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01-11-2012 | Breast Oncology

Characteristics and Outcomes of Sentinel Node–Positive Breast Cancer Patients after Total Mastectomy without Axillary-Specific Treatment

Authors: Sarah Milgrom, MD, Hiram Cody, MD, FACS, Lee Tan, MD, Monica Morrow, MD, FACS, Catherine Pesce, MD, Jeremy Setton, MD, Katherine Rogers, BA, Brittany Arnold, BA, Anne Eaton, MS, Jeffrey Catalano, BA, Beryl McCormick, MD, FACR, Simon Powell, MD, PhD, Alice Ho, MD

Published in: Annals of Surgical Oncology | Issue 12/2012

Abstract

Purpose

Regional failure rates are low in patients with a positive sentinel lymph node biopsy (SLNB) who undergo breast-conserving therapy without axillary lymph node dissection (ALND). The applicability of these findings to total mastectomy (TM) patients is not established. Our aims were to evaluate the characteristics and outcomes of SLNB-positive TM patients who did not receive axillary-specific treatment and to compare them to similar patients who underwent breast-conserving surgery (BCS).

Methods

A total of 535 patients with early-stage breast cancer who underwent definitive breast surgery (210 TM, 325 BCS), had a positive SLNB and did not receive ALND between 1997 and 2009 were identified from an institutional database. Characteristics and outcomes were compared between the TM and BCS groups.

Results

Most patients had stage I to IIA, estrogen receptor–positive, progesterone receptor–positive, Her2-negative invasive ductal carcinoma, with minimal nodal disease. Compared to the BCS group, TM patients were younger, had larger tumors, had higher nomogram scores predicting additional axillary disease and were more likely to receive chemotherapy. Ninety-four percent of the BCS cohort and 5 % of the TM cohort received adjuvant radiotherapy. At a median follow-up of 57.8 months, the 4-year local, regional and distant failure rates were 1.7, 1.2 and 0.7 % in the TM group and 1.4, 1.0 and 3.7 % in the BCS group. The 4-year disease-free and overall survival rates were 94.8 and 97.8 % in the TM group and 90.1 and 92.6 % in the BCS group.

Conclusions

Early-stage breast cancer patients with minimal sentinel node disease experience excellent outcomes without ALND, whether they undergo BCS or TM.

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Title: Characteristics and Outcomes of Sentinel Node–Positive Breast Cancer Patients after Total Mastectomy without Axillary-Specific Treatment
Authors: Sarah Milgrom, MD
Hiram Cody, MD, FACS
Lee Tan, MD
Monica Morrow, MD, FACS
Catherine Pesce, MD
Jeremy Setton, MD
Katherine Rogers, BA
Brittany Arnold, BA
Anne Eaton, MS
Jeffrey Catalano, BA
Beryl McCormick, MD, FACR
Simon Powell, MD, PhD
Alice Ho, MD
Publication date: 01-11-2012
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 12/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-012-2386-3

At a glance: The STEP trials

Springer Medicine

Characteristics and Outcomes of Sentinel Node–Positive Breast Cancer Patients after Total Mastectomy without Axillary-Specific Treatment

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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