Table 1.
Responses on questions asked in the survey regarding routines of axillary treatment in case of a non-vSLN, prior to versus after the Z0011 trial
| Questions | ||
|---|---|---|
| Prior to the Z0011 trial | Currently | |
| 1 (A + B) | N = 120 | N = 122 |
| What do/did you do when the sentinel node could not be visualized after lymphoscintigraphy and the use of a gamma probe? | ||
| I will perform an immediate axillary lymph node dissection (ALND) | 35 (30.3%) | 1 (0.8%) |
| I will refrain from further axillary treatment | 0 | 5 (4.1%) |
| I will attempt to find the sentinel node by means of Patent Blue (see question 2) | 79 (64.8%) | 92 (75.4%) |
| Whether I will perform an immediate ALND depends on patient and tumor characteristics, such as … | 6 (4.9%) | 22 (18%) |
| Never happened | 0 | 2 (16%) |
| 2 (A + B) | N = 115 | N = 118 |
| If in the previous question you chose to attempt to find the sentinel node by means of Patent Blue (option C), what do/did you do in case the sentinel node could not be visualized during this procedure? | ||
| I will perform an immediate ALND | 94 (81.7%) | 17 (14.4%) |
| I will refrain from further axillary treatment | 4 (3.5%) | 27 (22.9%) |
| Whether I will perform an immediate ALND depends on patient and tumor characteristics, such as … | 13 (11.3%) | 71 (60.2%) |
| Never happened | 4 (3.5%) | 3 (2.5%) |
| 3 (A + B) | N = 118 | N = 119 |
| What do/did you do in case the sentinel node could be visualized during the lymphoscintigraphy, but not during the operation, after using Patent Blue? | ||
| I will perform an immediate ALND | 94 (79.7%) | 19 (16%) |
| I will refrain from further axillary treatment | 1 (0.8) | 25 (21%) |
| Whether I will perform an immediate ALND depends on patient and tumor characteristics, such as … | 1 (14.4%) | 67 (56.3%) |
| Never happened | 6 (51%) | 8 (6.7%) |
| No | Yes | |
| 4 | ||
| I still execute the Dutch guideline of 2012 regarding the axillary work-up and treatment (n = 117) | 63 (54%) | 54 (46%) |
| Currently, the guideline regarding axillary work-up is clear-cut (n = 120) | 85 (71%) | 35 (29%) |
| I always perform a sentinel node procedure (n = 121) | 11 (9%) | 110 (91%) |
| Sometimes, in case of a negative axillary ultrasound, I omit further axillary diagnostics, including the sentinel node procedure (n = 120) | 114 (95%) | 6 (5%) |
| In addition to the axillary ultrasound, I apply additional imaging techniques to evaluate axillary nodal status, such as PET, PET/CT, MRI, etc. (n = 119) | 63 (53%) | 56 (47) |
| The confusion on the axillary work-up has increased (n = 120) | 34 (28%) | 86 (72%) |
| In my opinion, the sentinel node procedure will be obsolete and will disappear within the next few years (n = 120) | 80 (67%) | 40 (33%) |
| Surgical treatment of the axilla is, or will be, redundant (n = 119) | 94 (79%) | 25 (21%) |
| The guideline should be revised regarding further | ||
| axillary treatment in case of a non-visualized sentinel node. If so, which aspect? (n = 113) | 24 (21%) | 89 (79%) |
non-vSLN non-visualized sentinel lymph node, PET positron emission tomography, CT computed tomography, MRI magnetic resonance imaging