Abstract
Background : Sentinel lymph node biopsy (SNB) more accurately detects micrometastases (N1mi) and isolated tumor cells (N0(i+)) than conventional axillary dissection. However, their prognostic values, as well as the necessity of follow-up axillary surgery in such cases, are still uncertain. This study was done to answer these clinical questions ; patients with N1mi and N0(i+) were enrolled.
Methods : 1,177 breast cancer patients who were clinically node-negative received SNB between January 2001 and March 2011. Among these patients, a total of 81 patients with N1mi and N0(i+) was retrospectively assigned to either SNB alone (SNB group : 28 patients) or SNB followed by axillary dissection (ALND group : 53 patients). Clinicopathological features and long-term outcomes of these groups were compared.
Results : At a median follow-up of 5.6 years, there were no instances of axillary recurrence in either group. The five-year disease-free survival (DFS) rates were 86.8% and 82.8% in the ALND group and the SNB group, respectively ; the overall survival (OS) rates were 94.7% and 100% in the ALND group and the SNB group, respectively. There were no significant differences in DFS and OS between the two groups.
Conclusion : Our present study suggests that axillary dissection might be avoided in the carefully selected patients with micrometastases.
