To further evaluate the potential impact, a secondary objective was to examine current practice patterns with regards to axillary surgical management in this older population.Īll female, Medicare-enrolled patients aged 66 years and older diagnosed with non-metastatic invasive breast cancer within a SEER region between 20 were eligible.
#Breast lumpectomy with sentinel node biopsy cpt code trial
9 Given this, we sought to evaluate the potential impact of the ACOSOG Z0011 trial on the axillary surgical management of older breast cancer patients by determining the proportion of Medicare breast cancer patients eligible for ACOSOG Z0011.
However, others have argued that the stringent inclusion criteria associated with the trial limits the true clinical significance of these findings, as a relatively small proportion of patients will be eligible. The ACOSOG Z0011 study has been heralded by many as a “practice changing trial,” 6– 8 altering the treatment paradigm for axillary metastases and sparing eligible women the morbidity of a completion ALND without sacrificing survival or local control. In this select group of patients, no significant difference in survival 4 or locoregional recurrence 5 was observed between the patients undergoing SLN biopsy alone and those who received a completion ALND. Patients with 1 or 2 positive SLNs were randomized to undergo completion ALND or observation.
4, 5 This trial included patients with clinically node negative invasive breast cancer treated with lumpectomy and whole breast radiation.
1– 3 However, this treatment paradigm has changed based on the results of the American College of Surgeons Oncology Group (ACOSOG) Z0011 randomized trial initially reported in 2010. Sentinel lymph node (SLN) biopsy is currently the standard of care for staging the clinically negative axilla in breast cancer patients, with axillary lymph node dissection (ALND) reserved for patients with clinical axillary metastases or metastases found on SLN biopsy.
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