| Title |
Major Reduction in Axillary Lymph Node Dissections After Neoadjuvant Systemic Therapy for Node-Positive Breast Cancer by combining PET/CT and the MARI Procedure
|
|---|---|
| Published in |
Annals of Surgical Oncology, March 2018
|
| DOI | 10.1245/s10434-018-6404-y |
| Pubmed ID | |
| Authors |
M. E. M. van der Noordaa, F. H. van Duijnhoven, M. E. Straver, E. J. Groen, M. Stokkel, C. E. Loo, P. H. M. Elkhuizen, N. S. Russell, M. T. F. D. Vrancken Peeters |
| Abstract |
Axillary lymph node dissection (ALND) is frequently performed for node-positive (cN+) breast cancer patients. Combining positron emission tomography/computed tomography (PET/CT) before-NST and the MARI (marking axillary lymph nodes with radioactive iodine seeds) procedure after neoadjuvant systemic therapy (NST) has the potential for avoiding unnecessary ALNDs. This report presents the results from implementation of this strategy. All breast cancer patients treated with NST at the Netherlands Cancer Institute who underwent a PET/CT and the MARI procedure from July 2014 to July 2017 were included in the study. All the patients underwent tailored axillary treatment according to a protocol based on the combined results of PET/CT before NST and the MARI procedure after NST. With this protocol, patients showing one to three FDG-avid axillary lymph nodes (ALNs) on PET/CT (cN<4) and a tumor-negative MARI node receive no further axillary treatment. All cN (<4) patients with a tumor-positive MARI node receive locoregional radiotherapy, as well as patients with four or more FDG-avid ALNs [cN(4+)] and a tumor-negative MARI node after NST. An ALND is performed only for cN(4+) patients with a tumor-positive MARI node. The data of 159 patients who received a PET/CT before NST and a MARI procedure after NST were analyzed. Of these patients, 110 had one to three FDG-avid ALNs and 49 patients showed four or more FDG-avid ALNs on PET/CT before NST. For 130 patients (82%), ALND was omitted. Locoregional radiotherapy was administered to 91 patients (57%), and 39 patients (25%) received no further axillary treatment. Combining pre-NST axillary staging with PET/CT and post-NST staging with the MARI procedure resulted in an 82% reduction of ALNDs for cN + breast cancer patients. |
X Demographics
The data shown below were collected from the profiles of 16 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 4 | 25% |
| United Kingdom | 3 | 19% |
| Mexico | 1 | 6% |
| France | 1 | 6% |
| Sweden | 1 | 6% |
| Unknown | 6 | 38% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 10 | 63% |
| Practitioners (doctors, other healthcare professionals) | 6 | 38% |
Mendeley readers
The data shown below were compiled from readership statistics for 41 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 41 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 6 | 15% |
| Other | 5 | 12% |
| Researcher | 4 | 10% |
| Lecturer | 2 | 5% |
| Student > Bachelor | 2 | 5% |
| Other | 5 | 12% |
| Unknown | 17 | 41% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 15 | 37% |
| Social Sciences | 2 | 5% |
| Agricultural and Biological Sciences | 1 | 2% |
| Decision Sciences | 1 | 2% |
| Neuroscience | 1 | 2% |
| Other | 1 | 2% |
| Unknown | 20 | 49% |
Attention Score in Context
This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 February 2019.
All research outputs
#4,047,227
of 25,084,886 outputs
Outputs from Annals of Surgical Oncology
#1,168
of 7,161 outputs
Outputs of similar age
#73,895
of 337,808 outputs
Outputs of similar age from Annals of Surgical Oncology
#23
of 103 outputs
Altmetric has tracked 25,084,886 research outputs across all sources so far. Compared to these this one has done well and is in the 83rd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 7,161 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.6. This one has done well, scoring higher than 83% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 337,808 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 78% of its contemporaries.
We're also able to compare this research output to 103 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 78% of its contemporaries.