TY - JOUR
T1 - Sentinel node biopsy compared with complete axillary dissection for staging early breast cancer with clinically negative lymph nodes
T2 - Results of randomized trial
AU - Canavese, G.
AU - Catturich, A.
AU - Vecchio, C.
AU - Tomei, D.
AU - Gipponi, M.
AU - Villa, G.
AU - Carli, F.
AU - Bruzzi, P.
AU - Dozin, Beatrice
PY - 2009
Y1 - 2009
N2 - Background: Sentinel lymph node (SLN) staging is currently used to avoid complete axillary dissection in breast cancer patients with negative SLNs. Evidence of a similar efficacy, in terms of survival and regional control, of this strategy as compared with axillary resection is based on few clinical trials. In 1998, we started a randomized study comparing the two strategies, and we present here its results. Materials and methods: Patients were randomly assigned to sentinel lymph node biopsy (SLNB) and axillary dissection [axillary lymph node dissection (ALND arm)] or to SLNB plus axillary resection if SLNs contained metastases (SLNB arm). Main end points were overall survival (OS) and axillary recurrence. Results: One hundred and fifteen patientswere assigned to the ALND arm and 110 to the SLNB arm. A positive SLN was found in 27 patients in the ALND arm and in 31 in the SLNB arm. Overall accuracy of SLNB was 93.0%. Sensitivity and negative predictive values were 77.1% and 91.1%, respectively. At a median follow-up of 5.5 years, no axillary recurrence was observed in the SLNB arm. OS and event-free survival were not statistically different between the two arms. Conclusions: The SLNB procedure does not appear inferior to conventional ALND for the subset of patients here considered.
AB - Background: Sentinel lymph node (SLN) staging is currently used to avoid complete axillary dissection in breast cancer patients with negative SLNs. Evidence of a similar efficacy, in terms of survival and regional control, of this strategy as compared with axillary resection is based on few clinical trials. In 1998, we started a randomized study comparing the two strategies, and we present here its results. Materials and methods: Patients were randomly assigned to sentinel lymph node biopsy (SLNB) and axillary dissection [axillary lymph node dissection (ALND arm)] or to SLNB plus axillary resection if SLNs contained metastases (SLNB arm). Main end points were overall survival (OS) and axillary recurrence. Results: One hundred and fifteen patientswere assigned to the ALND arm and 110 to the SLNB arm. A positive SLN was found in 27 patients in the ALND arm and in 31 in the SLNB arm. Overall accuracy of SLNB was 93.0%. Sensitivity and negative predictive values were 77.1% and 91.1%, respectively. At a median follow-up of 5.5 years, no axillary recurrence was observed in the SLNB arm. OS and event-free survival were not statistically different between the two arms. Conclusions: The SLNB procedure does not appear inferior to conventional ALND for the subset of patients here considered.
KW - Axillary lymph node dissection
KW - Breast cancer
KW - Overall survival
KW - Randomized clinical trial
KW - Regional node recurrence
KW - Sentinel lymph node biopsy
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U2 - 10.1093/annonc/mdn746
DO - 10.1093/annonc/mdn746
M3 - Article
C2 - 19174453
AN - SCOPUS:66149093479
VL - 20
SP - 1001
EP - 1007
JO - Annals of Oncology
JF - Annals of Oncology
SN - 0923-7534
IS - 6
ER -