Survival outcomes in node-negative breast cancer patients evaluated with complete axillary node dissection versus sentinel lymph node biopsy

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

Research output: Contribution to journalArticle

35 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)708-711
Number of pages4
JournalAnnals of Surgical Oncology
Volume13
Issue number5
DOIs
StatePublished - May 1 2006

Fingerprint

Sentinel Lymph Node Biopsy
Dissection
Breast Neoplasms
Survival
Lymph Node Excision
Disease-Free Survival
Survival Rate
Research Ethics Committees
Keratins
Lymph Nodes
Guidelines
Staining and Labeling

Keywords

  • Axillary staging
  • Breast cancer
  • Complete axillary lymph node dissection
  • Lymphatic mapping
  • Sentinel lymph nodes

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Survival outcomes in node-negative breast cancer patients evaluated with complete axillary node dissection versus sentinel lymph node biopsy. / Cox, Charles; White, Laura; Allred, Nathon; Meyers, Michael; Dickson, Daniel; Dupont, Elisabeth; Cantor, Alan; Ly, Quan; Dessureault, Sophie; King, Jeff; Nicosia, Santo; Vrcel, Vesna; Diaz, Nils.

In: Annals of Surgical Oncology, Vol. 13, No. 5, 01.05.2006, p. 708-711.

Research output: Contribution to journalArticle

Cox, C, White, L, Allred, N, Meyers, M, Dickson, D, Dupont, E, Cantor, A, Ly, Q, Dessureault, S, King, J, Nicosia, S, Vrcel, V & Diaz, N 2006, 'Survival outcomes in node-negative breast cancer patients evaluated with complete axillary node dissection versus sentinel lymph node biopsy', Annals of Surgical Oncology, vol. 13, no. 5, pp. 708-711. https://doi.org/10.1245/ASO.2006.05.017
Cox, Charles ; White, Laura ; Allred, Nathon ; Meyers, Michael ; Dickson, Daniel ; Dupont, Elisabeth ; Cantor, Alan ; Ly, Quan ; Dessureault, Sophie ; King, Jeff ; Nicosia, Santo ; Vrcel, Vesna ; Diaz, Nils. / Survival outcomes in node-negative breast cancer patients evaluated with complete axillary node dissection versus sentinel lymph node biopsy. In: Annals of Surgical Oncology. 2006 ; Vol. 13, No. 5. pp. 708-711.
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title = "Survival outcomes in node-negative breast cancer patients evaluated with complete axillary node dissection versus sentinel lymph node biopsy",
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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AU - Cox, Charles

AU - White, Laura

AU - Allred, Nathon

AU - Meyers, Michael

AU - Dickson, Daniel

AU - Dupont, Elisabeth

AU - Cantor, Alan

AU - Ly, Quan

AU - Dessureault, Sophie

AU - King, Jeff

AU - Nicosia, Santo

AU - Vrcel, Vesna

AU - Diaz, Nils

PY - 2006/5/1

Y1 - 2006/5/1

N2 - 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.

AB - 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.

KW - Axillary staging

KW - Breast cancer

KW - Complete axillary lymph node dissection

KW - Lymphatic mapping

KW - Sentinel lymph nodes

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