Five-year follow-up of treatment outcomes in patients with early-stage breast cancer and clinically negative axillary nodes treated with no lymph node dissection or axillary clearance.

Autor:	Yamamoto D; Department of Surgery, Kansai Medical University, Hirakata, Japan., Tanaka K; Ribon-Rose Tanaka Kanji Breast Clinic, Japan., Tsubota Y; Department of Surgery, Kansai Medical University, Hirakata, Japan., Sueoka N; Department of Surgery, Kansai Medical University, Hirakata, Japan., Shoji T; Shoji Clinic, Osaka, Japan., Kuwana K; Department of Surgery, Kansai Medical University, Hirakata, Japan., Kwon AH; Department of Surgery, Kansai Medical University, Hirakata, Japan.
Jazyk:	angličtina
Zdroj:	Breast cancer (Dove Medical Press) [Breast Cancer (Dove Med Press)] 2012 Aug 27; Vol. 4, pp. 125-9. Date of Electronic Publication: 2012 Aug 27 (Print Publication: 2012).
DOI:	10.2147/BCTT.S36054
Abstrakt:	Background: Sentinel lymph node biopsy has steadily replaced axillary lymph node dissection (ALND) for staging clinically node-negative breast cancer. However, ALND remains standard management of the axilla when a tumor-positive sentinel lymph node is identified. Methods: We identified 460 patients with breast cancer (clinically T1/T2N0M0) from the database for 1999-2004. Patient age ranged from 26 to 81 (median 50) years. Patients who underwent mastectomy or breast-conserving surgery with or without ALND were compared for regional recurrence, disease-free survival, and overall survival. Results: Patients with ALND (n = 308) were compared with the no ALND group (n = 152). Five-year overall survival and disease-free survival were not significantly different between the two groups, while there was a significant difference between them for regional recurrence. Of the 152 patients who did not undergo axillary dissection, four developed ipsilateral axillary disease, most of whom were rescued by delayed axillary dissection. Further, the criterion for identifying lymphedema was used, ie, a 2 cm circumferential change at any measured location. As a result, the incidence of lymphedema in the ALND group was 12.7%, while it was not seen in the non ALND group. Conclusion: There is a possibility that ALND may be omitted for cT1/T2N0M0 breast cancer through a combination of hormone therapy and adjuvant chemotherapy.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu