Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2016 May 23:6:26304.
doi: 10.1038/srep26304.

Axillary radiotherapy: an alternative treatment option for adjuvant axillary management of breast cancer

Jie Zhang  1 , Chuan Wang  1
Affiliations
Meta-Analysis

Axillary radiotherapy: an alternative treatment option for adjuvant axillary management of breast cancer

Jie Zhang et al. Sci Rep. .

Abstract

Axillary lymph node dissection is standard management of axilla in invasive breast cancer. Radiotherapy also is important in local treatment. It is controversial as to whether axillary radiotherapy can displace axillary lymph node dissection. We performed a meta-analysis comparing axillary radiotherapy with axillary dissection. No significant difference was observed for disease free survival and overall survival between the radiation group and the dissection group. There was also no significant difference in either the axillary recurrence or the local recurrence between the two groups. But the axillary relapse rate in the radiation group was higher than in the surgery group at five-year follow-up while the local recurrence rate in the surgery group was higher than in the radiation group. A subgroup analysis showed that the difference in the axillary recurrence rate (RR = 0.20, P = 0.01) and local recurrence rate (RR = 4.7, P = 0.01) mainly appeared in the clinical node-positive subgroup. The edema rate in the surgery group was higher than in the radiation group (RR = 2.08, 95%: 1.71-2.54, P < 0.0001). We concluded that radiotherapy may be an alternative treatment option for adjuvant management of the axilla in selected sub-groups of patients.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Flowchart of the study selection strategy.
Figure 2
Figure 2. Forest plot of meta-analysis on overall survival (OS) of the axillary dissection group and axillary radiotherapy group.
(a) Short-term outcome, (b) long-term outcome, (c) short-term outcome of the cN0 group.
Figure 3
Figure 3. Forest plot of meta-analysis on disease free survival (DFS) of the axillary dissection group and axillary radiotherapy group.
(a) Short-term outcome, (b) long-term outcome, (c) short-term outcome of the cN0 group.
Figure 4
Figure 4. Forest plot of meta-analysis on axillary recurrence (AR) of the axillary dissection group and axillary radiotherapy group.
(a) Short-term outcome, (b) long-term outcome.
Figure 5
Figure 5. Forest plot of meta-analysis on local recurrence (LR) of the axillary dissection group and axillary radiotherapy group.
(a) Short-term outcome including the cN0 group and the cN+ group, (b) Short-term outcome including subgroup analysis for exploring the source of heterogeneity.
Figure 6
Figure 6. Forest plot of meta-analysis on short outcome of distant recurrence (DR) of the axillary dissection group and axillary radiotherapy group.
Figure 7
Figure 7. Forest plot of meta-analysis of lymphoedema risk of the axillary dissection group and axillary radiotherapy group.
See this image and copyright information in PMC

References

    1. Fleissig A. et al.. Post-operative arm morbidity and quality of life. Results of the ALMANAC randomised trial comparing sentinel node biopsy with standard axillary treatment in the management of patients with early breast cancer. Breast Cancer Res Treat. 95, 279–293 (2006). - PubMed
    1. Deutsch M. et al.. The incidence of arm edema in women with breast cancer randomized on the National Surgical Adjuvant Breast and Bowel Project study B-04 to radical mastectomy versus total mastectomy and radiotherapy versus total mastectomy alone. Int J Radiat Oncol Biol Phys. 70, 1020–1024 (2008). - PubMed
    1. Gnant M. et al.. St. Gallen/Vienna 2015: A Brief Summary of the Consensus Discussion. Breast Care (Basel). 10, 124–130 (2015). - PMC - PubMed
    1. Krag D. N. et al.. Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncol. 11, 927–933 (2010). - PMC - PubMed
    1. Giuliano A. E. et al.. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 220, 391–401 (1994). - PMC - PubMed

Publication types