Clinical Edge Journal Scan

Axillary surgery not always indicated in BC patients with 1-2 positive sentinel lymph nodes undergoing mastectomy


 

Key clinical point: In patients with cT1-2 N0 breast cancer (BC) who underwent mastectomy and had 1-2 positive nodes on sentinel lymph node biopsy (SLNB), the rate of local-regional recurrence (LRR) was extremely low regardless of completion axillary node dissection (CLND) or radiation therapy.

Major finding: The 5-year cumulative incidence rate of overall LRR was comparable between patients who underwent vs did not undergo CLND (1.8% vs 1.3%; P = .93), with the receipt of post-mastectomy radiation therapy not affecting the LRR rate in both categories of patients who underwent SLNB alone and SLNB with CLND ( P = .1638 for both).

Study details: Findings are from the analysis of a prospective institutional database including 548 patients with cT1-2 N0 BC who underwent mastectomy and had 1-2 positive lymph nodes on SLNB, and 77% of these patients underwent CLND.

Disclosures: This study was supported by the PH and Fay Etta Robinson Distinguished Professorship in Cancer Research and other sources. The authors declared no conflicts of interest.

Source: Zaveri S et al. Extremely low incidence of local-regional recurrences observed among T1-2 N1 (1 or 2 positive SLNs) breast cancer patients receiving upfront mastectomy without completion axillary node dissection. Ann Surg Oncol. 2023 (Jul 17). doi: 10.1245/s10434-023-13942-1

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