What is the Z11 trial?
The American College of Surgeons Oncology Group (ACOSOG) Z0011 trial was a multicenter noninferiority study which enrolled and randomized 891 patients with breast cancer, T1-2 disease, clinically negative axillary nodes, 1 or 2 macrometastatic nodes on SLNB, and a plan for breast conserving therapy consisting of lumpectomy and whole-breast radiation.
What is Z0011?
ACOSOG Z0011: A randomized trial of axillary node dissection in women with clinical T1-2 N0 M0 breast cancer who have a positive sentinel node.Jun 20, 2010
What is sentina trial?
The SENTINA trial was designed to evaluate the relationship of sentinel lymph node dissection in patients who received neoadjuvant chemotherapy; the study arms are depicted below. Source publication. Targeting and limiting surgery for patients with node-positive breast cancer. Article.
What is axillary dissection for breast cancer?
Axillary dissection is a surgical procedure that incises the axilla to identify, examine, or remove lymph nodes. Axillary dissection has been the standard technique used in the staging and treatment of the axilla in breast cancer.Mar 11, 2019
What is axillary web syndrome?
Background: Axillary web syndrome (AWS) is a poorly understood but common cause of significant morbidity after axillary lymph node dissection for breast cancer. It is characterized by painful scar tissue formation and contracture extending from the axilla down the medial arm which limits shoulder and arm mobility.
What are sentinel lymph nodes?
A sentinel lymph node is defined as the first lymph node to which cancer cells are most likely to spread from a primary tumor. Sometimes, there can be more than one sentinel lymph node.Jun 25, 2019
What does Nsabp stand for?
The National Surgical Adjuvant Breast and Bowel Project (NSABP) is a clinical trials cooperative group supported since its inception by the National Cancer Institute (NCI).
What happens if sentinel node is positive?
A positive result means there are cancer cells in the sentinel nodes. This means the cancer has started to spread. Your doctor will talk to you about further treatment. You'll also have scans to see if the cancer has spread anywhere else.
What does a mastectomy?
A mastectomy is surgery to remove all breast tissue from a breast as a way to treat or prevent breast cancer. For those with early-stage breast cancer, a mastectomy may be one treatment option.Oct 30, 2021
Do you need radiation after axillary node dissection?
Axillary radiation therapy and axillary lymph node dissection provide excellent locoregional control and comparable rates of survival and recurrence. Axillary radiation therapy reduced the rate of lymphedema compared with axillary lymph node dissection.Mar 10, 2019
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Do lymph nodes grow back after removal?
The surgery reconnects the system. “As the reconnected lymph nodes start working, they send signals to the body to start recreating channels that have not been working,” Dr. Manrique says. “The procedure sets in motion the regeneration of the lymphatic system and ultimately the circulation of the lymphatic fluid.Jul 20, 2017
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What happens if axillary lymph nodes are removed?
When lymph nodes are removed, the liquid they store (lymph) can begin to collect in the area. More lymph nodes are removed with ALND, which raises the risk of lymphedema. Patients with lymphedema are more likely to have an infection in the affected arm. Patients must carefully watch for swelling or changes.
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What are the long term side effects of lymph node removal?
A possible long-term effect of lymph node surgery is swelling in the arm or chest called lymphedema. Because any excess fluid in the arms normally travels back into the bloodstream through the lymphatic system, removing the lymph nodes sometimes blocks drainage from the arm, causing this fluid to build up.Sep 18, 2019
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Is the follow-up of z0011 adequate?
- There were concerns that the follow-up was inadequate to assure non-inferiority. The 10-year survival results of Z0011 are reported here. Methods: Clinically node-negative pts with 1 or 2 SNs with H&E-detected metastases were randomized to ALND or no further axillary specific treatment.
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What was the last date of follow-up in the ACOSOG z0011 trial?
- Design, setting, and participants: The ACOSOG Z0011 phase 3 randomized clinical trial enrolled patients from May 1999 to December 2004 at 115 sites (both academic and community medical centers). The last date of follow-up was September 29, 2015, in the ACOSOG Z0011 (Alliance) trial.
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What are the exclusion criteria for the evaluation of extranodal cancer?
- Exclusion Criteria 1 Metastasis identified by immunohistchemical staining 2 Mastectomy 3 Partial or no radiation treatment 4 Palpable adenopathy or gross extranodal disease 5 ≥3 positive nodes on SLNB 6 Matted nodes 7 Neoadjuvant hormonal/chemotherapy treatment 8 No third field axillary nodal irradiation in “observation group” More ...
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Is the ACOSOG z0011 trial relevant to HER2-positive patients with high-risk breast cancer?Is the ACOSOG z0011 trial relevant to HER2-positive patients with high-risk breast cancer?
The relevance of the American College ofSurgeons Oncology Group (ACOSOG) Z0011 trial inpatients with high-risk breast cancer has been questioned.We hypothesize that Z0011 applies to women with HER2-positive disease (HER2?), triple-negative breast cancer(TNBC), and/or age50 years at diagnosis (YA).
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What was the last date of follow-up in the ACOSOG z0011 trial?What was the last date of follow-up in the ACOSOG z0011 trial?
Design, setting, and participants: The ACOSOG Z0011 phase 3 randomized clinical trial enrolled patients from May 1999 to December 2004 at 115 sites (both academic and community medical centers). The last date of follow-up was September 29, 2015, in the ACOSOG Z0011 (Alliance) trial.
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Does ALND improve outcomes in patients with T1-T2 breast cancer?Does ALND improve outcomes in patients with T1-T2 breast cancer?
In the American College of Surgeons Oncology Group Z0011 randomized trial, ALND did not significantly affect overall or disease-free survival of patients with clinical T1-T2 breast cancer and a positive SLN who were treated with lumpectomy, adjuvant systemic therapy, and tangential-field whole-breast radiation therapy.
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What are the exclusion criteria for the evaluation of extranodal cancer?What are the exclusion criteria for the evaluation of extranodal cancer?
Exclusion Criteria 1 Metastasis identified by immunohistchemical staining 2 Mastectomy 3 Partial or no radiation treatment 4 Palpable adenopathy or gross extranodal disease 5 ≥3 positive nodes on SLNB 6 Matted nodes 7 Neoadjuvant hormonal/chemotherapy treatment 8 No third field axillary nodal irradiation in “observation group” More ...
