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The Attitudes of Brazilian Breast Surgeons on Axillary Management in Early Breast Cancer-10 Years after the ACOSOG Z0011 Trial First Publication
- Source :
- Annals of surgical oncology. 29(2)
- Publication Year :
- 2021
-
Abstract
- To evaluate the impact of the ACOSOG Z0011 trial on axillary breast cancer surgery management in Brazil following publication of that study (2010) and again in 2020. A survey of members of the Brazilian Society of Mastology. Of 1627 breast surgeons, 799 (49.1%) completed and returned the questionnaire. For patients with the Z11 inclusion criteria, following detection of a positive sentinel lymph node (SLN), axillary dissection (AD) was recommended by 99.2% of respondents before publication of the study, 47.5% in 2010 and 18.5% in 2020 (p < 0.001). In breast-conserving surgery, if there were micro-metastases, 2.6% would perform AD, 30.3% axillary radiotherapy, and 67.1% no additional axillary treatment, while with macro-metastases, these proportions were 21.3%, 52.2%, and 26.5%, respectively. In cases of mastectomy and of nodal extracapsular extension, 43.4% and 36% of surgeons, respectively, recommended AD. For clinically negative axilla and suspicious findings at ultrasonography, 69% of the surgeons would apply the Z11 approach. Most applied the Z11 criteria in cases of younger patients (83.6%) and triple-negative and/or HER2 positive tumors (74%). AD was significantly more likely to be recommended by surgeons who did not work in academic institutes, who worked in locations other than capital cities, who were not board-certified, and who were ≥ 50 years old. This survey revealed substantial changes in axillary surgery management in cN0/pathologically positive SLN, particularly following publication of the updated Z11 results and other similar studies. A better education environment and long-term follow-up were factors associated with the incorporation of Z11-related changes in practice.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Sentinel lymph node
Breast Neoplasms
Mastectomy, Segmental
Breast cancer
Surgical oncology
Breast-conserving surgery
Medicine
Humans
Mastectomy
Surgeons
Clinical Trials as Topic
business.industry
Breast surgeons
Sentinel Lymph Node Biopsy
General surgery
Axillary Lymph Node Dissection
Middle Aged
medicine.disease
Axilla
medicine.anatomical_structure
Oncology
Attitude
Lymphatic Metastasis
Lymph Node Excision
Surgery
Female
Lymph Nodes
business
Brazil
Subjects
Details
- ISSN :
- 15344681
- Volume :
- 29
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Annals of surgical oncology
- Accession number :
- edsair.doi.dedup.....1da20d4c76757316b11203398bbd2eaf