Management of the Axilla in T1-2 Breast Cancer Patients with Macrometastatic Sentinel Node Involvement Who Underwent Breast-Conserving Therapy
JOURNAL OF INVESTIGATIVE SURGERY, cilt.32, sa.1, ss.48-54, 2019 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 32 Sayı: 1
- Basım Tarihi: 2019
- Doi Numarası: 10.1080/08941939.2017.1375051
- Dergi Adı: JOURNAL OF INVESTIGATIVE SURGERY
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.48-54
- Anahtar Kelimeler: invasive breast carcinoma, breast-conserving therapy, sentinel lymph node metastasis, axillary dissection, arm morbidity, radiotherapy, AMERICAN-SOCIETY, Z0011 CRITERIA, DISSECTION, RADIOTHERAPY, BIOPSY, LYMPHEDEMA, RADIATION, SURGERY, WOMEN, RISK
- Ondokuz Mayıs Üniversitesi Adresli: Evet
Özet
Purpose: The aims of our study were to determine the incidence of axillary recurrence and arm morbidity in T1-2 invasive breast cancer patients with macrometastases on the sentinel lymph node (SLN) who underwent breast-conserving therapy (BCT), with or without axillary lymph node dissection (ALND). Methods: One hundred and nine T1-2 invasive breast cancer patients with macrometastases on the SLN who underwent BCT in our institution were included in the study. Patients with 1-2 positive SLN and without extra nodal extension (ENE) on the SLN did not undergo ALND (SLN-only group) and patients with ENE or patients who had >2 metastatic nodes underwent level I, II ALND (ALND group). The SLN-only group received radiotherapy to three axillary levels, the supraclavicular fossa, and +/- mammaria interna. ALND group received radiotherapy to axillary level III, the supraclavicular fossa, and +/- mammaria interna. The incidence of axillary recurrence and arm morbidity were investigated. Results: Of the 109 patients, 18 patients with >2 metastatic SLNs and 10 with ENE on the SLN underwent ALND and 81 patients underwent SLN only. Median follow-up time was 37 months (3-77). There was no axillary recurrence in SLN-only group. However, in the ALND group 1 patient had developed axillary metastasis. There were 2 objective lymphoedema and 3 arm-shoulder restriction cases in the SLN-only group, and 2 and 3 in the ALND group, respectively. Conclusions: Axillary dissection could safely be omitted in patients with 1-2 macrometastatic SLN and without ENE who undergo BCT and axillary radiotherapy.