Time trends in axilla management among early breast cancer patients: Persisting major variation in clinical practice across European centers

Adam Gondos, Lina Jansen, Jörg Heil, Andreas Schneeweiss, Adri C. Voogd, Jan Frisell, Irma Fredriksson, Ulla Johansson, Tove Filtenborg Tvedskov, Maj Britt Jensen, Eva Balslev, Olaf Johan Hartmann-Johnsen, Milena Sant, Paolo Baili, Roberto Agresti, Tony van de Velde, Annegien Broeks, Jean Marie Nogaret, Pierre Bourgeois, Michel MoreauZoltán Mátrai, Ákos Sávolt, Péter Nagy, M. Kásler, Petra Schrotz-King, Cornelia Ulrich, Hermann Brenner

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background We examined time trends in axilla management among patients with early breast cancer in European clinical settings. Material and methods EUROCANPlatform partners, including population-based and cancer center-specific registries, provided routinely available clinical cancer registry data for a comparative study of axillary management trends among patients with first non-metastatic breast cancer who were not selected for neoadjuvant therapy during the last decade. We used an additional short questionnaire to compare clinical care patterns in 2014. Results Patients treated in cancer centers were younger than population-based registry populations. Tumor size and lymph node status distributions varied little between settings or over time. In 2003, sentinel lymph node biopsy (SLNB) use varied between 26% and 81% for pT1 tumors, and between 2% and 68% for pT2 tumors. By 2010, SLNB use increased to 79–96% and 49–92% for pT1 and pT2 tumors, respectively. Axillary lymph node dissection (ALND) use for pT1 tumors decreased from between 75% and 27% in 2003 to 47% and 12% in 2010, and from between 90% and 55% to 79% and 19% for pT2 tumors, respectively. In 2014, important differences in axillary management existed for patients with micrometastases only, and for patients fulfilling the ACOSOG Z0011 criteria for omitting ALND. Conclusion This study demonstrates persisting differences in important aspects of axillary management throughout the recent decade. The results highlight the need for international comparative patterns of care studies in oncology, which may help to identify areas where further studies and consensus building may be necessary.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalActa Oncologica
DOIs
Publication statusAccepted/In press - Feb 4 2016

Fingerprint

Axilla
Breast Neoplasms
Neoplasms
Registries
Sentinel Lymph Node Biopsy
Lymph Node Excision
Population
Neoplasm Micrometastasis
Neoadjuvant Therapy
Lymph Nodes

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Cite this

Time trends in axilla management among early breast cancer patients : Persisting major variation in clinical practice across European centers. / Gondos, Adam; Jansen, Lina; Heil, Jörg; Schneeweiss, Andreas; Voogd, Adri C.; Frisell, Jan; Fredriksson, Irma; Johansson, Ulla; Tvedskov, Tove Filtenborg; Jensen, Maj Britt; Balslev, Eva; Hartmann-Johnsen, Olaf Johan; Sant, Milena; Baili, Paolo; Agresti, Roberto; van de Velde, Tony; Broeks, Annegien; Nogaret, Jean Marie; Bourgeois, Pierre; Moreau, Michel; Mátrai, Zoltán; Sávolt, Ákos; Nagy, Péter; Kásler, M.; Schrotz-King, Petra; Ulrich, Cornelia; Brenner, Hermann.

In: Acta Oncologica, 04.02.2016, p. 1-8.

Research output: Contribution to journalArticle

Gondos, A, Jansen, L, Heil, J, Schneeweiss, A, Voogd, AC, Frisell, J, Fredriksson, I, Johansson, U, Tvedskov, TF, Jensen, MB, Balslev, E, Hartmann-Johnsen, OJ, Sant, M, Baili, P, Agresti, R, van de Velde, T, Broeks, A, Nogaret, JM, Bourgeois, P, Moreau, M, Mátrai, Z, Sávolt, Á, Nagy, P, Kásler, M, Schrotz-King, P, Ulrich, C & Brenner, H 2016, 'Time trends in axilla management among early breast cancer patients: Persisting major variation in clinical practice across European centers', Acta Oncologica, pp. 1-8. https://doi.org/10.3109/0284186X.2015.1136751
Gondos, Adam ; Jansen, Lina ; Heil, Jörg ; Schneeweiss, Andreas ; Voogd, Adri C. ; Frisell, Jan ; Fredriksson, Irma ; Johansson, Ulla ; Tvedskov, Tove Filtenborg ; Jensen, Maj Britt ; Balslev, Eva ; Hartmann-Johnsen, Olaf Johan ; Sant, Milena ; Baili, Paolo ; Agresti, Roberto ; van de Velde, Tony ; Broeks, Annegien ; Nogaret, Jean Marie ; Bourgeois, Pierre ; Moreau, Michel ; Mátrai, Zoltán ; Sávolt, Ákos ; Nagy, Péter ; Kásler, M. ; Schrotz-King, Petra ; Ulrich, Cornelia ; Brenner, Hermann. / Time trends in axilla management among early breast cancer patients : Persisting major variation in clinical practice across European centers. In: Acta Oncologica. 2016 ; pp. 1-8.
@article{f421651e0e0d433ba8d838a7952926ae,
title = "Time trends in axilla management among early breast cancer patients: Persisting major variation in clinical practice across European centers",
abstract = "Background We examined time trends in axilla management among patients with early breast cancer in European clinical settings. Material and methods EUROCANPlatform partners, including population-based and cancer center-specific registries, provided routinely available clinical cancer registry data for a comparative study of axillary management trends among patients with first non-metastatic breast cancer who were not selected for neoadjuvant therapy during the last decade. We used an additional short questionnaire to compare clinical care patterns in 2014. Results Patients treated in cancer centers were younger than population-based registry populations. Tumor size and lymph node status distributions varied little between settings or over time. In 2003, sentinel lymph node biopsy (SLNB) use varied between 26{\%} and 81{\%} for pT1 tumors, and between 2{\%} and 68{\%} for pT2 tumors. By 2010, SLNB use increased to 79–96{\%} and 49–92{\%} for pT1 and pT2 tumors, respectively. Axillary lymph node dissection (ALND) use for pT1 tumors decreased from between 75{\%} and 27{\%} in 2003 to 47{\%} and 12{\%} in 2010, and from between 90{\%} and 55{\%} to 79{\%} and 19{\%} for pT2 tumors, respectively. In 2014, important differences in axillary management existed for patients with micrometastases only, and for patients fulfilling the ACOSOG Z0011 criteria for omitting ALND. Conclusion This study demonstrates persisting differences in important aspects of axillary management throughout the recent decade. The results highlight the need for international comparative patterns of care studies in oncology, which may help to identify areas where further studies and consensus building may be necessary.",
author = "Adam Gondos and Lina Jansen and J{\"o}rg Heil and Andreas Schneeweiss and Voogd, {Adri C.} and Jan Frisell and Irma Fredriksson and Ulla Johansson and Tvedskov, {Tove Filtenborg} and Jensen, {Maj Britt} and Eva Balslev and Hartmann-Johnsen, {Olaf Johan} and Milena Sant and Paolo Baili and Roberto Agresti and {van de Velde}, Tony and Annegien Broeks and Nogaret, {Jean Marie} and Pierre Bourgeois and Michel Moreau and Zolt{\'a}n M{\'a}trai and {\'A}kos S{\'a}volt and P{\'e}ter Nagy and M. K{\'a}sler and Petra Schrotz-King and Cornelia Ulrich and Hermann Brenner",
year = "2016",
month = "2",
day = "4",
doi = "10.3109/0284186X.2015.1136751",
language = "English",
pages = "1--8",
journal = "Acta Oncologica",
issn = "0284-186X",
publisher = "Informa Healthcare",

}

TY - JOUR

T1 - Time trends in axilla management among early breast cancer patients

T2 - Persisting major variation in clinical practice across European centers

AU - Gondos, Adam

AU - Jansen, Lina

AU - Heil, Jörg

AU - Schneeweiss, Andreas

AU - Voogd, Adri C.

AU - Frisell, Jan

AU - Fredriksson, Irma

AU - Johansson, Ulla

AU - Tvedskov, Tove Filtenborg

AU - Jensen, Maj Britt

AU - Balslev, Eva

AU - Hartmann-Johnsen, Olaf Johan

AU - Sant, Milena

AU - Baili, Paolo

AU - Agresti, Roberto

AU - van de Velde, Tony

AU - Broeks, Annegien

AU - Nogaret, Jean Marie

AU - Bourgeois, Pierre

AU - Moreau, Michel

AU - Mátrai, Zoltán

AU - Sávolt, Ákos

AU - Nagy, Péter

AU - Kásler, M.

AU - Schrotz-King, Petra

AU - Ulrich, Cornelia

AU - Brenner, Hermann

PY - 2016/2/4

Y1 - 2016/2/4

N2 - Background We examined time trends in axilla management among patients with early breast cancer in European clinical settings. Material and methods EUROCANPlatform partners, including population-based and cancer center-specific registries, provided routinely available clinical cancer registry data for a comparative study of axillary management trends among patients with first non-metastatic breast cancer who were not selected for neoadjuvant therapy during the last decade. We used an additional short questionnaire to compare clinical care patterns in 2014. Results Patients treated in cancer centers were younger than population-based registry populations. Tumor size and lymph node status distributions varied little between settings or over time. In 2003, sentinel lymph node biopsy (SLNB) use varied between 26% and 81% for pT1 tumors, and between 2% and 68% for pT2 tumors. By 2010, SLNB use increased to 79–96% and 49–92% for pT1 and pT2 tumors, respectively. Axillary lymph node dissection (ALND) use for pT1 tumors decreased from between 75% and 27% in 2003 to 47% and 12% in 2010, and from between 90% and 55% to 79% and 19% for pT2 tumors, respectively. In 2014, important differences in axillary management existed for patients with micrometastases only, and for patients fulfilling the ACOSOG Z0011 criteria for omitting ALND. Conclusion This study demonstrates persisting differences in important aspects of axillary management throughout the recent decade. The results highlight the need for international comparative patterns of care studies in oncology, which may help to identify areas where further studies and consensus building may be necessary.

AB - Background We examined time trends in axilla management among patients with early breast cancer in European clinical settings. Material and methods EUROCANPlatform partners, including population-based and cancer center-specific registries, provided routinely available clinical cancer registry data for a comparative study of axillary management trends among patients with first non-metastatic breast cancer who were not selected for neoadjuvant therapy during the last decade. We used an additional short questionnaire to compare clinical care patterns in 2014. Results Patients treated in cancer centers were younger than population-based registry populations. Tumor size and lymph node status distributions varied little between settings or over time. In 2003, sentinel lymph node biopsy (SLNB) use varied between 26% and 81% for pT1 tumors, and between 2% and 68% for pT2 tumors. By 2010, SLNB use increased to 79–96% and 49–92% for pT1 and pT2 tumors, respectively. Axillary lymph node dissection (ALND) use for pT1 tumors decreased from between 75% and 27% in 2003 to 47% and 12% in 2010, and from between 90% and 55% to 79% and 19% for pT2 tumors, respectively. In 2014, important differences in axillary management existed for patients with micrometastases only, and for patients fulfilling the ACOSOG Z0011 criteria for omitting ALND. Conclusion This study demonstrates persisting differences in important aspects of axillary management throughout the recent decade. The results highlight the need for international comparative patterns of care studies in oncology, which may help to identify areas where further studies and consensus building may be necessary.

UR - http://www.scopus.com/inward/record.url?scp=84958062701&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84958062701&partnerID=8YFLogxK

U2 - 10.3109/0284186X.2015.1136751

DO - 10.3109/0284186X.2015.1136751

M3 - Article

C2 - 26878397

AN - SCOPUS:84958062701

SP - 1

EP - 8

JO - Acta Oncologica

JF - Acta Oncologica

SN - 0284-186X

ER -