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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2006

01-05-2006

Survival Outcomes in Node-Negative Breast Cancer Patients Evaluated With Complete Axillary Node Dissection Versus Sentinel Lymph Node Biopsy

Authors: Charles Cox, MD, Laura White, BS, Nathon Allred, Michael Meyers, Daniel Dickson, BS, Elisabeth Dupont, MD, Alan Cantor, PhD, Quan Ly, MD, Sophie Dessureault, MD, PhD, Jeff King, BS, Santo Nicosia, MD, Vesna Vrcel, MD, Nils Diaz, MD

Published in: Annals of Surgical Oncology | Issue 5/2006

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Abstract

Background

Sentinel lymph node (SLN) biopsy combined with microstaging-associated immunohistochemical staining for cytokeratin more accurately assigns patients to their corresponding diagnostic stage. The purpose of this study was to compare the survival outcomes of node-negative patients who received an SLN biopsy with historical control data of node-negative patients who received routine complete axillary lymph node dissection (CALND) in the pre-SLN biopsy era.

Methods

Under institutional review board approval, 2458 node-negative invasive breast cancer patients between the ages of 25 and 94 years (mean, 60 years) were treated at our institution from January 1986 to May 2004. Of these 2458 patients, 604 (25%) were evaluated with CALND, whereas 1854 (75%) were evaluated with SLN biopsy. All were treated according to the current stage-specific guidelines. Kaplan-Meier graphs of overall survival and disease-free survival were constructed for each group of patients, and the two groups were compared by using the log-rank test.

Results

Overall survival and disease-free survival for the CALND and SLN biopsy groups did not differ significantly (P = .98). The average number of lymph nodes extracted in the pre-SLN biopsy group was 18, whereas the average number of SLNs extracted in the post-SLN biopsy group was 3.

Conclusions

The survival rate among node-negative breast cancer patients who received an SLN biopsy alone has proven to have no significant difference (P = .98) from the survival rate among node-negative patients who received a CALND. SLN biopsy alone should replace CALND as the primary tool for axillary staging of breast cancer in node-negative patients.
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Metadata
Title
Survival Outcomes in Node-Negative Breast Cancer Patients Evaluated With Complete Axillary Node Dissection Versus Sentinel Lymph Node Biopsy
Authors
Charles Cox, MD
Laura White, BS
Nathon Allred
Michael Meyers
Daniel Dickson, BS
Elisabeth Dupont, MD
Alan Cantor, PhD
Quan Ly, MD
Sophie Dessureault, MD, PhD
Jeff King, BS
Santo Nicosia, MD
Vesna Vrcel, MD
Nils Diaz, MD
Publication date
01-05-2006
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 5/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/ASO.2006.05.017

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