Prognosis of early breast cancer sentinel lymph node negative patients with axillary lymphadenec-tomy

doi:10.3877/cma.j.issn.1674-0793.2016.01.005

Abstract

Abstract:

Objective

To compare the prognosis of early breast cancer patients with negative sentinel lymph nodes (SLN) treated only by sentinel lymph node biopsy (SLNB) and SLNB plus axillary lymph node dissection (ALND).

Methods

A retrospective analysis of early breast cancer patients in our hospital from January 2005 to December 2010 with negative SLN (only SLNB in 241 cases and SLNB+ALND in 220 cases) was carried out. According to the clinical and pathological data, we compared postop-erative complications and long-term prognosis in the two groups.

Results

The average postoperative hos-pital stay of NALND group and ALND group was (5.2±1.3) d and (8.1±1.8) d (t=1.450, P=0.003), respec-tively, upper extremity with abnormal sensation after resection was 3.7% (9/241) and 73.2% (161/220) (χ²=283.239, P<0.000 1), and upper limb edema was 0 (0/241) and 10.9% (24/220) (χ²=7.735, P<0.000 1), and the differences were statistically significant. 5-year disease free survival rates of two groups were 95.4% and 95.5% (χ²=0.231, P=0.902).

Conclusions

Patients undergoing only SLNB without ALND has less trauma and less postoperative complications than ALND in early breast cancer of negative SLN, and the long-term efficacy is comparable to ALND. We propose it is not necessary to carry out ALND for early breast cancer patients with negative SLN.

Key words: Breast neoplasms, Sentinel lymph node biopsy, Lymph node excision, Prognosis

Yunlong Zeng, Jun Li. Prognosis of early breast cancer sentinel lymph node negative patients with axillary lymphadenec-tomy[J]. Chinese Archives of General Surgery(Electronic Edition), 2016, 10(01): 36-39.

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References 10

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特征变量		NALND组(241例)	ALND组(220例)	统计值	P值
年龄（ ± s，岁）		58.2±6.1	57.9±5.6	1.134	0.977
临床分期［例(%)］		?	?	?	?
?	Ⅰ期	131(54.4)	118(53.6)	0.024	0.877
?	Ⅱ期	110(45.6)	102(46.4)	0.024	0.877
组织学分类［例(%)］		?	?	?	?
?	导管内癌	80(33.2)	71(32.3)	?	?
?	浸润性导管癌	86(35.7)	69(31.4)	0.930	0.335
?	浸润性乳头状癌	72(34.0)	74(33.6)	0.930	0.335
?	黏液癌	3(1.2)	6(2.7)	?	?
手术方式［例(%)］		?	?	?	?
?	保乳术	90(37.3)	73(33.2)	0.872	0.350
?	改良根治术	151(62.7)	147(66.8)	0.872	0.350
ER状态［例(%)］		?	?	?	?
?	阳性	180(74.7)	165(75.0)	0.006	0.939
?	阴性	61(25.3)	55(25.0)	0.006	0.939

特征变量		NALND组(241例)	ALND组(220例)	统计值	P值
年龄（ ± s，岁）		58.2±6.1	57.9±5.6	1.134	0.977
临床分期［例(%)］		?	?	?	?
?	Ⅰ期	131(54.4)	118(53.6)	0.024	0.877
?	Ⅱ期	110(45.6)	102(46.4)	0.024	0.877
组织学分类［例(%)］		?	?	?	?
?	导管内癌	80(33.2)	71(32.3)	?	?
?	浸润性导管癌	86(35.7)	69(31.4)	0.930	0.335
?	浸润性乳头状癌	72(34.0)	74(33.6)	0.930	0.335
?	黏液癌	3(1.2)	6(2.7)	?	?
手术方式［例(%)］		?	?	?	?
?	保乳术	90(37.3)	73(33.2)	0.872	0.350
?	改良根治术	151(62.7)	147(66.8)	0.872	0.350
ER状态［例(%)］		?	?	?	?
?	阳性	180(74.7)	165(75.0)	0.006	0.939
?	阴性	61(25.3)	55(25.0)	0.006	0.939

预后指标	NALDN组(241例)	ALND组(220例)	χ²值	P值
局部复发	5(2.1)	3(1.4)	0.340	0.560
远处转移	7(2.9)	7(3.2)	1.223	0.269
复发和（或）转移	11(4.6)	10(4.5)	0.001	0.992

预后指标	NALDN组(241例)	ALND组(220例)	χ²值	P值
局部复发	5(2.1)	3(1.4)	0.340	0.560
远处转移	7(2.9)	7(3.2)	1.223	0.269
复发和（或）转移	11(4.6)	10(4.5)	0.001	0.992

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