Results of the First Austrian Multidisciplinary Expert Panel on Controversies in Local Treatment of Breast Cancer

Breast care

Michael Gnant¹  Florian Fitzal¹  Michael Knauer¹ 

[1] aBreast Cancer Center, Department of Surgery, Sisters of Charity Hospital, Linz

关键词: Breast cancer: local therapy;    surgery;    radiotherapy;    Expert panel;   

DOI  :  10.1159/000336983

学科分类：泌尿医学

来源: S Karger AG

【 摘 要 】

At the first Austrian multidisciplinary expert panel on controversies in local treatment of breast cancer, 22 experts of all relevant disciplines discussed current areas of debate (surgery of the breast, surgery and pathology of the axilla, reconstructive surgery, radiotherapy, and imaging) in local therapy. The most controversial area of debate was the area of axillary surgery. The panel agreed that it was no longer necessary to perform completion axillary lymph node dissection (ALND) when micrometastases are diagnosed in the sentinel lymph node. The only prospective trial comparing patients with sentinel node macrometastases with or without completion ALND had to be terminated early due to failure in sufficient patient recruitment. As long as the frequently discussed issues have not been solved and in light of the lack of any clear level 1 evidence, the panel decided not to recommend omitting axillary dissection in patients with 1 or 2 macrometastases meeting the inclusion criteria of the ACOSOG Z0011 trial. The Austrian panel similarly decided not to recommend omitting axillary dissection in patients with macrometastases and low-risk breast cancer in general. These decisions reflect the increasing skepticism of the scientific community against rapidly shifting paradigms without sufficient and clear evidence.

【 授权许可】

Unknown