Characteristics and Outcomes of Sentinel Node–Positive Breast Cancer Patients after Total Mastectomy without Axillary-Specific Treatment
Annals of Surgical Oncology, 05/21/2012
Milgrom S et al. – Early–stage breast cancer patients with minimal sentinel node disease experience excellent outcomes without ALND, whether they undergo BCS or TM.Methods
- A total of 535 patients with early–stage breast cancer who underwent definitive breast surgery (210 TM, 325 BCS), had a positive SLNB and did not receive ALND between 1997 and 2009 were identified from an institutional database.
- Characteristics and outcomes were compared between the TM and BCS groups.
- Most patients had stage I to IIA, estrogen receptor–positive, progesterone receptor–positive, Her2–negative invasive ductal carcinoma, with minimal nodal disease.
- Compared to the BCS group, TM patients were younger, had larger tumors, had higher nomogram scores predicting additional axillary disease and were more likely to receive chemotherapy.
- Ninety–four percent of the BCS cohort and 5 % of the TM cohort received adjuvant radiotherapy.
- At a median follow–up of 57.8 months, the 4–year local, regional and distant failure rates were 1.7, 1.2 and 0.7 % in the TM group and 1.4, 1.0 and 3.7 % in the BCS group.
- The 4–year disease–free and overall survival rates were 94.8 and 97.8 % in the TM group and 90.1 and 92.6 % in the BCS group.