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Relevance of the A merican C ollege of S urgeons O ncology G roup Z 0011 Trial to breast cancer in the A ustralian setting
Author(s) -
Ngui Nicholas K.,
Elder Elisabeth E.,
Jayasinghe Upali W.,
French James
Publication year - 2013
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12388
Subject(s) - medicine , oncology , breast cancer , relevance (law) , clinical oncology , general surgery , cancer , political science , law
Background: Conventional wisdom suggests that a patient with a positive sentinel node requires a completion axillary clearance to obtain full staging and durable regional control. However, this dictum has been challenged by the recent A merican C ollege of S urgeons O ncology G roup Z 0011 T rial demonstrating that women with node‐positive breast cancer who underwent sentinel node biopsy only, and were treated with breast conserving surgery and radiation, had equivalent locoregional recurrence and survival rates to those who had a completion axillary clearance. The aim of our study was to determine what the clinical impact of the Z 0011 findings might be if patients were managed according to the Z 0011 criteria in an A ustralian teaching hospital setting. Methods: We performed a retrospective review, using prospectively collected data, of all female patients with breast cancer assessed at the W estmead B reast C ancer I nstitute in 2010 and identified the subgroup who would potentially have fulfilled all Z 0011 criteria. The characteristics and management of this group were compared with node‐positive and to mastectomy patient subgroups. Results: A total of 280 patients with invasive breast cancer were identified. Twenty‐six patients satisfied all Z 0011 criteria, representing 9.3% of all patients and 21.5% of node‐positive patients. Twenty‐two (84.6%) patients had a subsequent axillary clearance, with six (27.3%) having additional positive nodes. Conclusions: The Z 0011 study is relevant to 9.3% of all breast cancer patients and 21.5% of node‐positive breast cancer patients treated in a major A ustralian teaching hospital.