Axillary Dissection vs. no Axillary Dissection in Breast Cancer Patients With Positive Sentinel Lymph Node: A Single Institution Experience

In Vivo. 2019 Nov-Dec;33(6):1941-1947. doi: 10.21873/invivo.11689.

Abstract

Background/aim: Axillary surgery of breast cancer patients is undergoing a paradigm shift, as axillary lymph node dissection's (ALND) usefulness is being questioned in the treatment of patients with tumor-positive sentinel lymph node biopsy (SLNB). The aim of this study was to investigate the overall survival (OS) and relapse-free survival (RFS) of patients with positive SLNB treated with ALND or not.

Patients and methods: We investigated 617 consecutive patients with cN0 operable breast cancer with positive SLNB undergoing mastectomy or conservative surgery. A total of 406 patients underwent ALND and 211 were managed expectantly.

Results: No significant difference in OS and RFS was found between the two groups. The incidence of loco-regional recurrence in the SLNB-only group and the ALND group was low and not significant.

Conclusion: The type of breast cancer surgery and the omission of ALND does not improve OS or RSF rate in cases with metastatic SLN.

Keywords: Axillary surgery; breast cancer; breast conservative surgery; local recurrence; mastectomy; sentinel lymph node biopsy.

MeSH terms

  • Axilla / surgery*
  • Breast Neoplasms / surgery*
  • Female
  • Humans
  • Lymph Node Excision / methods
  • Lymph Nodes / surgery*
  • Mastectomy / methods
  • Middle Aged
  • Neoplasm Recurrence, Local / surgery
  • Sentinel Lymph Node / surgery*
  • Sentinel Lymph Node Biopsy / methods