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
Identifieur interne : 006096 ( Ncbi/Merge ); précédent : 006095; suivant : 006097Five-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
Auteurs : Daigo Yamamoto [Japon] ; Kanji Tanaka [Japon] ; Yu Tsubota [Japon] ; Noriko Sueoka [Japon] ; Tetsuji Shoji [Japon] ; Kayoko Kuwana [Japon] ; A-Hon Kwon [Japon]Source :
- Breast Cancer : Targets and Therapy [ 1179-1314 ] ; 2012.
Abstract
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.
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.
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.
There is a possibility that ALND may be omitted for cT1/T2N0M0 breast cancer through a combination of hormone therapy and adjuvant chemotherapy.
Url:
DOI: 10.2147/BCTT.S36054
PubMed: 24367200
PubMed Central: 3846707
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>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.</p>
</sec>
<sec><title>Methods</title>
<p>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.</p>
</sec>
<sec><title>Results</title>
<p>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.</p>
</sec>
<sec><title>Conclusion</title>
<p>There is a possibility that ALND may be omitted for cT1/T2N0M0 breast cancer through a combination of hormone therapy and adjuvant chemotherapy.</p>
</sec>
</div>
</front>
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<author><name sortKey="Kwon, A Hon" sort="Kwon, A Hon" uniqKey="Kwon A" first="A-Hon" last="Kwon">A-Hon Kwon</name>
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</affiliation>
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<author><name sortKey="Tsubota, Yu" sort="Tsubota, Yu" uniqKey="Tsubota Y" first="Yu" last="Tsubota">Yu Tsubota</name>
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<author><name sortKey="Sueoka, Noriko" sort="Sueoka, Noriko" uniqKey="Sueoka N" first="Noriko" last="Sueoka">Noriko Sueoka</name>
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<author><name sortKey="Shoji, Tetsuji" sort="Shoji, Tetsuji" uniqKey="Shoji T" first="Tetsuji" last="Shoji">Tetsuji Shoji</name>
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<author><name sortKey="Kwon, A Hon" sort="Kwon, A Hon" uniqKey="Kwon A" first="A-Hon" last="Kwon">A-Hon Kwon</name>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>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.</p>
</sec>
<sec><title>Methods</title>
<p>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.</p>
</sec>
<sec><title>Results</title>
<p>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.</p>
</sec>
<sec><title>Conclusion</title>
<p>There is a possibility that ALND may be omitted for cT1/T2N0M0 breast cancer through a combination of hormone therapy and adjuvant chemotherapy.</p>
</sec>
</div>
</front>
</TEI>
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<author><name sortKey="Yamamoto, Daigo" sort="Yamamoto, Daigo" uniqKey="Yamamoto D" first="Daigo" last="Yamamoto">Daigo Yamamoto</name>
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<affiliation wicri:level="1"><nlm:affiliation>Department of Surgery, Kansai Medical University, Hirakata, Japan.</nlm:affiliation>
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<author><name sortKey="Sueoka, Noriko" sort="Sueoka, Noriko" uniqKey="Sueoka N" first="Noriko" last="Sueoka">Noriko Sueoka</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Surgery, Kansai Medical University, Hirakata, Japan.</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Surgery, Kansai Medical University, Hirakata</wicri:regionArea>
<wicri:noRegion>Hirakata</wicri:noRegion>
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</author>
<author><name sortKey="Shoji, Tetsuji" sort="Shoji, Tetsuji" uniqKey="Shoji T" first="Tetsuji" last="Shoji">Tetsuji Shoji</name>
<affiliation wicri:level="1"><nlm:affiliation>Shoji Clinic, Osaka, Japan.</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Shoji Clinic, Osaka</wicri:regionArea>
<wicri:noRegion>Osaka</wicri:noRegion>
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<author><name sortKey="Kuwana, Kayoko" sort="Kuwana, Kayoko" uniqKey="Kuwana K" first="Kayoko" last="Kuwana">Kayoko Kuwana</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Surgery, Kansai Medical University, Hirakata, Japan.</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Surgery, Kansai Medical University, Hirakata</wicri:regionArea>
<wicri:noRegion>Hirakata</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Kwon, A Hon" sort="Kwon, A Hon" uniqKey="Kwon A" first="A-Hon" last="Kwon">A-Hon Kwon</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Surgery, Kansai Medical University, Hirakata, Japan.</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Surgery, Kansai Medical University, Hirakata</wicri:regionArea>
<wicri:noRegion>Hirakata</wicri:noRegion>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">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.</title>
<author><name sortKey="Yamamoto, Daigo" sort="Yamamoto, Daigo" uniqKey="Yamamoto D" first="Daigo" last="Yamamoto">Daigo Yamamoto</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Surgery, Kansai Medical University, Hirakata, Japan.</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Surgery, Kansai Medical University, Hirakata</wicri:regionArea>
<wicri:noRegion>Hirakata</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Tanaka, Kanji" sort="Tanaka, Kanji" uniqKey="Tanaka K" first="Kanji" last="Tanaka">Kanji Tanaka</name>
<affiliation wicri:level="1"><nlm:affiliation>Ribon-Rose Tanaka Kanji Breast Clinic, Japan.</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Ribon-Rose Tanaka Kanji Breast Clinic</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Tsubota, Yu" sort="Tsubota, Yu" uniqKey="Tsubota Y" first="Yu" last="Tsubota">Yu Tsubota</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Surgery, Kansai Medical University, Hirakata, Japan.</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Surgery, Kansai Medical University, Hirakata</wicri:regionArea>
<wicri:noRegion>Hirakata</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Sueoka, Noriko" sort="Sueoka, Noriko" uniqKey="Sueoka N" first="Noriko" last="Sueoka">Noriko Sueoka</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Surgery, Kansai Medical University, Hirakata, Japan.</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Surgery, Kansai Medical University, Hirakata</wicri:regionArea>
<wicri:noRegion>Hirakata</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Shoji, Tetsuji" sort="Shoji, Tetsuji" uniqKey="Shoji T" first="Tetsuji" last="Shoji">Tetsuji Shoji</name>
<affiliation wicri:level="1"><nlm:affiliation>Shoji Clinic, Osaka, Japan.</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Shoji Clinic, Osaka</wicri:regionArea>
<wicri:noRegion>Osaka</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Kuwana, Kayoko" sort="Kuwana, Kayoko" uniqKey="Kuwana K" first="Kayoko" last="Kuwana">Kayoko Kuwana</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Surgery, Kansai Medical University, Hirakata, Japan.</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Surgery, Kansai Medical University, Hirakata</wicri:regionArea>
<wicri:noRegion>Hirakata</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Kwon, A Hon" sort="Kwon, A Hon" uniqKey="Kwon A" first="A-Hon" last="Kwon">A-Hon Kwon</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Surgery, Kansai Medical University, Hirakata, Japan.</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Surgery, Kansai Medical University, Hirakata</wicri:regionArea>
<wicri:noRegion>Hirakata</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">Breast cancer (Dove Medical Press)</title>
<idno type="ISSN">1179-1314</idno>
<imprint><date when="2012" type="published">2012</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
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<profileDesc><textClass></textClass>
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<front><div type="abstract" xml:lang="en">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.</div>
</front>
</TEI>
</pubmed>
</double>
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