trial (ClinicalTrials.gov identifier, NCT00123669). Patients and Methods One thousand patients with OBC were randomly assigned to receive surgery or an intramuscular injection of depot hydroxyprogesterone 500 mg 5 to 14 days before surgery. Primary and secondary end points were disease-free survival (DFS) and overall survival (OS), respectively. An analysis by axillary lymph node status was preplanned. Results At a median follow-up of 65 months among 976 eligible patients, 273 recurrences and 202 deaths were recorded. In the progesterone group versus control group, 5-year DFS and OS rates were 73.9% v 70.2% (hazard ratio [HR], 0.87; 95% CI, 0.68 to 1.09; P = .23) and 80.2% v 78.4% (HR, 0.92; 95% CI, 0.69 to 1.21; P = .53), respectively. In 471 node-positive patients, the 5-year DFS and OS rates in the progesterone group versus control group were 65.3% v 54.7% (HR, 0.72; 95% CI, 0.54 to 0.97; P = .02) and 75.7% v 66.8% (HR, 0.70; 95% CI, 0.49 to 0.99; P = .04), respectively. In multivariate analysis, DFS was significantly improved with progesterone in node-positive patients (adjusted HR, 0.71; 95% CI, 0.53 to 0.95; P = .02), whereas there was no significant effect in node-negative patients (P for interaction = .04). Conclusion A single injection of hydroxyprogesterone before surgery did not improve outcomes in all women with OBC. This intervention showed significant improvement in node-positive women that may be considered hypothesis generating. If replicated in other studies, this could be a simple and inexpensive intervention, especially in developing countries where the incidence of lymph node metastasis is high.

scholarly journals Hyperalgesia and Persistent Pain after Breast Cancer Surgery: A Prospective Randomized Controlled Trial with Perioperative COX-2 Inhibition

PLoS ONE ◽  
2016 ◽  
Vol 11 (12) ◽  
pp. e0166601 ◽  
Author(s):  
Noud van Helmond ◽  
Monique A. Steegers ◽  
Gertie P. Filippini-de Moor ◽  
Kris C. Vissers ◽  
Oliver H. Wilder-Smith
Keyword(s):  
Breast Cancer ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Persistent Pain ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Cox 2
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