Title: Omission of axillary lymph node dissection in breast conservative surgery for early breast cancer: effect on treatment outcome
Abstract: Objective To analyse the treatment results of breast conservative surgery with or without axillary dissection plus radiotherapy for early breast cancer and ascertain the value of axillary dissection. Methods Between 1985 and 1993, 66 patients with stageⅠorⅡbreast cancer were divided into two groups: lumpectomy with axillary dissection(36 patients); lumpectomy without axillary dissection(30 patients). The whole breast, chest wall and regional lymph nodes were irradiated, followed by tumor bed boost for all patients. Results Axillary lymph node metastasis were found in 6 cases of 28 patients with clinically negative axillary lymph nodes after surgery. The rates of axillary lymph nodes involvement in stage T 1 and T 2 were 30.0%(6/20) and 43.8%(7/16) respectively. The recurrence rates of breast and regional lymph node in the axillary dissection group and no axillary dissection group were 4 (11.1%),7 ( 23.3% ) and 2(5.5%),3(10.0%)respectively (P0.05). The distant metastasis rates in the two groups were 6( 16.6% )and 7(23.3%)(P0.05). There was no significant difference in the overall survival and disease free survival between these two groups (P0.05). The risk of arm edema in the axillary dissection group and no axillary dissection group were 12(33.4%)and 5 ( 16.7% ) respectively. Conclusions It is unnecessary to perform axillary dissection for stage T 1 and some T 2 cases with clinically negative axillary lymph nodes. Lumpectomy plus postoperative radiotherapy is comparable to lumpectomy plus axillary dissection in local control,distant metastasis and survival.
Publication Year: 1999
Publication Date: 1999-01-01
Language: en
Type: article
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