The aim of this study was to identify a subgroup of breast cancer patients in whom it is possible to avoid axillary lymph node dissection (ALND) when the sentinel lymph node (SLN) is positive.
A series of 292 patients treated with breast-conserving surgery or mastectomy underwent ALND after positive SLN detection. To correlate SLN metastasis with the chances of finding additional metastasis in non-SLNs we evaluated the main clinicopathological characteristics. No patients received adjuvant radiotherapy to the axillary region.
Fifty-six patients (35.4%) with positive SLNs for macrometastases (n = 158) had additional metastases upon completion ALND compared with 7 patients (5.2%) with micrometastases in the SLN (n = 132). Cases with a higher number of positive axillary lymph nodes tended to have higher pT stage (p = 0.004). In multivariate analysis, pT was confirmed as an independent predictor of non-SLN metastases (OR = 2.40; 95% CI = 1.16-4.99). No patients with micrometastases in SLN and cancer <10 mm had additional positive non-SLNs.
Our results, in agreement with the major published studies, suggest that ALND can be avoided in selected patients without the need for additional treatment to the axillary region.
Tumori 2015; 101(1): 78 - 83
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsIcro Meattini, Calogero Saieva, Silvia Bertocci, Giulio Francolini, Giacomo Zei, Carla De Luca Cardillo, Vieri Scotti, Daniela Greto, Pierluigi Bonomo, Lorenzo Orzalesi, Simonetta Bianchi, Lorenzo Livi
- • Accepted on 09/06/2014
- • Available online on 24/01/2015
- • Published in print on 20/03/2015
This article is available as full text PDF.
- Meattini, Icro [PubMed] [Google Scholar] 1, * Corresponding Author (email@example.com)
- Saieva, Calogero [PubMed] [Google Scholar] 2
- Bertocci, Silvia [PubMed] [Google Scholar] 1
- Francolini, Giulio [PubMed] [Google Scholar] 1
- Zei, Giacomo [PubMed] [Google Scholar] 1
- Cardillo, Carla De Luca [PubMed] [Google Scholar] 1
- Scotti, Vieri [PubMed] [Google Scholar] 1
- Greto, Daniela [PubMed] [Google Scholar] 1
- Bonomo, Pierluigi [PubMed] [Google Scholar] 1
- Orzalesi, Lorenzo [PubMed] [Google Scholar] 3
- Bianchi, Simonetta [PubMed] [Google Scholar] 4
- Livi, Lorenzo [PubMed] [Google Scholar] 1
Department of Radiation-Oncology, University of Florence, Florence - Italy
Molecular and Nutritional Epidemiology Unit, ISPO (Cancer Research and Prevention Institute), Florence - Italy
Department of Surgery, University of Florence, Florence - Italy
Division of Pathological Anatomy, Department of Medical and Surgical Critical Care, University of Florence, Florence - Italy