Omission of axillary lymph node dissection in patients who underwent total mastectomy with 1 or 2 metastatic lymph nodes

Bong Kyun Kim; Byeong-Woo Park; Min Hee Hur; Han-Byoel Lee; Min Ho Park; Joon Jeong; Hyouk Jin Lee; Jina Lee; Dongju Kim; Woo Young Sun

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저자정보: Bong Kyun Kim (The Catholic University of Korea) Byeong-Woo Park (Yonsei University College of Medicine) Min Hee Hur (Inha University School of Medicine) Han-Byoel Lee (Seoul National University College of Medicine) Min Ho Park (Chonnam National University Hwasun Hospital) Joon Jeong (Yonsei University College of Medicine) Hyouk Jin Lee (Saegyaero Hospital) Jina Lee (The Catholic University of Korea) Dongju Kim (The Catholic University of Korea) Woo Young Sun (The Catholic University of Korea)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.98 No.6

발행연도: 2020.6

수록면: 283 - 290 (8page)

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Purpose: Sentinel lymph node biopsy (SLNB) is the standard axillary procedure in early breast cancer patients. In a randomized trial, the survival rates were not different when axillary lymph node dissection (ALND) was omitted in patients with 1 or 2 lymph node metastases who underwent breast conserving surgery. This study aimed to compare the outcomes in patients who underwent total mastectomy (TM) with 1 or 2 metastatic nodes according to the types of axillary surgery.
Methods: In total, 79,058 patients registered in the Korean Breast Cancer Society database who underwent TM were included in the analysis. The inclusion criteria were history of TM and SLNB, pathologic T stage 1 or 2, clinically negative axillary lymph nodes, 1 or 2 metastatic axillary lymph nodes, no radiation therapy, and no neoadjuvant therapy. We divided the patients into the SLNB only and SLNB + ALND groups. The groups were matched by propensity scores. We retrospectively analyzed the differences in the overall survival (OS) between the 2 groups.
Results: A total of 883 patients were matched in a 1:4 ratio for the SLNB only and SLNB + ALND groups in the cohort from 1999 to 2014. There were no significant differences in OS between the 2 groups (P = 0.413). Subgroup analysis revealed a significant survival benefit in the SLNB + ALND group in the T2 subgroup (P = 0.013).
Conclusion: OS did not differ between the 2 groups in early breast cancer patients with 1 or 2 metastatic axillary lymph nodes who underwent TM. Omission of ALND may be considered in selected patients.

#Lymph node dissection #Mastectomy #Sentinel lymph node biopsy #Survival analysis

참고문헌 (30)

참고문헌 신청

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