Search: WFRF:(Bergkvist L)
> (2020-2024) >
Omitting axillary d...
Omitting axillary dissection in breast cancer with sentinel-node metastases
-
- de Boniface, J. (author)
- Departments of Molecular Medicine and Surgery, Sweden; Department of Surgery, Capio St. Göran’s Hospital,, Sweden
-
- Tvedskov, T. Filtenborg (author)
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Breast Surgery, Gentofte Hospital, Denmark
-
- Rydén, L. (author)
- Faculty of Medicine, Institute of Clinical Sciences, Lund University, Sweden
-
show more...
-
- Szulkin, R. (author)
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden; Department of Surgery, Capio St. Göran’s Hospital,, Sweden
-
- Reimer, T. (author)
- Department of Obstetrics and Gynecology, University of Rostock, Rostock Breast Center, Die Filderklinik, Germany
-
- Kühn, T. (author)
- Department of Obstetrics and Gynecology, University of Rostock, Rostock Breast Center, Die Filderklinik, Germany; Department of Gynecology and Obstetrics, University of Ulm, Germany
-
- Kontos, M. (author)
- First Department of Surgery, National and Kapodistrian University of Athens, Greece
-
- Gentilini, O.D. (author)
- Department of Breast Surgery, IRCCS Ospedale San Raffaele, Italy; Vita-Salute San Raffaele University,, Italy
-
- Bagge, R. Olofsson (author)
- Skåne University Hospital Lund, Sweden; Departments of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at Gothenburg University, Sweden
-
- Sund, Malin (author)
- Umeå universitet,Kirurgi,Departments of Surgery, Sahlgrenska University Hospital, Sweden; Department of Surgery, University of Helsinki and Helsinki University Hospital, Italy
-
- Lundstedt, D. (author)
- Departments of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at Gothenburg University, Sweden; Departments of Oncology, Sahlgrenska University Hospital, Sweden
-
- Appelgren, M. (author)
- Departments of Molecular Medicine and Surgery, Sweden; Department of Surgery, Capio St. Göran’s Hospital,, Sweden
-
- Ahlgren, J. (author)
- Department of Oncology, Faculty of Medicine and Health, Örebro University, Sweden; Regional Cancer Center of Mid-Sweden, Sweden
-
- Norenstedt, S. (author)
- Departments of Molecular Medicine and Surgery, Sweden; Department of Surgery, Capio St. Göran’s Hospital,, Sweden
-
- Celebioglu, F. (author)
- Department of Surgery, Sweden
-
- Sackey, H. (author)
- Breast Center Karolinska, Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Sweden
-
- Andersen, I. Scheel (author)
- Department of Surgery, Breast Clinic, Viborg Hospital, Denmark
-
- Hoyer, U. (author)
- Department of Plastic and Breast Surgery, Aalborg University Hospital, Denmark
-
- Nyman, P.F. (author)
- Department of Surgery, Skaraborg Hospital, Sweden
-
- Patil, E. Vikhe (author)
- Linköping University, and the Department of Surgery, Linköping University Hospital, Linköping, Sweden
-
- Wieslander, E. (author)
- Radiation Physics, Department of Hematology, Oncology, and Radiation Physics, Sweden
-
- Nissen, H. Dahl (author)
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Denmark
-
- Alkner, S. (author)
- Faculty of Medicine, Institute of Clinical Sciences, Lund University, Sweden; Department of Hematology, Oncology, and Radiation Physics, Skåne University Hospital Lund, Sweden
-
- Andersson, Y. (author)
- Center for Clinical Research, Uppsala University and Region Vastmanland, Vastmanland Hospital, Sweden
-
- Offersen, B.V. (author)
- Departments of Oncology and Plastic and Breast Surgery, Denmark; University Hospital, the Departments of Oncology, Denmark; Department of Experimental Clinical Oncology, Danish Center for Particle Therapy, Denmark
-
- Bergkvist, L. (author)
- Center for Clinical Research, Uppsala University and Region Vastmanland, Vastmanland Hospital, Sweden
-
- Frisell, J. (author)
- Breast Center Karolinska, Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Sweden
-
- Christiansen, P. (author)
- Departments of Oncology and Plastic and Breast Surgery, Denmark; Clinical Medicine, Aarhus University, Denmark
-
show less...
-
Departments of Molecular Medicine and Surgery, Sweden; Department of Surgery, Capio St Göran’s Hospital,, Sweden Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Breast Surgery, Gentofte Hospital, Denmark (creator_code:org_t)
- 2024
- 2024
- English.
-
In: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 390:13, s. 1163-1175
- Related links:
-
https://urn.kb.se/re...
-
show more...
-
https://doi.org/10.1...
-
show less...
Abstract
Subject headings
Close
- BACKGROUND Trials evaluating the omission of completion axillary-lymph-node dissection in patients with clinically node-negative breast cancer and sentinel-lymph-node metastases have been compromised by limited statistical power, uncertain nodal radiotherapy target volumes, and a scarcity of data on relevant clinical subgroups.METHODS We conducted a noninferiority trial in which patients with clinically node-negative primary T1 to T3 breast cancer (tumor size, T1, ≤20 mm; T2, 21 to 50 mm; and T3, >50 mm in the largest dimension) with one or two sentinel-node macrometastases (metastasis size, >2 mm in the largest dimension) were randomly assigned in a 1:1 ratio to completion axillary-lymph-node dissection or its omission (sentinel-node biopsy only). Adjuvant treatment and radiation therapy were used in accordance with national guidelines. The primary end point was overall survival. We report here the per-protocol and modified intention-to-treat analyses of the prespecified secondary end point of recurrence-free survival. To show noninferiority of sentinel-node biopsy only, the upper boundary of the confidence interval for the hazard ratio for recurrence or death had to be below 1.44.RESULTS Between January 2015 and December 2021, a total of 2766 patients were enrolled across five countries. The per-protocol population included 2540 patients, of whom 1335 were assigned to undergo sentinel-node biopsy only and 1205 to undergo completion axillary-lymph-node dissection (dissection group). Radiation therapy including nodal target volumes was administered to 1192 of 1326 patients (89.9%) in the sentinel-node biopsy–only group and to 1058 of 1197 (88.4%) in the dissection group. The median follow-up was 46.8 months (range, 1.5 to 94.5). Overall, 191 patients had recurrence or died. The estimated 5-year recurrence-free survival was 89.7% (95% confidence interval [CI], 87.5 to 91.9) in the sentinel-node biopsy–only group and 88.7% (95% CI, 86.3 to 91.1) in the dissection group, with a country-adjusted hazard ratio for recurrence or death of 0.89 (95% CI, 0.66 to 1.19), which was significantly (P<0.001) below the prespecified noninferiority margin.CONCLUSIONS The omission of completion axillary-lymph-node dissection was noninferior to the more extensive surgery in patients with clinically node-negative breast cancer who had sentinel-node macrometastases, most of whom received nodal radiation therapy. (Funded by the Swedish Research Council and others; SENOMAC ClinicalTrials.gov number, NCT02240472.).
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
To the university's database
- By the author/editor
-
de Boniface, J.
-
Tvedskov, T. Fil ...
-
Rydén, L.
-
Szulkin, R.
-
Reimer, T.
-
Kühn, T.
-
show more...
-
Kontos, M.
-
Gentilini, O.D.
-
Bagge, R. Olofss ...
-
Sund, Malin
-
Lundstedt, D.
-
Appelgren, M.
-
Ahlgren, J.
-
Norenstedt, S.
-
Celebioglu, F.
-
Sackey, H.
-
Andersen, I. Sch ...
-
Hoyer, U.
-
Nyman, P.F.
-
Patil, E. Vikhe
-
Wieslander, E.
-
Nissen, H. Dahl
-
Alkner, S.
-
Andersson, Y.
-
Offersen, B.V.
-
Bergkvist, L.
-
Frisell, J.
-
Christiansen, P.
-
show less...
- About the subject
-
- MEDICAL AND HEALTH SCIENCES
-
MEDICAL AND HEAL ...
-
and Clinical Medicin ...
-
and Cancer and Oncol ...
-
- MEDICAL AND HEALTH SCIENCES
-
MEDICAL AND HEAL ...
-
and Clinical Medicin ...
-
and Surgery
- Articles in the publication
-
New England Jour ...
- By the university
-
Umeå University