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dc.contributor.authorWallis, Matthewen
dc.contributor.authorKilburn-Toppin, Fleuren
dc.contributor.authorTaylor-Phillips, Sen
dc.date.accessioned2018-02-13T17:29:09Z
dc.date.available2018-02-13T17:29:09Z
dc.date.issued2018-05en
dc.identifier.issn0009-9260
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/273211
dc.description.abstractAim To determine the impact of pre-operative axillary ultrasound staging in a screen detected breast cancer population Materials and Method Ultrasound and needle biopsy staging results alongside reference standard sentinel lymph node biopsy and axillary lymph node dissection were retrospectively extracted from the unit's computer records between 01/04/2008 and 31/03/2015. Axillary staging was compared with final pathology and treatment. Results Of the 215,661 screening examinations performed, 780 invasive cancers were diagnosed which had pre-operative axillary staging data, of which 162 (20.7%) were node positive. 36 (4.6%) had a heavy nodal burden (3 or more nodes). 90 (11.5%) had an abnormal axillary ultrasound and axillary biopsy of which 54 were positive for cancer (33.3% of the node positive cases) and triaged to axillary lymph node dissection avoiding a sentinel lymph node biopsy. Of these 22 (40.7%) had neoadjuvant treatment, and 32 (59.3%) proceeded directly to axillary lymph node dissection. The sensitivity of axillary ultrasound and biopsy to detect women with a heavy nodal burden (3 or more nodes) was 41.7% (15 of 36). However, 17 (53%) of the 32 women with a positive axillary biopsy had a low burden of axillary disease (≤2 positive nodes) at axillary lymph node dissection, the mean number of nodes obtained was 14.6. Conclusion Significant numbers of women are being potentially overtreated or denied entry into Positive Sentinel Node: adjuvant therapy only vs adjuvant therapy and clearance or axillary radiotherapy (POSNOC) because of routine pre-operative axillary staging.
dc.format.mediumPrint-Electronicen
dc.languageengen
dc.publisherElsevier
dc.subjectAxillaen
dc.subjectHumansen
dc.subjectBreast Neoplasmsen
dc.subjectLymphatic Metastasisen
dc.subjectUltrasonographyen
dc.subjectBiopsy, Needleen
dc.subjectSentinel Lymph Node Biopsyen
dc.subjectNeoplasm Stagingen
dc.subjectSensitivity and Specificityen
dc.subjectRetrospective Studiesen
dc.subjectAdulten
dc.subjectAgeden
dc.subjectMiddle Ageden
dc.subjectFemaleen
dc.subjectMedical Overuseen
dc.titleDoes preoperative axillary staging lead to overtreatment of women with screen-detected breast cancer?en
dc.typeArticle
prism.endingPage472
prism.issueIdentifier5en
prism.publicationDate2018en
prism.publicationNameClinical radiologyen
prism.startingPage467
prism.volume73en
dc.identifier.doi10.17863/CAM.20217
dcterms.dateAccepted2017-11-14en
rioxxterms.versionofrecord10.1016/j.crad.2017.11.023en
rioxxterms.versionAM*
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2018-05en
dc.contributor.orcidTaylor-Phillips, S [0000-0002-1841-4346]
dc.identifier.eissn1365-229X
rioxxterms.typeJournal Article/Reviewen
rioxxterms.freetoread.startdate2018-12-27


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