| Title |
The Association of Extent of Axillary Surgery and Survival in Women with N2–3 Invasive Breast Cancer
|
|---|---|
| Published in |
Annals of Surgical Oncology, July 2018
|
| DOI | 10.1245/s10434-018-6587-2 |
| Pubmed ID | |
| Authors |
Tristen S. Park, Samantha M. Thomas, Laura H. Rosenberger, Oluwadamilola M. Fayanju, Jennifer K. Plichta, Rachel C. Blitzblau, Cecilia T. Ong, Terry Hyslop, E. Shelley Hwang, Rachel A. Greenup |
| Abstract |
Although surgical management of the axilla for breast cancer continues to evolve, axillary lymphadenectomy remains the standard of care for women with advanced nodal disease. We sought to evaluate national patterns of care in axillary surgery, and its association with overall survival (OS) among women with N2-3 invasive breast cancer. Women (18-90 years) with clinical N2-3 invasive breast cancer who underwent axillary surgery were identified from the National Cancer Data Base (NCDB) from 2004 to 2013. Axillary surgery was categorized as sentinel lymph node biopsy (SLNB, 1-5 nodes) or axillary lymph node dissection (ALND, ≥ 10 nodes). Patient and treatment characteristics, trends over time, and overall survival (OS) were compared by surgical treatment. Overall, 22,156 patients were identified. At diagnosis, 68.5% had cN2 and 31.5% had cN3 disease. Treatment included: lumpectomy (27%), mastectomy (73%), adjuvant chemotherapy (53.4%), neoadjuvant chemotherapy (NAC) (39.7%), radiation (74%), and endocrine therapy (54.4%). In total, 9.9% (n = 2190) underwent SLNB and 90.1% (n = 19,966) underwent ALND. Receipt of SLNB was associated with private insurance, grade 3 disease, invasive ductal cancer, NAC, and lumpectomy (all p < 0.001). After adjustment for known covariates, including chemotherapy use, ALND was associated with improved survival [hazard ratio (HR) 0.68, p < 0.001] and this effect was similar for N2 and N3 patients (axillary surgery × cN-stage interaction p = 0.29). Axillary lymphadenectomy was associated with improved survival in patients presenting with clinical N2-3 invasive breast cancer. Further studies, particularly in the neoadjuvant setting, are needed to identify breast cancer patients with advanced nodal disease who may safely avoid a lesser extent of axillary surgery. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 32 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 32 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 5 | 16% |
| Student > Master | 4 | 13% |
| Researcher | 2 | 6% |
| Student > Ph. D. Student | 2 | 6% |
| Student > Bachelor | 1 | 3% |
| Other | 5 | 16% |
| Unknown | 13 | 41% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 10 | 31% |
| Business, Management and Accounting | 2 | 6% |
| Agricultural and Biological Sciences | 2 | 6% |
| Nursing and Health Professions | 2 | 6% |
| Computer Science | 1 | 3% |
| Other | 1 | 3% |
| Unknown | 14 | 44% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. 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 07 July 2018.
All research outputs
#18,641,800
of 23,094,276 outputs
Outputs from Annals of Surgical Oncology
#5,053
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Outputs of similar age
#252,942
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Outputs of similar age from Annals of Surgical Oncology
#118
of 126 outputs
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