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Radiotherapy in sentinel node-positive breast cancer: results of an international survey

Published online by Cambridge University Press:  05 April 2016

Siobhra O’Sullivan ,
Kathy Rock  and
Nazmy ElBeltagi
Siobhra O’Sullivan
Affiliation:
St Luke’s Radiation Oncology Network, Rathgar, Dublin, Ireland
Kathy Rock
Affiliation:
St Luke’s Radiation Oncology Network, Rathgar, Dublin, Ireland
Nazmy ElBeltagi*
Affiliation:
St Luke’s Radiation Oncology Network, Rathgar, Dublin, Ireland Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
*
Correspondence to: Dr Nazmy ElBeltagi, Consultant Radiation Oncologist, St Luke’s Radiation Oncology Network, Rathgar, Dublin 6, Ireland. Tel: +353 1406 5000. Fax: +353 1497 2941. E-mail: Nazmy.elbeltagi@slh.ie
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Abstract

Purpose

The purpose of this study was to assess the radiotherapy fields being offered to women with a positive sentinel lymph node (SLN) who have not had axillary lymph node dissection (ALND), based on the American College of Surgeons Oncology Group Z11 results.

Methods

We conducted a postal survey, addressed to radiation oncologists specialising in breast cancer treatment. In total, 179 cancer centres were contacted. Three hypothetical case scenarios were presented. In each case, the patient is clinically node negative but has a positive SLN following breast-conserving surgery, without further ALND. Respondents were asked what radiotherapy fields they would treat with in each scenario.

Results

We received responses from 90 radiation oncologists from 73 centres in 11 countries. In the three scenarios (low, intermediate and high risk of further lymph node involvement), standard tangential beams would be used by only 27, 12 and 7%, respectively; high tangential beams by 33, 18 and 13%; tangents with full axillary/supraclavicular irradiation by 26, 51 and 61%; the remaining 14, 19 and 19% would use a nomogram to aid their decision.

Conclusion

This survey describes the lack of consensus regarding the management of the axilla in patients with clinically node-negative breast cancer but a positive sentinel node and who have not had ALND.

Keywords

ACOSOG Z0011axillabreast cancerradiotherapysentinel node
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 15 , Issue 3 , September 2016 , pp. 247 - 253
Copyright
© Cambridge University Press 2016 

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