Management of the axilla in women with breast cancer: current clinical practice and a new selective targeted approach.


BACKGROUND:Axillary nodal status is the most important prognostic factor for patients with breast cancer. Clinical assessment and imaging modalities are not always reliable. Surgical removal and histopathological examination of axillary lymph nodes remain essential methods of staging the axilla. However, the optimal management of the axilla remains uncertain. METHODS:We performed Medline searches to identify relevant systematic reviews, meta-analysis, and nonrandomized and randomized controlled trials for the past 5 years (up to December 2007), as well as important historical articles and clinical guidelines relating to management of the axilla in women with breast cancer. RESULTS:Axillary lymph node dissection (ALND) has been the standard surgical approach for many years. It is, however, associated with marked morbidity; survival benefit remains uncertain. Axillary node sampling, widely practiced in the United Kingdom, is a reliable alternative procedure in staging the axilla, with less morbidity. Sentinel lymph node biopsy (SLNB) has become an accurate method for staging the axilla in women with operable, clinically node-negative breast cancer. SLNB alone appears to be a safe and acceptable procedure for patients with uninvolved SLNs. Completion ALND or axillary radiotherapy remains the standard treatment for patients with tumor-involved SLNs. SLNB is associated with less morbidity than ALND. However, long-term follow-up and therapeutic outcomes are being awaited from randomized controlled trials. CONCLUSIONS:Several procedures are available for staging and treating the axilla. A tailored surgical approach, with careful assessment of risk-benefit and patient preference, is guiding the evolving modern management of the axilla for women with breast cancer.


Ann Surg Oncol


Samphao S,Eremin JM,El-Sheemy M,Eremin O




Has Abstract


2008-05-01 00:00:00












  • Prognostic Impact of Renin-Angiotensin System Blockade on Renal Cell Carcinoma After Surgery.

    abstract:BACKGROUND:Angiotensin 2 is a key biologic peptide in the renin-angiotensin system (RAS) that regulates blood pressure and renal hemodynamics. The potential role of the RAS in the promotion of tumor growth, angiogenesis, and metastasis also has been shown in the past few decades. This study investigated the prognostic ...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Miyajima A,Yazawa S,Kosaka T,Tanaka N,Shirotake S,Mizuno R,Kikuchi E,Oya M

    更新日期:2015-10-01 00:00:00

  • Laparoscopic resection of large adrenal tumors.

    abstract:BACKGROUND:The maximum size of adrenal tumors that should be removed with a laparoscopic approach is controversial. It has been suggested that laparoscopic adrenalectomy is appropriate only for adrenal tumors < 6 cm in size. We report our experience with laparoscopic adrenalectomy in patients with adrenal tumors of > o...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: MacGillivray DC,Whalen GF,Malchoff CD,Oppenheim DS,Shichman SJ

    更新日期:2002-06-01 00:00:00

  • Prognostic value of cytokeratin-positive bone marrow cells of gastric cancer patients.

    abstract:BACKGROUND:Epithelial cells in the bone marrow of patients with gastric cancer suggest tumor dissemination; however, their prognostic implications are controversial. We prospectively evaluated the correlation of bone marrow findings, recurrence rate, and disease-free survival after long-term follow-up. METHODS:Bone ma...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Gretschel S,Schick C,Schneider U,Estevez-Schwarz L,Bembenek A,Schlag PM

    更新日期:2007-02-01 00:00:00

  • Improved Locoregional Control in a Contemporary Cohort of Nonmetastatic Inflammatory Breast Cancer Patients Undergoing Surgery.

    abstract:BACKGROUND:Inflammatory breast cancer (IBC) is an aggressive form of breast cancer characterized by rapid progression and early metastatic dissemination. The purpose of this study was to assess contemporary rates of local regional recurrence (LRR) in the era of trimodality therapy for nonmetastatic IBC and identify ris...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Rosso KJ,Tadros AB,Weiss A,Warneke CL,DeSnyder S,Kuerer H,Ueno NT,Stecklein SR,Woodward WA,Lucci A

    更新日期:2017-10-01 00:00:00

  • Standard Clinical Protocol for Bidirectional Hyperthermic Intraperitoneal Chemotherapy (HIPEC): Systemic Leucovorin, 5-Fluorouracil, and Heated Intraperitoneal Oxaliplatin in a Chloride-Containing Carrier Solution.

    abstract:BACKGROUND:Intraperitoneal chemotherapy has an established role in the treatment of selected patients with colorectal peritoneal metastases. Oxaliplatin is highly suitable as a chemotherapeutic agent for hyperthermic intraperitoneal chemotherapy (HIPEC), but its use to date has been limited because of the morbidity cau...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Mehta AM,Huitema AD,Burger JW,Brandt-Kerkhof AR,van den Heuvel SF,Verwaal VJ

    更新日期:2017-04-01 00:00:00

  • Reoperative Surgery in Patients with Multiple Endocrine Neoplasia Type 1 Associated Primary Hyperparathyroidism.

    abstract:BACKGROUND:Persistent/recurrent primary hyperparathyroidism (pHPT) occurs frequently in multiple endocrine neoplasia type 1 (MEN1). We assessed the usefulness of intraoperative PTH (IOPTH) and preoperative localizing studies based on the outcome of patients with MEN1-associated pHPT undergoing reoperative surgery. MET...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Keutgen XM,Nilubol N,Agarwal S,Welch J,Cochran C,Marx SJ,Weinstein LS,Simonds WF,Kebebew E

    更新日期:2016-12-01 00:00:00

  • Elective Regional Therapy Treatment for Hepatic Adenoma.

    abstract:BACKGROUND:Locoregional therapy treatments for hepatic adenoma (HA) are typically limited to selective hepatic arterial embolization (HAE) to control acute hemorrhage. This systematic review sought to report the utilization of HAE and ablation for non-emergent treatment of HA. METHODS:A PubMed query identified studies...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Silva JP,Klooster B,Tsai S,Christians KK,Clarke CN,Mogal H,Clark Gamblin T

    更新日期:2019-01-01 00:00:00

  • Impact of Radical Hysterectomy Versus Simple Hysterectomy on Survival of Patients with Stage 2 Endometrial Cancer: A Meta-analysis.

    abstract:BACKGROUND:The strategy of radical surgery for stage 2 endometrial cancer (EC) remains controversial. This meta-analysis aimed to investigate the impact of radical hysterectomy (RH) versus simple hysterectomy (SH) on survival of patients with stage 2 EC. METHODS:A systematic review was conducted to identify studies co...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,meta分析


    authors: Liu T,Tu H,Li Y,Liu Z,Liu G,Gu H

    更新日期:2019-09-01 00:00:00

  • Surrogate End Points for Overall Survival in Metastatic, Locally Advanced, or Unresectable Pancreatic Cancer: A Systematic Review and Meta-Analysis of 24 Randomized Controlled Trials.

    abstract:BACKGROUND:Overall survival (OS) has traditionally been the primary end point in studies evaluating the clinical benefit of first-line chemotherapy in metastatic, locally advanced, or unresectable pancreatic cancer (MLAUPC). Given the prolonged follow-up assessment required to obtain OS and its potential to be confound...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,meta分析,评审


    authors: Makris EA,MacBarb R,Harvey DJ,Poultsides GA

    更新日期:2017-08-01 00:00:00

  • Prevalence and Clinicopathological Characteristics of BRAF Mutations in Chinese Patients with Lung Adenocarcinoma.

    abstract:BACKGROUND:This study was designed to identify the prevalence of BRAF mutations in Chinese patients with lung adenocarcinoma, and to reveal the association between BRAF mutations and clinicopathological characteristics in these patients. METHODS:From October 2007 to February 2013, patients with newly diagnosed primary...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Zheng D,Wang R,Pan Y,Zheng S,Zhang Y,Li H,Cheng C,Gong R,Li Y,Shen X,Hu H,Cai D,Cheng X,Sun Y,Chen H

    更新日期:2015-12-01 00:00:00

  • Risk Factors for Ipsilateral Breast Tumor Recurrence in Triple-Negative or HER2-Positive Breast Cancer Patients Who Achieve a Pathologic Complete Response After Neoadjuvant Chemotherapy.

    abstract:BACKGROUND:Attention has been focused on attempts to eliminate breast surgery for breast cancer patients who achieve a pathologic complete response after neoadjuvant chemotherapy (NAC). However, there are few data on ipsilateral breast tumor recurrence (IBTR) among patients with triple-negative or epidermal growth fact...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Ishitobi M,Matsuda N,Tazo M,Nakayama S,Tokui R,Ogawa T,Yoshida A,Kojima Y,Kuwayama T,Nakayama T,Yamauchi H,Nakamura S,Tsugawa K,Hayashi N

    更新日期:2020-10-06 00:00:00

  • Trends in contralateral prophylactic mastectomy for unilateral cancer: a report from the National Cancer Data Base, 1998-2007.

    abstract:BACKGROUND:Several studies have reported an increased rate of contralateral prophylactic mastectomy (CPM) in patients with unilateral breast cancer. This study reports on CPM trends from the American College of Surgeon's National Cancer Data Base (NCDB) diagnosed over a 10-year period. METHODS:Data about women diagnos...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Yao K,Stewart AK,Winchester DJ,Winchester DP

    更新日期:2010-10-01 00:00:00

  • Sarcopenia and Short-Term Outcomes After Esophagectomy: A Meta-analysis.

    abstract:BACKGROUND:This meta-analysis aimed to investigate the value of preoperative sarcopenia in predicting complications after esophagectomy. Clinicopathologic characteristics of sarcopenia patients, which may support sarcopenia management, also were studied. METHODS:This study searched for articles describing an associati...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Wang PY,Xu LD,Chen XK,Xu L,Yu YK,Zhang RX,Sun HB,Wu HL,Li Y

    更新日期:2020-08-01 00:00:00

  • Fibrosis-4 Index, a Noninvasive Fibrosis Marker, Predicts Survival Outcomes After Hepatectomy for Colorectal Cancer Liver Metastases.

    abstract:BACKGROUND:Liver fibrosis influences liver regeneration and surgical outcomes, and several noninvasive models based on laboratory data have been developed to predict liver fibrosis. This study was performed to determine whether the Fibrosis-4 (FIB-4) index, a noninvasive fibrosis marker, can predict the prognosis in pa...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Akiyama T,Miyamoto Y,Imai K,Yamashita Y,Nomoto D,Daitoku N,Sakamoto Y,Kiyozumi Y,Tokunaga R,Eto K,Harada K,Hiyoshi Y,Iwatsuki M,Nagai Y,Iwagami S,Baba Y,Yoshida N,Baba H

    更新日期:2020-09-01 00:00:00

  • Laparoscopic versus open surgery for rectal cancer: a meta-analysis.

    abstract:BACKGROUND:Laparoscopic rectal cancer surgery aims to provide patients with curative resection while minimizing postoperative morbidity and mortality. This study used meta-analytical techniques to compare laparoscopic and open surgery as the primary treatment for patients with rectal cancer with regard to short-term an...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,meta分析


    authors: Aziz O,Constantinides V,Tekkis PP,Athanasiou T,Purkayastha S,Paraskeva P,Darzi AW,Heriot AG

    更新日期:2006-03-01 00:00:00

  • Complete hepatic venous isolation and extracorporeal chemofiltration as treatment for human hepatocellular carcinoma: a phase I study.

    abstract:BACKGROUND:We performed a phase I study of a novel system of complete hepatic venous isolation and extracorporeal chemofiltration in patients with unresectable hepatocellular carcinoma (HCC) to determine (a) whether systemic exposure to doxorubicin could be limited after high-dose hepatic arterial infusion (HAI), and (...

    journal_title:Annals of surgical oncology

    pub_type: 临床试验,杂志文章


    authors: Curley SA,Newman RA,Dougherty TB,Fuhrman GM,Stone DL,Mikolajek JA,Guercio S,Guercio A,Carrasco CH,Kuo MT

    更新日期:1994-09-01 00:00:00

  • Cross-Sectional Study on MRI Restaging After Chemoradiotherapy and Interval to Surgery in Rectal Cancer: Influence on Short- and Long-Term Outcomes.

    abstract:BACKGROUND:The time interval between CRT and surgery in rectal cancer patients is still the subject of debate. The aim of this study was to first evaluate the nationwide use of restaging magnetic resonance imaging (MRI) and its impact on timing of surgery, and, second, to evaluate the impact of timing of surgery after ...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Detering R,Borstlap WAA,Broeders L,Hermus L,Marijnen CAM,Beets-Tan RGH,Bemelman WA,van Westreenen HL,Tanis PJ,Dutch Snapshot Research Group.

    更新日期:2019-02-01 00:00:00

  • Prognostic Value and Prediction of Extratumoral Microvascular Invasion for Hepatocellular Carcinoma.

    abstract:BACKGROUND:There are few reports on microvascular invasion (MVI) located intra- or extratumorally and prognosis of hepatocellular carcinoma (HCC). OBJECTIVE:The aim of this study was to evaluate patient outcome according to the location of MVI, and to build a nomogram predicting extratumoral MVI. METHODS:We included ...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Nitta H,Allard MA,Sebagh M,Ciacio O,Pittau G,Vibert E,Sa Cunha A,Cherqui D,Castaing D,Bismuth H,Guettier C,Lewin M,Samuel D,Baba H,Adam R

    更新日期:2019-08-01 00:00:00

  • Disseminated peritoneal adenomucinosis: a critical review.

    abstract:BACKGROUND:The term pseudomyxoma peritonei has been used in reference to any condition, benign or malignant, in which the peritoneal cavity becomes filled with a gelatinous substance. The term is nonspecific and does not denote therapeutic or prognostic significance. Controversy centers around which patients benefit fr...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,评审


    authors: Wirtzfeld DA,Rodriguez-Bigas M,Weber T,Petrelli NJ

    更新日期:1999-12-01 00:00:00

  • Surgical safety and oncologic effectiveness in robotic versus conventional open thyroidectomy in thyroid cancer: a systematic review and meta-analysis.

    abstract:BACKGROUND:Although many experiences using the da Vinci Robot System have been reported by several groups, there is substantial controversy over the role of the robot in thyroidectomy. We performed a systematic review and meta-analyses in order to evaluate the safety and effectiveness of robotic thyroidectomy (RT) comp...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,meta分析,评审


    authors: Son SK,Kim JH,Bae JS,Lee SH

    更新日期:2015-09-01 00:00:00

  • Up-regulation of NEK2 by microRNA-128 methylation is associated with poor prognosis in colorectal cancer.

    abstract:BACKGROUND:NIMA-related kinase 2 (NEK2), an enzyme involved in the development and progression of cancer, is abnormally expressed in a wide variety of human cancers, including colorectal cancer (CRC), and is known to have roles in cell division and mitotic regulation through centrosome splitting. We investigated the cl...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Takahashi Y,Iwaya T,Sawada G,Kurashige J,Matsumura T,Uchi R,Ueo H,Takano Y,Eguchi H,Sudo T,Sugimachi K,Yamamoto H,Doki Y,Mori M,Mimori K

    更新日期:2014-01-01 00:00:00

  • Comparison Between Familial and Sporadic Non-medullary Thyroid Carcinoma: A Retrospective Individual Risk Factor-Matched Cohort Study.

    abstract:BACKGROUND:This study aimed to compare clinicopathologic features and outcomes between patients with familial non-medullary thyroid carcinoma (FNMTC) and patients with sporadic non-medullary thyroid carcinoma (SNMTC) after performing individual risk factor-matching. Additionally, the study evaluated a dynamic risk stra...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Lee YM,Jeon MJ,Kim WW,Chung KW,Baek JH,Shong YK,Sung TY,Hong SJ

    更新日期:2020-08-14 00:00:00

  • Survival of Patients with Uterine Carcinosarcoma Undergoing Sentinel Lymph Node Mapping.

    abstract:PURPOSE:This study was designed to evaluate the outcome of patients with uterine carcinosarcoma undergoing sentinel lymph node (SLN) mapping. METHODS:A prospectively maintained database was reviewed for all women with uterine cancer treated at our institution from January 1, 1998 to August 31, 2014. Patients were grou...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Schiavone MB,Zivanovic O,Zhou Q,Leitao MM Jr,Levine DA,Soslow RA,Alektiar KM,Makker V,Iasonos A,Abu-Rustum NR

    更新日期:2016-01-01 00:00:00

  • Effect of body composition on outcomes after hepatic resection for hepatocellular carcinoma.

    abstract:PURPOSE:To evaluate the effect of body composition on outcomes after hepatic resection for patients with hepatocellular carcinoma (HCC). METHODS:We performed 190 hepatic resections for HCC and divided the patients into 2 groups on the basis of visceral fat area (VFA), assessed by computed tomographic measurement at th...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Itoh S,Shirabe K,Matsumoto Y,Yoshiya S,Muto J,Harimoto N,Yamashita Y,Ikegami T,Yoshizumi T,Nishie A,Maehara Y

    更新日期:2014-09-01 00:00:00

  • Sphincter-sparing treatment for distal rectal adenocarcinoma.

    abstract:BACKGROUND:Studies suggest that the anal sphincter can be preserved in some patients with distal rectal adenocarcinoma (DRA), but this has not been validated in any prospective multi-institutional trial. METHODS:To test the hypothesis that the anal sphincter can be preserved in some patients with DRA, the Cancer and L...

    journal_title:Annals of surgical oncology

    pub_type: 临床试验,杂志文章,多中心研究


    authors: Steele GD Jr,Herndon JE,Bleday R,Russell A,Benson A 3rd,Hussain M,Burgess A,Tepper JE,Mayer RJ

    更新日期:1999-07-01 00:00:00

  • Resection Margins in Merkel Cell Carcinoma: Is a 1-cm Margin Wide Enough?

    abstract:BACKGROUND:Guidelines regarding specific resection margins for primary Merkel cell carcinoma (MCC) are not well established. The current National Comprehensive Cancer Network (NCCN) guidelines recommend 1- to 2-cm resection margins. This study aimed to determine the impact of margin width on local recurrence (LR), dise...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Perez MC,de Pinho FR,Holstein A,Oliver DE,Naqvi SMH,Kim Y,Messina JL,Burke E,Gonzalez RJ,Sarnaik AA,Cruse CW,Wuthrick EJ,Harrison LB,Sondak VK,Zager JS

    更新日期:2018-10-01 00:00:00

  • The Ethics of Breast Surgery.

    abstract::Breast surgery has evolved as a subspecialty of general surgery and requires a working knowledge of benign and malignant diseases, surgical techniques, shared decision-making with patients, collaboration with a multi-disciplinary team, and a basic foundation in surgical ethics. Ethics is defined as the practice of ana...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,评审


    authors: Throckmorton A,VanderWalde L,Brackett C,Dominici L,Eisenhauer T,Johnson N,Kong A,Ludwig K,O'Neill J,Pugliese M,Teller P,Sarantou T

    更新日期:2015-10-01 00:00:00

  • Predictive factors of level IIb lymph node metastasis in patients with papillary thyroid carcinoma.

    abstract:BACKGROUND:The extent of neck dissection (ND) appropriate for necks yielding clinical evidence of metastases of papillary thyroid carcinoma (PTC) is controversial. The need for level IIb lymph node (LN) dissection is particularly uncertain in view of its association with postoperative shoulder dysfunction. In the prese...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Koo BS,Yoon YH,Kim JM,Choi EC,Lim YC

    更新日期:2009-05-01 00:00:00

  • Risk Factors for Positive Deep Pelvic Nodal Involvement in Patients with Palpable Groin Melanoma Metastases: Can the Extent of Surgery be Safely Minimized? : A Retrospective, Multicenter Cohort Study.

    abstract:BACKGROUND:Patients with palpable melanoma groin metastases have a poor prognosis. There is debate whether a combined superficial and deep groin dissection (CGD) is necessary or if superficial groin dissection (SGD) alone is sufficient. AIM:The aim of this study was to analyze risk factors for deep pelvic nodal involv...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,多中心研究


    authors: Oude Ophuis CM,van Akkooi AC,Hoekstra HJ,Bonenkamp JJ,van Wissen J,Niebling MG,de Wilt JH,van der Hiel B,van de Wiel B,Koljenović S,Grünhagen DJ,Verhoef C

    更新日期:2015-12-01 00:00:00

  • Does Failure to Achieve Pathologic Complete Response with Neoadjuvant Chemotherapy Identify Node-Negative Patients Who Would Benefit from Postmastectomy Radiation or Regional Nodal Irradiation?

    abstract:BACKGROUND:Postmastectomy radiation (PMRT) and regional nodal irradiation (RNI) improve outcomes for patients at high risk of locoregional recurrence (LRR). Node-negative patients with the triple-negative (TN) subtype and those who do not have a pCR with neoadjuvant chemotherapy (NAC) are at increased risk for LRR, but...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章


    authors: Crown A,Gonen M,Le T,Morrow M

    更新日期:2020-09-21 00:00:00