Can we avoid axillary dissection in the macrometastatic sentinel node in breast cancer

Cancer Science & Therapy

ISSN: 1948-5956

Open Access

Can we avoid axillary dissection in the macrometastatic sentinel node in breast cancer

3rd World Congress on Women’s Health & Breast Cancer

October 03-05, 2016 London, UK

Sigita Liutkauskien

Lithuanian University of Health Sciences Oncology Institute, Lithuania

Posters & Accepted Abstracts: J Cancer Sci Ther

Abstract :

Axillary lymph node dissection (ALND) has traditionally been a routine component of the management of early breast cancer. The benefits of ALND include its impact on disease control (ie, axillary recurrence and survival), its prognostic value, and its role in treatment selection. However, the anatomic disruption caused by ALND may result in lymphedema, nerve injury, and shoulder dysfunction, which compromise functionality and quality of life. Early cancer detection by screening mammography have led to earlier intervention in breast cancer, reducing the incidence of nodal metastases. The logical next question in the evolution of axillary staging is to ask whether there are SLN-positive patients who can avoid ALND. It is clear that there are 30% to 50% of SLN-positive patients have disease limited to the SLN. The most def?±nitive data are from ACOSOG Z0011 prospective noninferiority randomized trial in which 813 SLN-positive patients with clinical stage T1â??2N0 breast cancer were randomized to ALND compared with no further surgery. Additional positive nodes were found in 27% of the patients who had ALND, but at 6 years' follow-up there were no differences between the ALND and no-ALND arms in local (3.6% vs. 1.9%), regional (0.5% vs. 0.9%), or overall locoregional recurrence (4.1% vs. 2.8%), nor were there any differences in DFS or OS. Despite these results, this trial has been criticized for a number of reasons including premature study termination, protocol noncompliance, loss to follow-up, lack of analysis, impact of other factors on outcomes could not be controlled.

Biography :


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