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01-11-2008 | Breast Oncology

Breast Cancer Patients with Extra-Axillary Sentinel Nodes Only may be Spared Axillary Lymph Node Dissection

Authors: Iris M. C. van der Ploeg, MD, Pieter J. Tanis, MD, PhD, Renato A. Valdés Olmos, MD, PhD, Bin B. R. Kroon, MD, PhD, FRCS, Emiel J. T. Rutgers, MD, PhD, FRCS, Omgo E. Nieweg, MD, PhD

Published in: Annals of Surgical Oncology | Issue 11/2008

Abstract

Background

In breast cancer patients with only extra-axillary sentinel nodes, surgeons typically perform axillary node dissection. The purpose of this study was to evaluate our approach to spare such patients further dissection based on the hypothesis that a sentinel node is not necessarily located in the axilla.

Methods

Between March 11, 1999 and March 5, 2008, 1,949 breast cancer patients underwent lymphatic mapping with preoperative lymphoscintigraphy and intraoperative use of a gamma-ray detection probe and patent blue dye. The tracers were injected into the tumors.

Results

Eighty-two of the 1,949 patients had only extra-axillary drainage on their lymphoscintigrams. A sentinel node was harvested from the axilla in 62 patients but not in the remaining 20 patients. No axillary lymph nodes were removed in 4 of these 20 patients, suspicious palpable nodes were excised in another 4 patients, and node sampling was done in the remaining 12. These nodes were all free of disease. All sentinel nodes outside the axilla were removed. Two patients had a metastasis in an internal mammary chain node. No lymph node recurrences were detected in or outside the axilla in any of the 20 patients with a median follow-up time of 49 months.

Conclusion

4% of the patients have only extra-axillary drainage on preoperative lymphoscintigrams. It is worthwhile to explore the axilla since a sentinel node can be found in three-quarters. In the remaining 1% without axillary sentinel nodes, axillary sampling seems unnecessary and the approach to refrain from axillary dissection appears valid.

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Title: Breast Cancer Patients with Extra-Axillary Sentinel Nodes Only may be Spared Axillary Lymph Node Dissection
Authors: Iris M. C. van der Ploeg, MD
Pieter J. Tanis, MD, PhD
Renato A. Valdés Olmos, MD, PhD
Bin B. R. Kroon, MD, PhD, FRCS
Emiel J. T. Rutgers, MD, PhD, FRCS
Omgo E. Nieweg, MD, PhD
Publication date: 01-11-2008
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 11/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-008-0120-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Breast Cancer Patients with Extra-Axillary Sentinel Nodes Only may be Spared Axillary Lymph Node Dissection

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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