Axillary Management in Breast Cancer Patients Undergoing Upfront Surgery: Results from a Nationwide Survey on Behalf of the Clinical Oncology Breast Cancer Group (COBCG) and the Breast Cancer Study Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)
Background: We assessed the current practice concerning the axillary management of breast cancer (BC) patients undergoing upfront surgery among radiation oncologists (ROs) practising in Italy. Methods: An online survey via SurveyMonkey (including 21 questions) was distributed amongst ROs in Italy th...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/30/8/542 |
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| author | Fiorenza De Rose Riccardo Ray Colciago Sara Lucidi Eliana La Rocca Agnese Prisco Elisabetta Bonzano Bruno Meduri Maria Carmen De Santis Samantha Dicuonzo Nadia Pasinetti Isabella Palumbo Icro Meattini Pierfrancesco Franco |
| author_facet | Fiorenza De Rose Riccardo Ray Colciago Sara Lucidi Eliana La Rocca Agnese Prisco Elisabetta Bonzano Bruno Meduri Maria Carmen De Santis Samantha Dicuonzo Nadia Pasinetti Isabella Palumbo Icro Meattini Pierfrancesco Franco |
| author_sort | Fiorenza De Rose |
| collection | DOAJ |
| description | Background: We assessed the current practice concerning the axillary management of breast cancer (BC) patients undergoing upfront surgery among radiation oncologists (ROs) practising in Italy. Methods: An online survey via SurveyMonkey (including 21 questions) was distributed amongst ROs in Italy through personal contacts and the Italian Association for Radiotherapy and Clinical Oncology (AIRO) network from August to September 2022. We particularly focused on the emerging omission of axillary lymph node dissection (ALND) in the presence of 1–2 sentinel node-positive patients and the consequent change in the role of regional nodal irradiation (RNI). Results: A total of 101/195 (51% response rate) Italian Radiotherapy Cancer Care Centres answered the survey. With respect to patients with 1–2 sentinel node-positive, the relative proportion of respondents that offer patients ALND a) always, b) only in selected cases, and c) never was 37.6%, 60.4%, and 2.0%, respectively, with no significant geographical (North vs. Centre–South Italy; <i>p</i> = 0.92) or institutional (Academic vs. non-Academic; <i>p</i> = 0.49) differences. Radiation therapy indications varied widely in patients who did not undergo ALND. Among these, about a third of the respondents (17/56, 30.4%) stated that RNI was constantly performed. On the other hand, half of the respondents offered RNI in selected cases, stating that an unfavourable biologic tumour profile and extracapsular nodal extension were considered drivers of their decision. Conclusions: Results of the present survey show the variability of axillary management offered in clinical practice for BC patients undergoing conserving surgery upfront in Italy. Analysis of these attitudes may trigger the modification of some clinical approaches through multidisciplinary collaboration and create the background for future clinical investigations. |
| first_indexed | 2024-03-11T00:00:47Z |
| format | Article |
| id | doaj.art-0026889dff4c495c8247f2701b0745be |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-11T00:00:47Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-0026889dff4c495c8247f2701b0745be2023-11-19T00:46:36ZengMDPI AGCurrent Oncology1198-00521718-77292023-08-013087489749810.3390/curroncol30080542Axillary Management in Breast Cancer Patients Undergoing Upfront Surgery: Results from a Nationwide Survey on Behalf of the Clinical Oncology Breast Cancer Group (COBCG) and the Breast Cancer Study Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)Fiorenza De Rose0Riccardo Ray Colciago1Sara Lucidi2Eliana La Rocca3Agnese Prisco4Elisabetta Bonzano5Bruno Meduri6Maria Carmen De Santis7Samantha Dicuonzo8Nadia Pasinetti9Isabella Palumbo10Icro Meattini11Pierfrancesco Franco12Department of Radiation Oncology, Santa Chiara Hospital, 38122 Trento, ItalyClinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, ItalyDepartment of Radiation Oncology, Santa Chiara Hospital, 38122 Trento, ItalyClinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, ItalyClinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, ItalyClinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, ItalyClinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, ItalyClinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, ItalyDivision of Radiotherapy, IEO, European Institute of Oncology IRCCS, 20122 Milan, ItalyClinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, ItalyBreast Cancer Group, Italian Association of Radiotherapy and Clinical Oncology (AIRO), 20124 Milano, ItalyClinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, ItalyClinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, ItalyBackground: We assessed the current practice concerning the axillary management of breast cancer (BC) patients undergoing upfront surgery among radiation oncologists (ROs) practising in Italy. Methods: An online survey via SurveyMonkey (including 21 questions) was distributed amongst ROs in Italy through personal contacts and the Italian Association for Radiotherapy and Clinical Oncology (AIRO) network from August to September 2022. We particularly focused on the emerging omission of axillary lymph node dissection (ALND) in the presence of 1–2 sentinel node-positive patients and the consequent change in the role of regional nodal irradiation (RNI). Results: A total of 101/195 (51% response rate) Italian Radiotherapy Cancer Care Centres answered the survey. With respect to patients with 1–2 sentinel node-positive, the relative proportion of respondents that offer patients ALND a) always, b) only in selected cases, and c) never was 37.6%, 60.4%, and 2.0%, respectively, with no significant geographical (North vs. Centre–South Italy; <i>p</i> = 0.92) or institutional (Academic vs. non-Academic; <i>p</i> = 0.49) differences. Radiation therapy indications varied widely in patients who did not undergo ALND. Among these, about a third of the respondents (17/56, 30.4%) stated that RNI was constantly performed. On the other hand, half of the respondents offered RNI in selected cases, stating that an unfavourable biologic tumour profile and extracapsular nodal extension were considered drivers of their decision. Conclusions: Results of the present survey show the variability of axillary management offered in clinical practice for BC patients undergoing conserving surgery upfront in Italy. Analysis of these attitudes may trigger the modification of some clinical approaches through multidisciplinary collaboration and create the background for future clinical investigations.https://www.mdpi.com/1718-7729/30/8/542breast cancersentinel lymph node biopsy (SLNB)axillary lymph node dissection (ALND)node-positive diseaseregional node irradiation (RNI)multidisciplinary discussion |
| spellingShingle | Fiorenza De Rose Riccardo Ray Colciago Sara Lucidi Eliana La Rocca Agnese Prisco Elisabetta Bonzano Bruno Meduri Maria Carmen De Santis Samantha Dicuonzo Nadia Pasinetti Isabella Palumbo Icro Meattini Pierfrancesco Franco Axillary Management in Breast Cancer Patients Undergoing Upfront Surgery: Results from a Nationwide Survey on Behalf of the Clinical Oncology Breast Cancer Group (COBCG) and the Breast Cancer Study Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) Current Oncology breast cancer sentinel lymph node biopsy (SLNB) axillary lymph node dissection (ALND) node-positive disease regional node irradiation (RNI) multidisciplinary discussion |
| title | Axillary Management in Breast Cancer Patients Undergoing Upfront Surgery: Results from a Nationwide Survey on Behalf of the Clinical Oncology Breast Cancer Group (COBCG) and the Breast Cancer Study Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) |
| title_full | Axillary Management in Breast Cancer Patients Undergoing Upfront Surgery: Results from a Nationwide Survey on Behalf of the Clinical Oncology Breast Cancer Group (COBCG) and the Breast Cancer Study Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) |
| title_fullStr | Axillary Management in Breast Cancer Patients Undergoing Upfront Surgery: Results from a Nationwide Survey on Behalf of the Clinical Oncology Breast Cancer Group (COBCG) and the Breast Cancer Study Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) |
| title_full_unstemmed | Axillary Management in Breast Cancer Patients Undergoing Upfront Surgery: Results from a Nationwide Survey on Behalf of the Clinical Oncology Breast Cancer Group (COBCG) and the Breast Cancer Study Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) |
| title_short | Axillary Management in Breast Cancer Patients Undergoing Upfront Surgery: Results from a Nationwide Survey on Behalf of the Clinical Oncology Breast Cancer Group (COBCG) and the Breast Cancer Study Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) |
| title_sort | axillary management in breast cancer patients undergoing upfront surgery results from a nationwide survey on behalf of the clinical oncology breast cancer group cobcg and the breast cancer study group of the italian association of radiotherapy and clinical oncology airo |
| topic | breast cancer sentinel lymph node biopsy (SLNB) axillary lymph node dissection (ALND) node-positive disease regional node irradiation (RNI) multidisciplinary discussion |
| url | https://www.mdpi.com/1718-7729/30/8/542 |
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