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https://hdl.handle.net/2440/50637
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dc.contributor.author | Gill, P. | - |
dc.date.issued | 2009 | - |
dc.identifier.citation | Annals of Surgical Oncology, 2009; 16(2):266-275 | - |
dc.identifier.issn | 1068-9265 | - |
dc.identifier.issn | 1534-4681 | - |
dc.identifier.uri | http://hdl.handle.net/2440/50637 | - |
dc.description | © Society of Surgical Oncology 2008 | - |
dc.description.abstract | We sought the extent to which arm morbidity could be reduced by using sentinel-lymph-node-based management in women with clinically node-negative early breast cancer. One thousand eighty-eight women were randomly allocated to sentinel-lymph-node biopsy followed by axillary clearance if the sentinel node was positive or not detected (SNBM) or routine axillary clearance (RAC, sentinel-lymph-node biopsy followed immediately by axillary clearance). Sentinel nodes were located using blue dye, alone or with technetium-labeled antimony sulfide colloid. The primary endpoint was increase in arm volume from baseline to the average of measurements at 6 and 12 months. Secondary endpoints were the proportions of women with at least 15% increase in arm volume or early axillary morbidity, and average scores for arm symptoms, dysfunctions, and disabilities assessed at 6 and 12 months by patients with the SNAC Study-Specific Scales and other quality-of-life instruments. Sensitivity, false-negative rates, and negative predictive values for sentinel-lymph-node biopsy were estimated in the RAC group. The average increase in arm volume was 2.8% in the SNBM group and 4.2% in the RAC group (P = 0.002). Patients in the SNBM group gave lower ratings for arm swelling (P < 0.001), symptoms (P < 0.001), and dysfunctions (P = 0.02), but not disabilities (P = 0.5). Sentinel nodes were found in 95% of the SNBM group (29% positive) and 93% of the RAC group (25% positive). SNB had sensitivity 94.5%, false-negative rate 5.5%, and negative predictive value 98%. SNBM was successfully undertaken in a wide range of surgical centers and caused significantly less morbidity than RAC. | - |
dc.language.iso | en | - |
dc.publisher | Lippincott Williams & Wilkins | - |
dc.source.uri | http://dx.doi.org/10.1245/s10434-008-0229-z | - |
dc.subject | SNAC Trial Group of the Royal Australasian College of Surgeons (RACS) and NHMRC Clinical Trials Centre | - |
dc.subject | Axilla | - |
dc.subject | Lymph Nodes | - |
dc.subject | Humans | - |
dc.subject | Breast Neoplasms | - |
dc.subject | Lymphatic Metastasis | - |
dc.subject | Radionuclide Imaging | - |
dc.subject | Sentinel Lymph Node Biopsy | - |
dc.subject | Neoplasm Staging | - |
dc.subject | Treatment Outcome | - |
dc.subject | Lymph Node Excision | - |
dc.subject | Mastectomy | - |
dc.subject | Morbidity | - |
dc.subject | Quality of Life | - |
dc.subject | Adult | - |
dc.subject | Aged | - |
dc.subject | Middle Aged | - |
dc.subject | Female | - |
dc.title | Sentinel-Lymph-Node-Based Management or Routine Axillary Clearance? One-Year Outcomes of Sentinel Node Biopsy Versus Axillary Clearance (SNAC): A Randomized Controlled Surgical Trial | - |
dc.type | Journal article | - |
dc.contributor.organisation | The SNAC Trial Group of the Royal Australasian College of Surgeons (RACS), University of Sydney | - |
dc.identifier.doi | 10.1245/s10434-008-0229-z | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Gill, P. [0000-0001-7310-2970] | - |
Appears in Collections: | Aurora harvest Surgery publications |
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