Impact of the American College of Surgeons Oncology Group Z0011 Randomized Trial on the Number of Axillary Nodes Removed for Patients with Early-Stage.

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Impact of the American College of Surgeons Oncology Group Z0011 Randomized Trial on the Number of Axillary Nodes Removed for Patients with Early-Stage Breast Cancer Katharine Yao, MD, FACS, Erik Liederbach, BS, Catherine Pesce, MD, Chi-Hsiung Wang, PhD, David J. Winchester, MD, FACS Journal of the American College of Surgeons Volume 221, Issue 1, Pages 71-81 (July 2015) DOI: 10.1016/j.jamcollsurg.2015.02.035 Copyright © 2015 American College of Surgeons Terms and Conditions

Figure 1 (A) Trends in use of sentinel node biopsy (SNB) alone for breast cancer patients fulfilling Z0011 criteria, 1998–2011. Blue line, sentinel node biopsy. (B) Percentage of patients fulfilling Z0011 criteria receiving SNB alone by facility type, 1998–2011. Blue line, community; red line, comprehensive; green line, academic. (C) Percentage of patients fulfilling Z0011 criteria receiving SNB alone by facility location, 1998–2011. ENC, East North Central; ESC, East South Central; MA, Middle Atlantic; MT, Mountain; NE, New England; PA, Pacific; SA, South Atlantic; WNC, West North Central; WSC, West South Central. Journal of the American College of Surgeons 2015 221, 71-81DOI: (10.1016/j.jamcollsurg.2015.02.035) Copyright © 2015 American College of Surgeons Terms and Conditions

Figure 2 Percentage of patients undergoing axillary surgery defined by number of lymph nodes removed, 2010 to 2011. Journal of the American College of Surgeons 2015 221, 71-81DOI: (10.1016/j.jamcollsurg.2015.02.035) Copyright © 2015 American College of Surgeons Terms and Conditions

Figure 3 Trends in sentinel node biopsy use for patients not fulfilling Z0011 criteria, 1998–2011. APBI, accelerated partial breast irradiation; cN+, clinically node positive; RT, radiation therapy. Journal of the American College of Surgeons 2015 221, 71-81DOI: (10.1016/j.jamcollsurg.2015.02.035) Copyright © 2015 American College of Surgeons Terms and Conditions