Impact of American College of Surgeons Oncology Group Z0011 and National Surgical Adjuvant Breast and Bowel Project B-32 trial results on surgeon practice in the Pacific Northwest

Kristen Massimino, Crystal J. Hessman, Michelle C. Ellis, Arpana Naik, John Vetto

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

BACKGROUND: Recent clinical trials have suggested no survival benefit for completion axillary node dissection (CALND) after sentinel lymph node biopsy (American College of Surgeons Oncology Group Z0011) and no clinically meaningful benefit for the routine use of immunohistochemistry (National Surgical Adjuvant Breast and Bowel Project B-32) in clinically node-negative breast cancer. METHODS: A 12-question electronic survey was distributed to members of 3 Pacific Northwest surgical societies. Surgeons were queried regarding the impact of the trial results on their surgical management of breast cancer. RESULTS: The 181 respondents reported performing fewer CALNDs (63%), fewer intraoperative frozen sections (21%), and no immunohistochemistry (12%) because of trial data. However, 28% of surgeons continued to perform CALND in patients with 1 to 2 positive sentinel lymph nodes undergoing lumpectomy and postoperative radiation. CONCLUSIONS: Recent trial data have impacted the performance of CALNDs and the pathological evaluation of sentinel lymph nodes among Pacific Northwest surgeons. Our results suggest a need for regional surgical societies to disseminate practice-changing trial data to members.

Original languageEnglish (US)
Pages (from-to)618-622
Number of pages5
JournalAmerican Journal of Surgery
Volume203
Issue number5
DOIs
Publication statusPublished - May 2012

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Keywords

  • American College of Surgeons Oncology Group Z0011
  • Completion axillary dissection
  • Immunohistochemistry
  • National Surgical Adjuvant Breast and Bowel Project B-32
  • survey

ASJC Scopus subject areas

  • Surgery

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