Long-term follow-up of 5262 breast cancer patients with negative sentinel node and no axillary dissection confirms low rate of axillary disease

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Abstract

Abstract Aim It is established that axillary dissection (AD) can be safely avoided in breast cancer patients with a negative sentinel node (SN). In the present study we assessed whether the rate of axillary disease was sufficiently low on long term follow-up to consolidate the policy of AD avoidance. Methods We retrospectively analysed data on 5262 consecutive primary breast cancer patients with clinically negative axilla and negative SN, treated from 1996 to 2006, who did not receive AD. We used univariate and multivariate analyses to assess the influence of patient and tumour characteristics on first events and survival. The primary endpoint was the development of axillary disease as first event. Results After a median follow-up of 7.0 years (interquartile range 5.4-8.9 years) survival for the series was high (91.3%; 95% CI 90.3-92.3 at 10 years) and only 91 (1.7%) patients developed axillary disease as first event. Axillary disease was significantly more frequent in patients with the following characteristics: 1 cm, multifocality/multicentricity, G3, ductal histotype, Ki67 ≥ 30%, peritumoral vascular invasion, luminal B-like subtype, HER2 positivity, mastectomy, and not receiving radiotherapy. Conclusion Long-term follow-up of our large series confirms that axillary metastasis is infrequent when AD is omitted in SN-negative breast cancer patients, and has low impact on overall survival.

Original languageEnglish
Article number3883
Pages (from-to)1203-1208
Number of pages6
JournalEuropean Journal of Surgical Oncology
Volume40
Issue number10
DOIs
Publication statusPublished - Oct 1 2014

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Dissection
Breast Neoplasms
Survival
Axilla
Mastectomy
Blood Vessels
cyhalothrin
Radiotherapy
Multivariate Analysis
Neoplasm Metastasis
Neoplasms

Keywords

  • Axillary disease
  • Axillary dissection
  • Breast cancer
  • Sentinel node biopsy

ASJC Scopus subject areas

  • Oncology
  • Surgery
  • Medicine(all)

Cite this

@article{c000f629930e44b89953643be0edf7f6,
title = "Long-term follow-up of 5262 breast cancer patients with negative sentinel node and no axillary dissection confirms low rate of axillary disease",
abstract = "Abstract Aim It is established that axillary dissection (AD) can be safely avoided in breast cancer patients with a negative sentinel node (SN). In the present study we assessed whether the rate of axillary disease was sufficiently low on long term follow-up to consolidate the policy of AD avoidance. Methods We retrospectively analysed data on 5262 consecutive primary breast cancer patients with clinically negative axilla and negative SN, treated from 1996 to 2006, who did not receive AD. We used univariate and multivariate analyses to assess the influence of patient and tumour characteristics on first events and survival. The primary endpoint was the development of axillary disease as first event. Results After a median follow-up of 7.0 years (interquartile range 5.4-8.9 years) survival for the series was high (91.3{\%}; 95{\%} CI 90.3-92.3 at 10 years) and only 91 (1.7{\%}) patients developed axillary disease as first event. Axillary disease was significantly more frequent in patients with the following characteristics: 1 cm, multifocality/multicentricity, G3, ductal histotype, Ki67 ≥ 30{\%}, peritumoral vascular invasion, luminal B-like subtype, HER2 positivity, mastectomy, and not receiving radiotherapy. Conclusion Long-term follow-up of our large series confirms that axillary metastasis is infrequent when AD is omitted in SN-negative breast cancer patients, and has low impact on overall survival.",
keywords = "Axillary disease, Axillary dissection, Breast cancer, Sentinel node biopsy",
author = "V. Galimberti and A. Manika and P. Maisonneuve and G. Corso and {Salazar Moltrasio}, L. and M. Intra and O. Gentilini and P. Veronesi and G. Pagani and E. Rossi and L. Bottiglieri and G. Viale and N. Rotmensz and {De Cicco}, C. and Grana, {C. M.} and C. Sangalli and A. Luini",
year = "2014",
month = "10",
day = "1",
doi = "10.1016/j.ejso.2014.07.041",
language = "English",
volume = "40",
pages = "1203--1208",
journal = "European Journal of Surgical Oncology",
issn = "0748-7983",
publisher = "W.B. Saunders Ltd",
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}

TY - JOUR

T1 - Long-term follow-up of 5262 breast cancer patients with negative sentinel node and no axillary dissection confirms low rate of axillary disease

AU - Galimberti, V.

AU - Manika, A.

AU - Maisonneuve, P.

AU - Corso, G.

AU - Salazar Moltrasio, L.

AU - Intra, M.

AU - Gentilini, O.

AU - Veronesi, P.

AU - Pagani, G.

AU - Rossi, E.

AU - Bottiglieri, L.

AU - Viale, G.

AU - Rotmensz, N.

AU - De Cicco, C.

AU - Grana, C. M.

AU - Sangalli, C.

AU - Luini, A.

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Abstract Aim It is established that axillary dissection (AD) can be safely avoided in breast cancer patients with a negative sentinel node (SN). In the present study we assessed whether the rate of axillary disease was sufficiently low on long term follow-up to consolidate the policy of AD avoidance. Methods We retrospectively analysed data on 5262 consecutive primary breast cancer patients with clinically negative axilla and negative SN, treated from 1996 to 2006, who did not receive AD. We used univariate and multivariate analyses to assess the influence of patient and tumour characteristics on first events and survival. The primary endpoint was the development of axillary disease as first event. Results After a median follow-up of 7.0 years (interquartile range 5.4-8.9 years) survival for the series was high (91.3%; 95% CI 90.3-92.3 at 10 years) and only 91 (1.7%) patients developed axillary disease as first event. Axillary disease was significantly more frequent in patients with the following characteristics: 1 cm, multifocality/multicentricity, G3, ductal histotype, Ki67 ≥ 30%, peritumoral vascular invasion, luminal B-like subtype, HER2 positivity, mastectomy, and not receiving radiotherapy. Conclusion Long-term follow-up of our large series confirms that axillary metastasis is infrequent when AD is omitted in SN-negative breast cancer patients, and has low impact on overall survival.

AB - Abstract Aim It is established that axillary dissection (AD) can be safely avoided in breast cancer patients with a negative sentinel node (SN). In the present study we assessed whether the rate of axillary disease was sufficiently low on long term follow-up to consolidate the policy of AD avoidance. Methods We retrospectively analysed data on 5262 consecutive primary breast cancer patients with clinically negative axilla and negative SN, treated from 1996 to 2006, who did not receive AD. We used univariate and multivariate analyses to assess the influence of patient and tumour characteristics on first events and survival. The primary endpoint was the development of axillary disease as first event. Results After a median follow-up of 7.0 years (interquartile range 5.4-8.9 years) survival for the series was high (91.3%; 95% CI 90.3-92.3 at 10 years) and only 91 (1.7%) patients developed axillary disease as first event. Axillary disease was significantly more frequent in patients with the following characteristics: 1 cm, multifocality/multicentricity, G3, ductal histotype, Ki67 ≥ 30%, peritumoral vascular invasion, luminal B-like subtype, HER2 positivity, mastectomy, and not receiving radiotherapy. Conclusion Long-term follow-up of our large series confirms that axillary metastasis is infrequent when AD is omitted in SN-negative breast cancer patients, and has low impact on overall survival.

KW - Axillary disease

KW - Axillary dissection

KW - Breast cancer

KW - Sentinel node biopsy

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U2 - 10.1016/j.ejso.2014.07.041

DO - 10.1016/j.ejso.2014.07.041

M3 - Article

VL - 40

SP - 1203

EP - 1208

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

SN - 0748-7983

IS - 10

M1 - 3883

ER -