Breast cancer patients with 1-2 positive sentinel lymph nodes without axillary lymph node dissection: influencing factors and prognosis

doi:10.16139/j.1007-9610.2019.05.012

Abstract

Abstract: Objective To analyze the factors influencing breast cancer patients with 1-2 positive sentinel lymph nodes which meets ACOSGO Z0011 criteria without further axillary lymph node dissection (ALND) and their prognosis. Methods Patients with cT_1-2N₀ invasive breast cancer received breast conserving surgery and radiotherapy were enrolled retrospectively in Comprehensive Breast Health Center, Rujin Hospital between January 2012 and August 2019. Factors which influenced not to receive further ALND in patients with 1-2 positive sentinel lymph node and its association with prognosis were analyzed. Results were listed as odds ratio and 95% confidence interval. Results A total of 161 patients were studied, including 78 patients without ALND in the SLNB group and 83 patients in the ALND group. There were 11 (13.3%) patients with non-SLN metastasis and 4 (4.8%) patients with 3 axillary lymph node (ALN) metastasis in the ALND group. Both univariate and multivariate analysis found that surgical-year was associated with ALND (P<0.001). Patients in more recent surgical-year were received less ALND. Eleven (14.1%) and 6 (3.6%) patients in the SLNB and ALND groups had no further adjuvant chemotherapy, respectively. Univariate analysis showed that age (P<0.001), menopausal status (P=0.016), and ALN surgery(P=0.018) were related with adjuvant chemotherapy. Multivariate analysis showed that only age was independently related with chemotherapy(P<0.001). With a median follow up of 42.0 months, ALN recurrence was found only 1 (1.3%) patient in the SLNB group and none in the ALND group. Conclusions Patients with 1-2 positive sentinel nodes who met the eligible criteria of ACOSOG Z0011 trial could be treated without ALND. The association of ALND with long-term survival deserves further evaluation.

Key words: Breast cancer, Sentinel lymph node metastasis, Axillary lymph node dissection, Influencing factors, Prognosis

CLC Number:

R737.9

CHEN Xiaosong, WU Jiayi, HUANG Ou, HE Jianrong, ZHU Li, LI Yafen, CHEN Weiguo, SHEN Kunwei. Breast cancer patients with 1-2 positive sentinel lymph nodes without axillary lymph node dissection: influencing factors and prognosis[J]. Journal of Surgery Concepts & Practice, 2019, 24(05): 428-433.

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