The Z0011 Trial: Is this the end of axillary ultrasound in the pre-operative assessment of breast cancer patients?

European Radiology
T P J FarrellS A O'Keeffe

Abstract

The Z0011 trial questioned the role of axillary ultrasound (AxUS) in preoperative staging of breast cancer in patients with ≤2 positive sentinel lymph nodes (SLN). The purpose of this study was to correlate the number of abnormal nodes on AxUS with final nodal burden and determine the utility of AxUS with sampling (AxUS + S) in preoperative staging. Six hundred and seventy-nine patients underwent pre-operative AxUS. Suspicious nodes were sampled. Negative axillae proceeded to SLN biopsy. The number of abnormal nodes identified on ultrasound and final histology as well as sensitivity and specificity for AxUS + S were calculated. Subgroup analysis was performed on Z0011 eligible patients. Two hundred and ninety-six patients had positive axillary nodes on final histology with 169 detected by AxUS + S (sensitivity 86.2%, specificity 100%, PPV 100 %, NPV 71.9%). Patients with nodal metastases identified by AxUS had a mean burden of 7.3 nodes on histology (1 node on AxUS = 5.2 nodes on histology, 2 nodes on AxUS = 7.5 nodes, >2 nodes = 10.1 nodes). Patients diagnosed on SLNB had a mean burden of 2.2 nodes. A single nodal metastasis detected on AxUS + S correlated with a mean of 5.2 nodes on final histology highlighting that AxUS rema...Continue Reading

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Citations

Jul 15, 2015·European Radiology·Javier del RiegoUNKNOWN Grup de Mama Vallès-Osona-Bages (GMVOB; Cooperative Breast Workgroup Vallés-Osona-Bagés)
Jan 18, 2017·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Giacomo AgliataGian Marco Giuseppetti
Oct 16, 2019·The Oncologist·Maria Adele MarinoKatja Pinker
Apr 22, 2020·Radiology·Jung Min ChangWoo Kyung Moon
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Jan 4, 2021·Breast Cancer Research and Treatment·Su Min HaWoo Kyung Moon
Dec 19, 2020·European Journal of Radiology·Fabian RiedelJoerg Heil
Sep 2, 2020·Surgical Oncology·María Martínez GálvezFrancisco Ayala de la Peña
Feb 12, 2020·The Oncologist·Maria Adele MarinoKatja Pinker
May 13, 2021·Bulletin du cancer·Antoine DeferYann Delpech

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