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  • Original Article

    Potential Impact of the Z0011 Trial on the Omission of Axillary Dissection: A Retrospective Cohort Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(4):297-303

    Summary

    Original Article

    Potential Impact of the Z0011 Trial on the Omission of Axillary Dissection: A Retrospective Cohort Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(4):297-303

    DOI 10.1055/s-0041-1725052

    Views1

    Abstract

    Objective

    To evaluate the number of patients with early-stage breast cancer who could benefit from the omission of axillary surgery following the application of the Alliance for Clinical Trials in Oncology (ACOSOG) Z0011 trial criteria.

    Methods

    A retrospective cohort study conducted in the Hospital da Mulher da Universidade Estadual de Campinas. The study population included 384 women diagnosed with early-stage invasive breast cancer, clinically negative axilla, treated with breast-conserving surgery and sentinel lymph node biopsy, radiation therapy, chemotherapy and/or endocrine therapy, from January 2005 to December 2010. The ACOSOG Z0011 trial criteria were applied to this population and a statistical analysis was performed to make a comparison between populations.

    Results

    A total of 384 patients underwent breast-conserving surgery and sentinel lymph node biopsy. Of the total number of patients, 86 women underwent axillary lymph node dissection for metastatic sentinel lymph nodes (SNLs). One patient underwent axillary node dissection due to a suspicious SLN intraoperatively, thus, she was excluded fromthe study. Among these patients, 82/86 (95.3%) had one to two involved sentinel lymph nodes andmet the criteria for the ACOSOG Z0011 trial with the omission of axillary lymph node dissection. Among the 82 eligible women, there were only 13 cases (15.9%) of lymphovascular invasion and 62 cases (75.6%) of tumors measuring up to 2 cm in diameter (T1).

    Conclusion

    The ACOSOG Z0011 trial criteria can be applied to a select group of SLNpositive patients, reducing the costs and morbidities of breast cancer surgery.

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    Potential Impact of the Z0011 Trial on the Omission of Axillary Dissection: A Retrospective Cohort Study
  • Trabalhos Originais

    Ductal carcinoma in situ and invasive carcinoma in the same breast: evaluation of the nuclear grade and the expressions of proteins p53 and C-erbB-2 and estrogen receptors

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):435-439

    Summary

    Trabalhos Originais

    Ductal carcinoma in situ and invasive carcinoma in the same breast: evaluation of the nuclear grade and the expressions of proteins p53 and C-erbB-2 and estrogen receptors

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):435-439

    DOI 10.1590/S0100-72032004000600003

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    OBJECTIVES: The aim of the present study was to evaluate the nuclear grade, the expressions of p53 and c-erbB-2 proteins, and the estrogen receptors (ER) of 38 women with ductal carcinoma in situ (DCIS) and invasive carcinoma of the same breast. METHODS: the protein profile of 38 women was investigated in a descriptive and retrospective study, through the immune-histochemical technique. The cut-off limit for positive staining was chosen at 10% or more of positive cells for p53 and c-erbB-2 proteins and for ER. The analysis of the concordance between the expressions of proteins and the nuclear grade was done by the kappa coefficient, according to Landis and Koch's criteria. MacNemar's test was used to assess the differences between the two groups. RESULTS: there was a perfect concordance in the expression of p53 proteins (kappa coefficient = 1.00) and almost a perfect concordance for c-erbB-2 proteins, ER and nuclear grade (kappa coefficients = 0.84, 0.89 and 0.89) between in situ and invasive elements of the same tumor. CONCLUSION: there was no difference between the expressions of p53 and c-erbB-2 proteins, ER and nuclear grade in the DCIS and invasive carcinoma of the same breast.

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