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Jain AJ, Schultz K, Brainerd MJ, Murimwa GZ, Fleming AM, Fackche N, Bilir E, Chiba A, Martin AN, Singh P, Childers CP, Freidman LR, Zafar N, Abdelsattar Z, Cortina C, Stewart C, Cowher MD, Ganai S, Merck B, Nandakumar G, Pandalai PK, Narayan RR, Ahmad SA. The Top Ten Annals of Surgical Oncology Original Articles on Twitter/X: 2020-2023. Ann Surg Oncol 2024:10.1245/s10434-024-15936-z. [PMID: 39138773 DOI: 10.1245/s10434-024-15936-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 07/11/2024] [Indexed: 08/15/2024]
Abstract
Social media has become omnipresent in society, especially given that it enables the rapid and widespread communication of news, events, and information. Social media platforms have become increasingly used by numerous surgical societies to promote meetings and surgical journals to increase the visibility of published content. In September 2020, Annals of Surgical Oncology (ASO) established its Social Media Committee (SMC), which has worked to steadily increase the visibility of published content on social media platforms, namely X (formerly known as Twitter). The purpose of this review is to highlight the 10 ASO original articles with the most engagement on X, based on total number of mentions, since the founding of the SMC. These articles encompass a wide variety of topics from various oncologic disciplines including hepatopancreatobiliary, breast, and gynecologic surgery.
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Affiliation(s)
- Anish J Jain
- Division of General Surgery, Department of Surgery, Stanford University, Stanford, CA, USA.
| | - Kurt Schultz
- Division of Colon and Rectal Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Micah J Brainerd
- Department of Surgery, Cleveland Clinic Akron General, Akron, OH, USA
| | - Gilbert Z Murimwa
- Department of Surgery, University of Texas Southwestern, Dallas, TX, USA
| | - Andrew M Fleming
- Department of Surgery, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Nadege Fackche
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Esra Bilir
- Department of Gynecologic Oncology, Koc University School of Medicine, Istanbul, Turkey
- Department of Obstetrics and Gynecology, Die Klinik in Preetz, Preetz, Germany
| | - Akiko Chiba
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Allison N Martin
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Puneet Singh
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Christopher P Childers
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lindsay R Freidman
- Surgical Oncology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nabeel Zafar
- Division of Surgical Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Zaid Abdelsattar
- Division of Thoracic Surgery, Stritch School of Medicine, Chicago, IL, USA
| | - Chandler Cortina
- Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Camille Stewart
- Division of Surgical Oncology, CommonSpirit Associated Surgeons St. Anthony, Lakewood, CO, USA
| | - Michael D Cowher
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Sabha Ganai
- Department of Surgery, University of North Dakota, Grand Forks, ND, USA
| | - Belen Merck
- Departamento de Cirugía, Universidad Cardenal Herrera CEU, Alfara del Patriarca, Valencia, Spain
| | | | - Prakash K Pandalai
- Department of Surgery, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Raja R Narayan
- Division of Surgical Oncology, Department of Surgery, Loma Linda University, Loma Linda, CA, USA
| | - Syed A Ahmad
- Division of Surgical Oncology, University of Cincinnati Cancer Center, Cincinnati, OH, USA
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Heidinger M, Weber WP. Axillary Surgery for Breast Cancer in 2024. Cancers (Basel) 2024; 16:1623. [PMID: 38730576 PMCID: PMC11083357 DOI: 10.3390/cancers16091623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/18/2024] [Accepted: 04/21/2024] [Indexed: 05/13/2024] Open
Abstract
Axillary surgery for patients with breast cancer (BC) in 2024 is becoming increasingly specific, moving away from the previous 'one size fits all' radical approach. The goal is to spare morbidity whilst maintaining oncologic safety. In the upfront surgery setting, a first landmark randomized controlled trial (RCT) on the omission of any surgical axillary staging in patients with unremarkable clinical examination and axillary ultrasound showed non-inferiority to sentinel lymph node (SLN) biopsy (SLNB). The study population consisted of 87.8% postmenopausal patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative BC. Patients with clinically node-negative breast cancer and up to two positive SLNs can safely be spared axillary dissection (ALND) even in the context of mastectomy or extranodal extension. In patients enrolled in the TAXIS trial, adjuvant systemic treatment was shown to be similar with or without ALND despite the loss of staging information. After neoadjuvant chemotherapy (NACT), targeted lymph node removal with or without SLNB showed a lower false-negative rate to determine nodal pathological complete response (pCR) compared to SLNB alone. However, oncologic outcomes do not appear to differ in patients with nodal pCR determined by either one of the two concepts, according to a recently published global, retrospective, real-world study. Real-world studies generally have a lower level of evidence than RCTs, but they are feasible quickly and with a large sample size. Another global real-world study provides evidence that even patients with residual isolated tumor cells can be safely spared from ALND. In general, few indications for ALND remain. Three randomized controlled trials are ongoing for patients with clinically node-positive BC in the upfront surgery setting and residual disease after NACT. Pending the results of these trials, ALND remains indicated in these patients.
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Affiliation(s)
- Martin Heidinger
- Breast Surgery, University Hospital Basel, 4031 Basel, Switzerland;
- Faculty of Medicine, University of Basel, 4001 Basel, Switzerland
| | - Walter P. Weber
- Breast Surgery, University Hospital Basel, 4031 Basel, Switzerland;
- Faculty of Medicine, University of Basel, 4001 Basel, Switzerland
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Gündoğdu A, Uluşahin M, Çekiç AB, Kazaz SN, Güner A. Pathological complete response and associated factors in breast cancer after neoadjuvant chemotherapy: A retrospective study. Turk J Surg 2024; 40:73-81. [PMID: 39036007 PMCID: PMC11257731 DOI: 10.47717/turkjsurg.2024.6308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 03/17/2024] [Indexed: 07/23/2024]
Abstract
Objectives This study aimed to determine clinical and pathological factors that identify a pathological complete response (pCR) in breast cancer patients undergoing neoadjuvant chemotherapy (NAC). Material and Methods A retrospective, single-center study was conducted in women over the age of 18 who had been diagnosed with pathologically confirmed invasive breast cancer and who had received NAC between July 2016 and October 2021. Patient demographics, clinical, radiological, treatment, and pathological data were reviewed from the electronic hospital records. The primary outcome of interest was pCR, defined as the absence of residual invasive breast cancer in both the breast and axillary lymph nodes. Multivariable logistic regression analysis was used to identify factors associated with pCR. Results A total of 119 patients were included in the analysis. The distribution of age was 54.5 ± 11.5 years. pCR was observed in 33 (27.7%) patients. pCR for breast tissue was observed in 43 (36.1%) patients. There was no statistically significant relation between the clinical stage and pCR. Age, age at first labor, extent of disease in the breast, NAC completeness, clinical tumor size (cT) stage, clinical lymph node (cN) stage, and molecular subtype were analyzed in a multivariable model. Analysis showed that molecular subtype was the only independent factor related to pCR. pCR rates across molecular subtypes were: 8.7% in luminal-A, 10.8% in luminal-B, 54.5% in human epidermal growth factor receptor 2 (HER-2)-positive, 42.4% in luminal-B (HER-2 positive) and 46.7% in triple-negative. There was no statistically significant difference between luminal-A and luminal-B subgroups (odds ratio 1.15, 95% confidence interval, 0.19-9.35, p= 0.881). Despite the limited number of patients in HER2-positive and triple-negative groups, both demonstrated statistically significant higher odds compared to reference group. Conclusion The presented study underscores the relevance of molecular subtypes in determining the response to neoadjuvant chemotherapy in breast cancer patients. Particularly HER2-positive and triple-negative subtypes may demonstrate more favorable response rates.
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Affiliation(s)
- Adnan Gündoğdu
- Department of General Surgery, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
| | - Mehmet Uluşahin
- Department of General Surgery, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
| | - Arif Burak Çekiç
- Department of General Surgery, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
| | - Seher Nazlı Kazaz
- Department of Medical Oncology, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
- Clinic of Medical Oncology, Medical Park Trabzon Karadeniz Hospital, Trabzon, Türkiye
| | - Ali Güner
- Department of General Surgery, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
- Department of Biostatistics and Medical Informatics, Karadeniz Technical University Institute of Medical Science, Trabzon, Türkiye
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Yan Y, Jiang T, Sui L, Ou D, Qu Y, Chen C, Lai M, Ni C, Liu Y, Wang Y, Xu D. Combined conventional ultrasonography with clinicopathological features to predict axillary status after neoadjuvant therapy for breast cancer: A case-control study. Br J Radiol 2023; 96:20230370. [PMID: 37750854 PMCID: PMC10646660 DOI: 10.1259/bjr.20230370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/15/2023] [Accepted: 08/24/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate the value of a model combining conventional ultrasonography and clinicopathologic features for predicting axillary status after neoadjuvant therapy in breast cancer. METHODS This retrospective study included 329 patients with lymph node-positive who underwent neoadjuvant systemic treatment (NST) from June 2019 to March 2022. Ultrasound and clinicopathological characteristics of breast lesions and axillary lymph nodes were analyzed before and after NST. The diagnostic efficacy of ultrasound, clinicopathological characteristics, and combined model were evaluated using multivariate logistic regression and receiver operator characteristic curve (ROC) analyses. RESULTS The area under ROC (AUC) for the ability of the combined model to predict the axillary pathological complete response (pCR) after NST was 0.882, that diagnostic effectiveness was significantly better than that of the clinicopathological model (AUC of 0.807) and the ultrasound feature model (AUC of 0.795). In addition, eight features were screened as independent predictors of axillary pCR, including clinical N stage, ERBB2 status, Ki-67, and after NST the maximum diameter reduction rate and margins of breast lesions, the short diameter, cortical thickness, and fatty hilum of lymph nodes. CONCLUSIONS The combined model constructed from ultrasound and clinicopathological features for predicting axillary pCR has favorable diagnostic results, which allowed more accurate identification of BC patients who had received axillary pCR after NST. ADVANCES IN KNOWLEDGE A combined model incorporated ultrasound and clinicopathological characteristics of breast lesions and axillary lymph nodes demonstrated favorable performance in evaluating axillary pCR preoperatively and non-invasively.
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Affiliation(s)
| | | | | | | | - Yiyuan Qu
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
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Weber WP, Matrai Z, Hayoz S, Tausch C, Henke G, Zimmermann F, Montagna G, Fitzal F, Gnant M, Ruhstaller T, Muenst S, Mueller A, Lelièvre L, Heil J, Knauer M, Egle D, Sávolt Á, Heidinger M, Kurzeder C. Association of Axillary Dissection With Systemic Therapy in Patients With Clinically Node-Positive Breast Cancer. JAMA Surg 2023; 158:1013-1021. [PMID: 37466971 PMCID: PMC10357358 DOI: 10.1001/jamasurg.2023.2840] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/08/2023] [Indexed: 07/20/2023]
Abstract
Importance The role of axillary lymph node dissection (ALND) to determine nodal burden to inform systemic therapy recommendations in patients with clinically node (cN)-positive breast cancer (BC) is currently unknown. Objective To address the association of ALND with systemic therapy in cN-positive BC in the upfront surgery setting and after neoadjuvant chemotherapy (NACT). Design, Setting, and Participants This was a prospective, observational, cohort study conducted from August 2018 to June 2022. This was a preplanned study within the phase 3 randomized clinical OPBC-03/TAXIS trial. Included were patients with confirmed cN-positive BC from 44 private, public, and academic breast centers in 6 European countries. After NACT, residual nodal disease was mandatory, and a minimum follow-up of 2 months was required. Exposures All patients underwent tailored axillary surgery (TAS) followed by ALND or axillary radiotherapy (ART) according to TAXIS randomization. TAS removed suspicious palpable and sentinel nodes, whereas imaging-guidance was optional. Systemic therapy recommendations were at the discretion of the local investigators. Results A total of 500 patients (median [IQR] age, 57 [48-69] years; 487 female [97.4%]) were included in the study. In the upfront surgery setting, 296 of 335 patients (88.4%) had hormone receptor (HR)-positive and Erb-B2 receptor tyrosine kinase 2 (ERBB2; formerly HER2 or HER2/neu)-negative disease: 145 (49.0%) underwent ART, and 151 (51.0%) underwent ALND. The median (IQR) number of removed positive lymph nodes without ALND was 3 (1-4) nodes compared with 4 (2-9) nodes with ALND. There was no association of ALND with the proportion of patients undergoing adjuvant chemotherapy (81 of 145 [55.9%] vs 91 of 151 [60.3%]; adjusted odds ratio [aOR], 0.72; 95% CI, 0.19-2.67) and type of systemic therapy. Of 151 patients with NACT, 74 (51.0%) underwent ART, and 77 (49.0%) underwent ALND. The ratio of removed to positive nodes was a median (IQR) of 4 (3-7) nodes to 2 (1-3) nodes and 15 (12-19) nodes to 2 (1-5) nodes in the ART and ALND groups, respectively. There was no observed association of ALND with the proportion of patients undergoing postneoadjuvant systemic therapy (57 of 74 [77.0%] vs 55 of 77 [71.4%]; aOR, 0.86; 95% CI, 0.43-1.70), type of postneoadjuvant chemotherapy (eg, capecitabine: 10 of 74 [13.5%] vs 10 of 77 [13.0%]; trastuzumab emtansine-DM1: 9 of 74 [12.2%] vs 11 of 77 [14.3%]), or endocrine therapy (eg, aromatase inhibitors: 41 of 74 [55.4%] vs 36 of 77 [46.8%]; tamoxifen: 8 of 74 [10.8%] vs 6 of 77 [7.8%]). Conclusion Results of this cohort study suggest that patients without ALND were significantly understaged. However, ALND did not inform systemic therapy recommendations.
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Affiliation(s)
- Walter P. Weber
- Breast Center, University Hospital Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Zoltan Matrai
- Hamad Medical Corporation, Dept of Oncoplastic Breast Surgery, Doha, Qatar
| | | | | | - Guido Henke
- Department of Radiation Oncology, St Gallen Cantonal Hospital, St Gallen, Switzerland
- Breast Center, St Gallen Cantonal Hospital, St Gallen, Switzerland
| | - Frank Zimmermann
- Faculty of Medicine, University of Basel, Basel, Switzerland
- Clinic of Radiation Oncology, University Hospital Basel, Basel, Switzerland
| | - Giacomo Montagna
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Florian Fitzal
- Department of Surgery, Medical University Vienna, Vienna, Austria
- Comprehensive Cancer Center Medical University Vienna, Vienna, Austria
| | - Michael Gnant
- Comprehensive Cancer Center Medical University Vienna, Vienna, Austria
- Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria
| | - Thomas Ruhstaller
- Faculty of Medicine, University of Basel, Basel, Switzerland
- Tumor and Breast Center Eastern Switzerland, St Gallen, Switzerland
| | - Simone Muenst
- Faculty of Medicine, University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Andreas Mueller
- Competence Center of SAKK, Bern, Switzerland
- Breast Center, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Loïc Lelièvre
- Breast Center, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Jörg Heil
- Breast Center Heidelberg, Heidelberg, Germany
| | - Michael Knauer
- Tumor and Breast Center Eastern Switzerland, St Gallen, Switzerland
| | - Daniel Egle
- Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria
- Breast Cancer Center Tirol, Department of Gynecology, Medical University Innsbruck, Innsbruck, Austria
| | - Ákos Sávolt
- Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary
| | - Martin Heidinger
- Breast Center, University Hospital Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Christian Kurzeder
- Breast Center, University Hospital Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
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Ren X, Yu Y, Liu L, Xia W, Ni R, Wei S, Wu J, Wei Q. Axillary response and outcome in breast cancer patients after neoadjuvant treatment: The role of radiotherapy in reducing recurrence in ypN0 patients with initially cN+ stage. Front Oncol 2023; 13:1093155. [PMID: 37077821 PMCID: PMC10106717 DOI: 10.3389/fonc.2023.1093155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/23/2023] [Indexed: 04/05/2023] Open
Abstract
ObjectiveWe aim to explore the clinicopathological features associated with axillary node response and recurrence in breast cancer patients undergoing neoadjuvant treatment (NAT).MethodsWe retrospectively reviewed the medical records of 486 stage I to III breast cancer patients who received NAT and surgery between 2016 and 2021.ResultsA total of 486 cases were reviewed and 154 (31.7%) patients achieved breast pathological complete response (pCR) (ypT0/Tis). Of the 366 cases with initially cN+, 177 (48.4%) cases reach ypN0. Breast pCR is in high accordance to axillary pCR (81.5%). Hormone receptor (HR)-/HER2+ breast cancer patients have the highest axillary pCR rate (78.3%). Patients achieve axillary pCR have a significantly better disease-free survival (DFS) (P=0.0004). Further analysis reveals that the DFS of ypN0 and ypN1 cases are similar (P=0.9049). Moreover, DFS in patients with ypN0 (P<0.0001) and ypN1 (P<0.0001) is significantly better than that in patients with ypN2-3. For post-mastectomy ypN0 cases, radiation could only improve DFS in patients with initially cN+ stage (P=0.0499). Multivariate Cox regression analysis shows that radiation is an independent factor to improve DFS (Hazard ratio (HR): 0.288(0.098-0.841), P=0.0230). Radiation does not improve DFS in pre-cN0/ypN0 patients (P=0.1696).ConclusionAxillary pCR rate is higher than breast pCR rate. HR-/HER2+ patients have the highest axillary pCR rate. Axillary pCR is associated with better DFS. Radiation could further improve DFS in ypN0 patients with initially positive nodal disease.
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Affiliation(s)
- Xiaoqiu Ren
- Department of Radiation Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yaner Yu
- Department of Radiation Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Lihong Liu
- Department of Radiation Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wenjie Xia
- General Surgery, Cancer Center, Department of Breast Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Runliang Ni
- Department of Radiation Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Shumei Wei
- Department of Pathology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jun Wu
- General Surgery, Cancer Center, Department of Breast Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
- *Correspondence: Jun Wu, ; Qichun Wei,
| | - Qichun Wei
- Department of Radiation Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- *Correspondence: Jun Wu, ; Qichun Wei,
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Heidinger M, Knauer M, Tausch C, Weber WP. Tailored axillary surgery - A novel concept for clinically node positive breast cancer. Breast 2023; 69:281-289. [PMID: 36922305 PMCID: PMC10034500 DOI: 10.1016/j.breast.2023.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/25/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
Axillary surgery in patients with breast cancer has been a history of de-escalation; however, surgery for clinically node-positive breast cancer remained at the dogmatic level of axillary lymph node dissection (ALND). In these patients, currently the only way to avoid ALND is neoadjuvant systemic treatment (NST) with nodal pathologic complete response (pCR) as diagnosed by selective lymph node removal. However, pCR rates are highly dependent on tumor biology, with luminal tumors being most present yet showing the lowest pCR rates. Therefore, the TAXIS trial is investigating whether in clinically node-positive patients, either with residual disease after NST or in the upfront surgical setting, ALND can be safely omitted. All patients undergo tailored axillary surgery (TAS), which includes removal of the biopsied and clipped node, the sentinel lymph nodes as well as all palpably suspicious nodes, turning a clinically positive axilla into a clinically negative. Feasibility of TAS was recently confirmed in the first pre-specified TAXIS substudy. TAS is followed by axillary radiotherapy to treat any remaining nodal disease. Disease-free survival is the primary endpoint of this non-inferiority trial, and morbidity as well as quality of life are the main secondary endpoints, with ALND being known for having a relevant negative impact on both. Currently, 663 of 1500 patients were randomized; accrual completion is projected for 2025. The TAXIS trial stands out in including clinically node-positive patients in both the neoadjuvant and upfront surgery setting, thereby investigating surgical de-escalation at the far-end of the risk spectrum of patients with breast cancer.
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Affiliation(s)
- Martin Heidinger
- Breast Center, University Hospital Basel, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Michael Knauer
- Breast Center Eastern Switzerland, St. Gallen, Switzerland
| | | | - Walter P Weber
- Breast Center, University Hospital Basel, Basel, Switzerland; University of Basel, Basel, Switzerland.
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8
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Lim DW, Hong NJL. ASO Author Reflections: Identifying pCR After Neoadjuvant Chemotherapy: The Key to Treatment De-escalation in Breast Cancer. Ann Surg Oncol 2021; 29:570-571. [PMID: 34435298 DOI: 10.1245/s10434-021-10699-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 08/10/2021] [Indexed: 11/18/2022]
Affiliation(s)
- David W Lim
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada. .,Department of Surgery, Women's College Hospital, Toronto, ON, Canada. .,Division of General Surgery, Department of Surgery, University Health Network, Toronto, ON, Canada.
| | - Nicole J Look Hong
- Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.,Evaluative Clinical Sciences, Odette Cancer Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Division of Surgical Oncology, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
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9
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Calvillo KZ, Blair SL, Kuerer HM. 22nd Annual Virtual Meeting of the American Society of Breast Surgeons: Science, Innovation, and Practice Changes. Ann Surg Oncol 2021; 28:5453-5455. [PMID: 34365558 PMCID: PMC8349232 DOI: 10.1245/s10434-021-10523-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 07/16/2021] [Indexed: 12/01/2022]
Affiliation(s)
| | - Sarah L Blair
- Department of General Surgery, University of California, San Diego, CA, USA
| | - Henry M Kuerer
- Division of Surgery, Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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