Abstract
Introduction:
Traditionally, completion axillary lymph node dissection (ALND) has been standard for breast cancer patients with positive sentinel lymph nodes (SLNs). However, ALND poses risks of morbidity. Recent trials suggest omission of ALND may be safe in selected cases. Controversy exists regarding ALND omission in mastectomy patients with micrometastases.
Methods:
A retrospective study analyzed data from two databases: Shanghai Jiao Tong University Breast Cancer Data Base (SJTUBCDB) and the Surveillance, Epidemiology, and End Results (SEER) database. Patients with T1-2 breast cancer and SLN micrometastases undergoing mastectomy were included. Patients were stratified into Non-ALND and ALND groups. Clinicopathological factors and outcomes were compared.
Results:
Among 118 SJTUBCDB patients and 4,884 SEER patients, Non-ALND group exhibited non-inferiority in terms of recurrence-free survival (RFS), locoregional recurrence-free survival (LRFS), breast cancer-specific survival (BCSS), and overall survival (OS) compared to ALND group. Multivariable analysis identified predictors of survival outcomes.
Conclusion:
This study supports the omission of ALND in T1-2N1mi breast cancer patients undergoing mastectomy, demonstrating comparable survival outcomes to those undergoing ALND. Proper patient selection is essential for tailored treatment strategies.