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Omission of axillary lymph node dissection in patients who underwent total mastectomy with 1 or 2 metastatic lymph nodes
Omission of axillary lymph node dissection in patients who underwent total mastectomy with 1 or 2 metastatic lymph nodes
- Source :
- Annals of Surgical Treatment and Research
- Publication Year :
- 2019
-
Abstract
- Purpose Sentinel lymph node biopsy (SLNB) is the standard axillary procedure in early breast cancer patients. In a randomized trial, the survival rates were not different when axillary lymph node dissection (ALND) was omitted in patients with 1 or 2 lymph node metastases who underwent breast conserving surgery. This study aimed to compare the outcomes in patients who underwent total mastectomy (TM) with 1 or 2 metastatic nodes according to the types of axillary surgery. Methods In total, 79,058 patients registered in the Korean Breast Cancer Society database who underwent TM were included in the analysis. The inclusion criteria were history of TM and SLNB, pathologic T stage 1 or 2, clinically negative axillary lymph nodes, 1 or 2 metastatic axillary lymph nodes, no radiation therapy, and no neoadjuvant therapy. We divided the patients into the SLNB only and SLNB + ALND groups. The groups were matched by propensity scores. We retrospectively analyzed the differences in the overall survival (OS) between the 2 groups. Results A total of 883 patients were matched in a 1:4 ratio for the SLNB only and SLNB + ALND groups in the cohort from 1999 to 2014. There were no significant differences in OS between the 2 groups (P = 0.413). Subgroup analysis revealed a significant survival benefit in the SLNB + ALND group in the T2 subgroup (P = 0.013). Conclusion OS did not differ between the 2 groups in early breast cancer patients with 1 or 2 metastatic axillary lymph nodes who underwent TM. Omission of ALND may be considered in selected patients.
- Subjects :
- medicine.medical_specialty
Axillary lymph nodes
medicine.medical_treatment
Sentinel lymph node
Lymph node dissection
03 medical and health sciences
0302 clinical medicine
Breast cancer
Sentinel lymph node biopsy
Breast-conserving surgery
Medicine
030212 general & internal medicine
Total Mastectomy
Lymph node
Mastectomy
business.industry
Axillary Lymph Node Dissection
Survival analysis
medicine.disease
medicine.anatomical_structure
030220 oncology & carcinogenesis
Surgery
Original Article
Radiology
business
Subjects
Details
- ISSN :
- 22886575
- Volume :
- 98
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Annals of surgical treatment and research
- Accession number :
- edsair.doi.dedup.....d5b37824b37bd4f8c1b014b898160b62