Axillary management for young women with breast cancer varies between patients electing breast-conservation therapy or mastectomy Journal Article
| Authors: | Tadros, A. B.; Moo, T. A.; Stempel, M.; Zabor, E. C.; Khan, A. J.; Morrow, M. |
| Article Title: | Axillary management for young women with breast cancer varies between patients electing breast-conservation therapy or mastectomy |
| Abstract: | Purpose: Axillary treatment strategies for the young woman with early-stage, clinically node-negative breast cancer undergoing upfront surgery found to have 1–3 positive sentinel lymph nodes (SLNs) differ significantly after BCT and mastectomy. Here we compare axillary lymph node dissection (ALND) and regional nodal irradiation (NRI) rates between women electing breast-conservation therapy (BCT) versus mastectomy. Methods: From 2010 to 2016, women age < 50 years with clinical T1-T2N0 breast cancer having upfront surgery and found to have a positive SLN were identified. ALND and/or NRI receipt were compared between groups. Results: 192 women undergoing BCT and 165 undergoing mastectomy were identified (median age: 44 years). 5.2% (10/192) of women undergoing BCT had an ALND versus 87% (144/165) of women undergoing mastectomy (p < 0.01). NRI was given to 48% (78/165) of mastectomy patients compared to 30% (57/192) of BCT patients (p < 0.01). Of the 75 mastectomy patients with 1–2 total positive lymph nodes after completion ALND, 44% received NRI. Women undergoing mastectomy were significantly more likely to receive both ALND and NRI than women undergoing BCS (45% vs 6%, p < 0.01). Conclusion: Young cT1-2N0 breast cancer patients found to have 1–3 SLN metastases received ALND, NRI, and combined ALND/NRI more frequently if they elected mastectomy over BCT. Use of both ALND and postmastectomy radiotherapy (PMRT) in this population could be reduced in the future by omitting ALND in patients for whom the need for PMRT is clear with the finding of 1–2 SLN metastases. © 2020, Springer Science+Business Media, LLC, part of Springer Nature. |
| Keywords: | adult; controlled study; major clinical study; cancer patient; cancer staging; lymph node metastasis; lymph node dissection; sentinel lymph node; breast cancer; mastectomy; cohort analysis; high risk patient; axillary lymph node; population research; intermethod comparison; lymph node irradiation; lumpectomy; axillary lymph node dissection; elective surgery; human; female; priority journal; article; breast-conservation therapy; regional nodal irradiation |
| Journal Title: | Breast Cancer Research and Treatment |
| Volume: | 180 |
| Issue: | 1 |
| ISSN: | 0167-6806 |
| Publisher: | Springer |
| Date Published: | 2020-02-01 |
| Start Page: | 197 |
| End Page: | 205 |
| Language: | English |
| DOI: | 10.1007/s10549-019-05520-5 |
| PUBMED: | 31938938 |
| PROVIDER: | scopus |
| PMCID: | PMC7035176 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 April 2020 -- Source: Scopus |
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