Clinical Edge Journal Scan

Axillary Lymph Node Dissection Can Be Safely Skipped in Breast Cancer Patients Undergoing Mastectomy


 

Key clinical point: Sentinel lymph node biopsy (SLNB), a less invasive strategy, resulted in comparable survival and regional disease control as axillary lymph node dissection (ALND) in patients with sentinel node-positive early breast cancer (BC) who underwent total mastectomy (TM).

Major finding: There were no significant differences in 5-year ipsilateral locoregional recurrence-free survival (LRRFS; P = .21), 5-year distant metastasis-free survival ( P = .96), and disease-free survival ( P > .05) between the SLNB-alone and ALND groups. However, receipt vs no receipt of radiation therapy improved local disease control in the SLNB group (5-year LRRFS; 100.0% vs 92.9%; P = .02).

Study details: Findings are from a retrospective study including 643 patients with early BC with 1-3 metastatic sentinel lymph nodes who underwent total mastectomy, of which 237 and 406 patients underwent SLNB alone and completion ALND, respectively.

Disclosures: The open access funding for this study was enabled and organized by Seoul National University. The authors declared no conflicts of interest.

Source: Chun JW, Kang E, Kim H-K, et al. Oncological safety of skipping axillary lymph node dissection in patients with clinical N0, sentinel node-positive breast cancer undergoing total mastectomy. Ann Surg Oncol. 2024 (Feb 17). doi: 10.1245/s10434-024-15049-7 Source

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