Olson JA et al. - In a trial to examine the impact of the timing of completion axillary lymph node dissection (cALND) on pathologic results and complications in pts with breast cancer metastasis to the sentinel lymph nodes (SLNs), it was found that LN recovery and long-term complications were similar after either delayed or immediate cALND for these pts. Pts who undergo immediate cALND experience more short-term morbidity. There is no clear detriment for pts with a positive SLN who undergo a second procedure for cALND Methods
Outcomes from SLN-positive pts were examined
Pathologic data examined included primary tumor characteristics, total number of SLNs recovered, positive SLN(s) and non-SLN(s) identified
Complications assessed included axillary seroma, paresthesia, arm morbidity and range of motion, and lymphedema
Results
1003 assessable pts with SLN metastasis had immediate or delayed cALND
Median number of SLNs and axillary LNs removed were the same between groups
Pts who had immediate cALND more often had larger tumors, SLN metastasis identified intraoperatively, 2 or more positive SLNs, and higher pathologic N stage
Axillary paresthesia, seroma, and impaired extremity range of motion were more common in the immediate group during the early postoperative period, but not at later time points
There was no difference in lymphedema at any time point
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