Completion axillary dissection can safely be omitted in screen detected breast cancer patients with micrometastases. A decade's experience from a single institution.
Grabau, Dorthe LU ; Dihge, Looket LU ; Fernö, Mårten LU ; Ingvar, Christian LU and Rydén, Lisa LU
(2013)
In European Journal of Surgical Oncology
39(6).
p.601-607
- Abstract
- BACKGROUND: The need for completion axillary lymph node dissection (ALND) in breast cancer patients with micrometastases in the sentinel nodes (SNs) is controversial. The aim of this retrospective observational study is to determine if the method of detection of early breast cancer is predictive for additional positive nodes in patients with micrometastases in the SNs. METHODS: Between 2001 and 2011 a total of 1993 women with primary unilateral breast cancer had surgery at Skåne University Hospital, Lund. Of 1993 patients, 1458 had an SN biopsy and nearly all patients with micro- and macrometastases had ALND. RESULTS: Micrometastases defined as >0.2 mm/>200 cells and ≤2.0 mm were found in 62 of 757 screen-detected patients and in 81... (More)
- BACKGROUND: The need for completion axillary lymph node dissection (ALND) in breast cancer patients with micrometastases in the sentinel nodes (SNs) is controversial. The aim of this retrospective observational study is to determine if the method of detection of early breast cancer is predictive for additional positive nodes in patients with micrometastases in the SNs. METHODS: Between 2001 and 2011 a total of 1993 women with primary unilateral breast cancer had surgery at Skåne University Hospital, Lund. Of 1993 patients, 1458 had an SN biopsy and nearly all patients with micro- and macrometastases had ALND. RESULTS: Micrometastases defined as >0.2 mm/>200 cells and ≤2.0 mm were found in 62 of 757 screen-detected patients and in 81 of 701 patients with symptomatic breast cancer. Only 3 of the screen-detected patients with micrometastases, all with tumour size >15 mm (range 18-39 mm), had metastases in the completion ALND whereas this was found in 18 of the symptomatic patients with micrometastases (p = 0.01), (tumour size, range 10-30 mm). Logistic regression analysis adjusted for method of detection, tumour size and histological grade showed 5 times higher odds for further metastases in ALND in patients with symptomatic presentation vs. screen-detected breast cancer. CONCLUSION: Despite the small number of patients with micrometastases in this large cohort of breast cancer patients, these results support the contention that completion ALND can safely be omitted in screen-detected breast cancer patients with micrometastases in the SNs. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3733845
- author
- Grabau, Dorthe
LU
; Dihge, Looket
LU
; Fernö, Mårten
LU
; Ingvar, Christian
LU
and Rydén, Lisa
LU
- organization
- publishing date
- 2013
- type
- Contribution to journal
- publication status
- published
- subject
- in
- European Journal of Surgical Oncology
- volume
- 39
- issue
- 6
- pages
- 601 - 607
- publisher
- Elsevier
- external identifiers
-
- wos:000320413700010
- pmid:23579175
- scopus:84877579209
- pmid:23579175
- ISSN
- 1532-2157
- DOI
- 10.1016/j.ejso.2013.03.012
- project
- Breast Cancer Surgery
- language
- English
- LU publication?
- yes
- additional info
- The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Surgery (Lund) (013009000), Oncology, MV (013035000), Pathology, (Lund) (013030000)
- id
- a8859df3-ff33-4759-b058-f85996b9187c (old id 3733845)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/23579175?dopt=Abstract
- date added to LUP
- 2016-04-01 10:42:15
- date last changed
- 2022-03-27 18:46:17
@article{a8859df3-ff33-4759-b058-f85996b9187c,
abstract = {{BACKGROUND: The need for completion axillary lymph node dissection (ALND) in breast cancer patients with micrometastases in the sentinel nodes (SNs) is controversial. The aim of this retrospective observational study is to determine if the method of detection of early breast cancer is predictive for additional positive nodes in patients with micrometastases in the SNs. METHODS: Between 2001 and 2011 a total of 1993 women with primary unilateral breast cancer had surgery at Skåne University Hospital, Lund. Of 1993 patients, 1458 had an SN biopsy and nearly all patients with micro- and macrometastases had ALND. RESULTS: Micrometastases defined as >0.2 mm/>200 cells and ≤2.0 mm were found in 62 of 757 screen-detected patients and in 81 of 701 patients with symptomatic breast cancer. Only 3 of the screen-detected patients with micrometastases, all with tumour size >15 mm (range 18-39 mm), had metastases in the completion ALND whereas this was found in 18 of the symptomatic patients with micrometastases (p = 0.01), (tumour size, range 10-30 mm). Logistic regression analysis adjusted for method of detection, tumour size and histological grade showed 5 times higher odds for further metastases in ALND in patients with symptomatic presentation vs. screen-detected breast cancer. CONCLUSION: Despite the small number of patients with micrometastases in this large cohort of breast cancer patients, these results support the contention that completion ALND can safely be omitted in screen-detected breast cancer patients with micrometastases in the SNs.}},
author = {{Grabau, Dorthe and Dihge, Looket and Fernö, Mårten and Ingvar, Christian and Rydén, Lisa}},
issn = {{1532-2157}},
language = {{eng}},
number = {{6}},
pages = {{601--607}},
publisher = {{Elsevier}},
series = {{European Journal of Surgical Oncology}},
title = {{Completion axillary dissection can safely be omitted in screen detected breast cancer patients with micrometastases. A decade's experience from a single institution.}},
url = {{http://dx.doi.org/10.1016/j.ejso.2013.03.012}},
doi = {{10.1016/j.ejso.2013.03.012}},
volume = {{39}},
year = {{2013}},
}