Management of the Axilla in Early-Stage Breast Cancer: Ontario Health (Cancer Care Ontario) and ASCO Guideline

被引：190

作者：

Brackstone, Muriel ^{[1
]}

Baldassarre, Fulvia G. ^{[2
]}

Perera, Francisco E. ^{[1
]}

Cil, Tulin ^{[3
]}

Mac Gregor, Mariana Chavez ^{[4
]}

Dayes, Ian S. ^{[5
]}

Engel, Jay ^{[6
]}

Horton, Janet K.

King, Tari A. ^{[7
]}

Kornecki, Anat ^{[8
]}

George, Ralph ^{[9
]}

SenGupta, Sandip K. ^{[10
]}

Spears, Patricia A. ^{[11
]}

Eisen, Andrea F. ^{[12
]}

机构：

[1] London Hlth Sci Ctr, London, ON, Canada

[2] McMaster Univ, Program Evidence Based Care, Hamilton, ON, Canada

[3] Univ Hlth Network, Princess Margaret Hosp, Toronto, ON, Canada

[4] Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USA

[5] Juravinski Canc Ctr, Hamilton, ON, Canada

[6] Kingston Gen Hosp, Canc Ctr Southeastern Ontario, Kingston, ON, Canada

[7] Dana Farber Brigham & Womens Canc Ctr, Boston, MA USA

[8] Western Univ, London, ON, Canada

[9] St Michaels Hosp, Div Gen Surg, CIBC Breast Ctr, Toronto, ON, Canada

[10] Kingston Gen Hosp, Pathol Dept, Kingston, ON, Canada

[11] Univ N Carolina, Lineberger Comprehens Canc Ctr, Chapel Hill, NC 27515 USA

[12] Univ Toronto, Odette Canc Ctr, Toronto, ON, Canada

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2021年 / 39卷 / 27期

关键词：

SENTINEL-LYMPH-NODE; NEOADJUVANT SYSTEMIC THERAPY; EORTC; 10981-22023; AMAROS; PROSPECTIVE MULTICENTER TRIAL; 20-YEAR FOLLOW-UP; RANDOMIZED-TRIAL; IDENTIFICATION RATE; DEVELOPMENT CYCLE; AMERICAN SOCIETY; CLINICAL-TRIAL;

D O I：

10.1200/JCO.21.00934

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

PURPOSE To provide recommendations on the best strategies for the management and on the best timing and treatment (surgical and radiotherapeutic) of the axilla for patients with early-stage breast cancer. METHODS Ontario Health (Cancer Care Ontario) and ASCO convened a Working Group and Expert Panel to develop evidence-based recommendations informed by a systematic review of the literature. RESULTS This guideline endorsed two recommendations of the ASCO 2017 guideline for the use of sentinel lymph node biopsy in patients with early-stage breast cancer and expanded on that guideline with recommendations for radiotherapy interventions, timing of staging after neoadjuvant chemotherapy (NAC), and mapping modalities. Overall, the ASCO 2017 guideline, seven high-quality systematic reviews, 54 unique studies, and 65 corollary trials formed the evidentiary basis of this guideline. RECOMMENDATIONS Recommendations are issued for each of the objectives of this guideline: (1) To determine which patients with early-stage breast cancer require axillary staging, (2) to determine whether any further axillary treatment is indicated for women with early-stage breast cancer who did not receive NAC and are sentinel lymph node-negative at diagnosis, (3) to determine which axillary strategy is indicated for women with early-stage breast cancer who did not receive NAC and are pathologically sentinel lymph node-positive at diagnosis (after a clinically node-negative presentation), (4) to determine what axillary treatment is indicated and what the best timing of axillary treatment for women with early-stage breast cancer is when NAC is used, and (5) to determine which are the best methods for identifying sentinel nodes. Additional information is available at .

引用

页码：3056 / +

页数：29

共 92 条

[41] Does Blue Dye Contribute to Success of Sentinel Node Mapping for Breast Cancer? [J].