Sentinel node positive breast cancer patients who do not undergo axillary dissection: Are they different?

Shaheen Zakaria, Gouri Pantvaidya, Carol A. Reynolds, Clive S. Grant, Sylvester Sterioff, John H. Donohue, David R. Farley, Tanya L. Hoskin, Amy C Degnim

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: Little data address outcome in patients with sentinel lymph node (SN) metastases without completion axillary lymph node dissection (CALND). This study was designed to assess locoregional recurrence in patients with positive SNs who did not undergo CALND. Methods: An IRB-approved, retrospective chart review was conducted on breast cancer patients with a positive SN. Follow-up information on outcomes was obtained via mailed questionnaires and chart review. Comparative analyses were performed between patients who did and did not undergo CALND after a positive sentinel lymph node biopsy. Results: From November 1998 to June 2004, 625 breast cancer patients had a positive sentinel lymph node biopsy. One-hundred and eighteen patients with ≤0.2 mm nodal metastases (N0i+) were excluded from the study. Of the remaining 507 patients, 421 underwent CALND and 86 did not. In comparison to patients who had CALND, patients who did not undergo CALND had smaller primary tumors (2 vs 2.6 cm, P = .0007) and were more likely to have a single positive sentinel node (92% vs 77%, P = .002). The metastasis size of the sentinel node was smaller compared to patients who underwent axillary dissection (1.7 vs 6.4 mm, P < .0001). Mean predicted probability of nonsentinel node metastasis in patients who did not undergo CALND was 20% compared to 47% in patients who did (P < .0001). During a median follow-up of 30 months, there were no axillary recurrences. Conclusions: These data confirm that patients who have a positive sentinel node biopsy and do not undergo CALND have a lower risk profile for axillary disease. In this lower risk subset, axillary treatment may not be necessary.

Original languageEnglish (US)
Pages (from-to)641-647
Number of pages7
JournalSurgery
Volume143
Issue number5
DOIs
StatePublished - May 2008

Fingerprint

Dissection
Breast Neoplasms
Lymph Node Excision
Neoplasm Metastasis
Sentinel Lymph Node Biopsy
cyhalothrin
Recurrence
Research Ethics Committees
Biopsy

ASJC Scopus subject areas

  • Surgery

Cite this

Zakaria, S., Pantvaidya, G., Reynolds, C. A., Grant, C. S., Sterioff, S., Donohue, J. H., ... Degnim, A. C. (2008). Sentinel node positive breast cancer patients who do not undergo axillary dissection: Are they different? Surgery, 143(5), 641-647. https://doi.org/10.1016/j.surg.2007.10.023

Sentinel node positive breast cancer patients who do not undergo axillary dissection : Are they different? / Zakaria, Shaheen; Pantvaidya, Gouri; Reynolds, Carol A.; Grant, Clive S.; Sterioff, Sylvester; Donohue, John H.; Farley, David R.; Hoskin, Tanya L.; Degnim, Amy C.

In: Surgery, Vol. 143, No. 5, 05.2008, p. 641-647.

Research output: Contribution to journalArticle

Zakaria, S, Pantvaidya, G, Reynolds, CA, Grant, CS, Sterioff, S, Donohue, JH, Farley, DR, Hoskin, TL & Degnim, AC 2008, 'Sentinel node positive breast cancer patients who do not undergo axillary dissection: Are they different?', Surgery, vol. 143, no. 5, pp. 641-647. https://doi.org/10.1016/j.surg.2007.10.023
Zakaria S, Pantvaidya G, Reynolds CA, Grant CS, Sterioff S, Donohue JH et al. Sentinel node positive breast cancer patients who do not undergo axillary dissection: Are they different? Surgery. 2008 May;143(5):641-647. https://doi.org/10.1016/j.surg.2007.10.023
Zakaria, Shaheen ; Pantvaidya, Gouri ; Reynolds, Carol A. ; Grant, Clive S. ; Sterioff, Sylvester ; Donohue, John H. ; Farley, David R. ; Hoskin, Tanya L. ; Degnim, Amy C. / Sentinel node positive breast cancer patients who do not undergo axillary dissection : Are they different?. In: Surgery. 2008 ; Vol. 143, No. 5. pp. 641-647.
@article{9478865d95b84ed88a9f0a0cfe6d7e74,
title = "Sentinel node positive breast cancer patients who do not undergo axillary dissection: Are they different?",
abstract = "Background: Little data address outcome in patients with sentinel lymph node (SN) metastases without completion axillary lymph node dissection (CALND). This study was designed to assess locoregional recurrence in patients with positive SNs who did not undergo CALND. Methods: An IRB-approved, retrospective chart review was conducted on breast cancer patients with a positive SN. Follow-up information on outcomes was obtained via mailed questionnaires and chart review. Comparative analyses were performed between patients who did and did not undergo CALND after a positive sentinel lymph node biopsy. Results: From November 1998 to June 2004, 625 breast cancer patients had a positive sentinel lymph node biopsy. One-hundred and eighteen patients with ≤0.2 mm nodal metastases (N0i+) were excluded from the study. Of the remaining 507 patients, 421 underwent CALND and 86 did not. In comparison to patients who had CALND, patients who did not undergo CALND had smaller primary tumors (2 vs 2.6 cm, P = .0007) and were more likely to have a single positive sentinel node (92{\%} vs 77{\%}, P = .002). The metastasis size of the sentinel node was smaller compared to patients who underwent axillary dissection (1.7 vs 6.4 mm, P < .0001). Mean predicted probability of nonsentinel node metastasis in patients who did not undergo CALND was 20{\%} compared to 47{\%} in patients who did (P < .0001). During a median follow-up of 30 months, there were no axillary recurrences. Conclusions: These data confirm that patients who have a positive sentinel node biopsy and do not undergo CALND have a lower risk profile for axillary disease. In this lower risk subset, axillary treatment may not be necessary.",
author = "Shaheen Zakaria and Gouri Pantvaidya and Reynolds, {Carol A.} and Grant, {Clive S.} and Sylvester Sterioff and Donohue, {John H.} and Farley, {David R.} and Hoskin, {Tanya L.} and Degnim, {Amy C}",
year = "2008",
month = "5",
doi = "10.1016/j.surg.2007.10.023",
language = "English (US)",
volume = "143",
pages = "641--647",
journal = "Surgery (United States)",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "5",

}

TY - JOUR

T1 - Sentinel node positive breast cancer patients who do not undergo axillary dissection

T2 - Are they different?

AU - Zakaria, Shaheen

AU - Pantvaidya, Gouri

AU - Reynolds, Carol A.

AU - Grant, Clive S.

AU - Sterioff, Sylvester

AU - Donohue, John H.

AU - Farley, David R.

AU - Hoskin, Tanya L.

AU - Degnim, Amy C

PY - 2008/5

Y1 - 2008/5

N2 - Background: Little data address outcome in patients with sentinel lymph node (SN) metastases without completion axillary lymph node dissection (CALND). This study was designed to assess locoregional recurrence in patients with positive SNs who did not undergo CALND. Methods: An IRB-approved, retrospective chart review was conducted on breast cancer patients with a positive SN. Follow-up information on outcomes was obtained via mailed questionnaires and chart review. Comparative analyses were performed between patients who did and did not undergo CALND after a positive sentinel lymph node biopsy. Results: From November 1998 to June 2004, 625 breast cancer patients had a positive sentinel lymph node biopsy. One-hundred and eighteen patients with ≤0.2 mm nodal metastases (N0i+) were excluded from the study. Of the remaining 507 patients, 421 underwent CALND and 86 did not. In comparison to patients who had CALND, patients who did not undergo CALND had smaller primary tumors (2 vs 2.6 cm, P = .0007) and were more likely to have a single positive sentinel node (92% vs 77%, P = .002). The metastasis size of the sentinel node was smaller compared to patients who underwent axillary dissection (1.7 vs 6.4 mm, P < .0001). Mean predicted probability of nonsentinel node metastasis in patients who did not undergo CALND was 20% compared to 47% in patients who did (P < .0001). During a median follow-up of 30 months, there were no axillary recurrences. Conclusions: These data confirm that patients who have a positive sentinel node biopsy and do not undergo CALND have a lower risk profile for axillary disease. In this lower risk subset, axillary treatment may not be necessary.

AB - Background: Little data address outcome in patients with sentinel lymph node (SN) metastases without completion axillary lymph node dissection (CALND). This study was designed to assess locoregional recurrence in patients with positive SNs who did not undergo CALND. Methods: An IRB-approved, retrospective chart review was conducted on breast cancer patients with a positive SN. Follow-up information on outcomes was obtained via mailed questionnaires and chart review. Comparative analyses were performed between patients who did and did not undergo CALND after a positive sentinel lymph node biopsy. Results: From November 1998 to June 2004, 625 breast cancer patients had a positive sentinel lymph node biopsy. One-hundred and eighteen patients with ≤0.2 mm nodal metastases (N0i+) were excluded from the study. Of the remaining 507 patients, 421 underwent CALND and 86 did not. In comparison to patients who had CALND, patients who did not undergo CALND had smaller primary tumors (2 vs 2.6 cm, P = .0007) and were more likely to have a single positive sentinel node (92% vs 77%, P = .002). The metastasis size of the sentinel node was smaller compared to patients who underwent axillary dissection (1.7 vs 6.4 mm, P < .0001). Mean predicted probability of nonsentinel node metastasis in patients who did not undergo CALND was 20% compared to 47% in patients who did (P < .0001). During a median follow-up of 30 months, there were no axillary recurrences. Conclusions: These data confirm that patients who have a positive sentinel node biopsy and do not undergo CALND have a lower risk profile for axillary disease. In this lower risk subset, axillary treatment may not be necessary.

UR - http://www.scopus.com/inward/record.url?scp=43049097813&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=43049097813&partnerID=8YFLogxK

U2 - 10.1016/j.surg.2007.10.023

DO - 10.1016/j.surg.2007.10.023

M3 - Article

C2 - 18436012

AN - SCOPUS:43049097813

VL - 143

SP - 641

EP - 647

JO - Surgery (United States)

JF - Surgery (United States)

SN - 0039-6060

IS - 5

ER -