Do the ACOSOG Z0011 Criteria Affect the Number of Sentinel Lymph Nodes Removed? Academic Article uri icon

Overview

abstract

  • INTRODUCTION: We sought to determine if adoption of the Z0011 criteria was associated with removal of more sentinel lymph nodes (SLNs). METHODS: In a retrospective review of a prospective database of breast cancer patients treated at our institution from 2006 to 2013, we identified 5213 eligible patients who elected to undergo breast-conserving surgery; 2372 were treated pre-Z0011 and 2841 post-Z0011. Clinicopathologic factors were collected, and univariate and multivariate models were fit to identify variables associated with number of SLNs removed. RESULTS: Median patient age, 60 years, did not differ between groups. Median tumor size was similar in both groups: 1.1 (0.05-5.0) cm in the pre-Z0011 group and 1.2 (0.1-5.2) cm in the post-Z0011 group. The mean number of SLNs excised in the pre-Z0011 patients was 2.8 compared with 2.9 in post-Z0011 patients (p = 0.01). Three or fewer lymph nodes were removed in 1771 (75 %) pre-Z0011 patients compared with 2006 (71 %) post-Z0011 patients (p = 0.01). Factors associated with the removal of more SLNs on multivariate analysis included adoption of ACOSOG Z0011 criteria (p = 0.03), young age (p ≤ 0.0001), and large tumor size (p = 0.0005). Axillary lymph node dissection (ALND) was performed in 379 (16 %) patients pre-Z0011 compared with 68 (2 %) node-positive post-Z0011 patients (p < 0.0001). CONCLUSIONS: Since the adoption of Z0011 criteria, we found significantly fewer patients undergoing ALND for positive SLNs. We noted a significant, slight shift in the removal of ≥4 SLNs. The Z0011 criteria were not associated with a clinically significant increase in the number of SLNs removed.

publication date

  • July 16, 2015

Research

keywords

  • Breast Neoplasms
  • Carcinoma, Ductal, Breast
  • Carcinoma, Intraductal, Noninfiltrating
  • Carcinoma, Lobular
  • Decision Making
  • Lymph Node Excision
  • Practice Guidelines as Topic
  • Sentinel Lymph Node Biopsy

Identity

PubMed Central ID

  • PMC4688213

Scopus Document Identifier

  • 84952870273

Digital Object Identifier (DOI)

  • 10.1245/s10434-015-4698-6

PubMed ID

  • 26178759

Additional Document Info

volume

  • 22 Suppl 3

issue

  • 0 3