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

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

Riccardo Arisio  1 , Fulvio Borella  2 , Mauro Porpiglia  2   3 , Antonio Durando  3   4 , Roberto Bellino  3   4 , Maria Grazia Bau  3   5 , Corrado DE Sanctis  3   5 , Saverio Danese  3   6 , Chiara Benedetto  2 , Dionyssios Katsaros  7   3
Affiliations

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

Riccardo Arisio et al. In Vivo. 2019 Nov-Dec.

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.

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Conflict of interest statement

The Authors indicate no potential conflict of interest regarding this study.

Figures

Figure 1
Figure 1. Overall survival and cumulative risk of recurrence of pN1 patients with ALND versus patients with no ALND. A) Breast cancer survival (p=0.07). B) Cumulative risk of recurrence (p=0.43). ALND: Axillary lymph node dissection.
See this image and copyright information in PMC

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