{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T22:31:01Z","timestamp":1791325861910,"version":"4.3.1"},"reference-count":27,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T00:00:00Z","timestamp":1691452800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background: We assessed the current practice concerning the axillary management of breast cancer (BC) patients undergoing upfront surgery among radiation oncologists (ROs) practising in Italy. Methods: An online survey via SurveyMonkey (including 21 questions) was distributed amongst ROs in Italy through personal contacts and the Italian Association for Radiotherapy and Clinical Oncology (AIRO) network from August to September 2022. We particularly focused on the emerging omission of axillary lymph node dissection (ALND) in the presence of 1\u20132 sentinel node-positive patients and the consequent change in the role of regional nodal irradiation (RNI). Results: A total of 101\/195 (51% response rate) Italian Radiotherapy Cancer Care Centres answered the survey. With respect to patients with 1\u20132 sentinel node-positive, the relative proportion of respondents that offer patients ALND a) always, b) only in selected cases, and c) never was 37.6%, 60.4%, and 2.0%, respectively, with no significant geographical (North vs. Centre\u2013South Italy; p = 0.92) or institutional (Academic vs. non-Academic; p = 0.49) differences. Radiation therapy indications varied widely in patients who did not undergo ALND. Among these, about a third of the respondents (17\/56, 30.4%) stated that RNI was constantly performed. On the other hand, half of the respondents offered RNI in selected cases, stating that an unfavourable biologic tumour profile and extracapsular nodal extension were considered drivers of their decision. Conclusions: Results of the present survey show the variability of axillary management offered in clinical practice for BC patients undergoing conserving surgery upfront in Italy. Analysis of these attitudes may trigger the modification of some clinical approaches through multidisciplinary collaboration and create the background for future clinical investigations.<\/jats:p>","DOI":"10.3390\/curroncol30080542","type":"journal-article","created":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T12:45:53Z","timestamp":1691498753000},"page":"7489-7498","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Axillary Management in Breast Cancer Patients Undergoing Upfront Surgery: Results from a Nationwide Survey on Behalf of the Clinical Oncology Breast Cancer Group (COBCG) and the Breast Cancer Study Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)"],"prefix":"10.3390","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7994-495X","authenticated-orcid":false,"given":"Fiorenza","family":"De Rose","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Santa Chiara Hospital, 38122 Trento, Italy"},{"name":"Clinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Colciago","sequence":"additional","affiliation":[{"name":"Clinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, Italy"},{"name":"Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Lucidi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Santa Chiara Hospital, 38122 Trento, Italy"},{"name":"Clinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliana","family":"La Rocca","sequence":"additional","affiliation":[{"name":"Clinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, Italy"},{"name":"Department of Radiation Oncology, Azienda Ospedaliero Universitaria Integrata, 37126 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnese","family":"Prisco","sequence":"additional","affiliation":[{"name":"Clinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, Italy"},{"name":"Department of Radiation Oncology, University Hospital of Udine, ASUFC, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Bonzano","sequence":"additional","affiliation":[{"name":"Clinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, Italy"},{"name":"Radiation Oncology Department, Fondazione IRCCS Policlinico San Matteo and University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Meduri","sequence":"additional","affiliation":[{"name":"Clinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, Italy"},{"name":"Department of Radiation Oncology, University Hospital of Modena, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"De Santis","sequence":"additional","affiliation":[{"name":"Clinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, Italy"},{"name":"Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Dicuonzo","sequence":"additional","affiliation":[{"name":"Division of Radiotherapy, IEO, European Institute of Oncology IRCCS, 20122 Milan, Italy"},{"name":"Breast Cancer Group, Italian Association of Radiotherapy and Clinical Oncology (AIRO), 20124 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Pasinetti","sequence":"additional","affiliation":[{"name":"Clinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, Italy"},{"name":"Radiation Oncology Department, ASST Valcamonica Esine, University of Brescia, 25121 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Palumbo","sequence":"additional","affiliation":[{"name":"Breast Cancer Group, Italian Association of Radiotherapy and Clinical Oncology (AIRO), 20124 Milano, Italy"},{"name":"Radiation Oncology Section, Department of Surgical and Biomedical Science, University of Perugia, Perugia General Hospital, 06156 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1861-2895","authenticated-orcid":false,"given":"Icro","family":"Meattini","sequence":"additional","affiliation":[{"name":"Clinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, Italy"},{"name":"Department of Experimental and Clinical Biomedical Sciences \u201cM. Serio\u201d, University of Florence, 50121 Florence, Italy"},{"name":"Radiation Oncology Unit\u2014Oncology Department, Azienda Ospedaliero Universitaria Careggi, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2276-0687","authenticated-orcid":false,"given":"Pierfrancesco","family":"Franco","sequence":"additional","affiliation":[{"name":"Clinical Oncology Breast Cancer Group (COBCG), 50134 Firenze, Italy"},{"name":"Department of Translational Medicine, University of Eastern Piedmont & Radiation Oncology Unit, AOU \u201cMaggiore della Carita\u201d, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1056\/NEJMoa022152","article-title":"Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer","volume":"34","author":"Fisher","year":"2002","journal-title":"N. 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