Sentinel node biopsy compared with complete axillary dissection for staging early breast cancer with clinically negative lymph nodes: Results of randomized trial

G. Canavese, A. Catturich, C. Vecchio, D. Tomei, M. Gipponi, G. Villa, F. Carli, P. Bruzzi, Beatrice Dozin

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)1001-1007
Number of pages7
JournalAnnals of Oncology
Volume20
Issue number6
DOIs
Publication statusPublished - 2009

Keywords

  • Axillary lymph node dissection
  • Breast cancer
  • Overall survival
  • Randomized clinical trial
  • Regional node recurrence
  • Sentinel lymph node biopsy

ASJC Scopus subject areas

  • Oncology
  • Hematology

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