Annals of Surgical Oncology

, Volume 24, Issue 3, pp 652–659

Outcomes of Sentinel Lymph Node-Positive Breast Cancer Patients Treated with Mastectomy Without Axillary Therapy

  • Elizabeth FitzSullivan
  • Roland L. Bassett
  • Henry M. Kuerer
  • Elizabeth A. Mittendorf
  • Min Yi
  • Kelly K. Hunt
  • Gildy V. Babiera
  • Abigail S. Caudle
  • Dalliah M. Black
  • Isabelle Bedrosian
  • Chantal Reyna
  • Mediget Teshome
  • Funda Meric-Bernstam
  • Rosa Hwang
Breast Oncology

DOI: 10.1245/s10434-016-5605-5

Cite this article as:
FitzSullivan, E., Bassett, R.L., Kuerer, H.M. et al. Ann Surg Oncol (2017) 24: 652. doi:10.1245/s10434-016-5605-5

Abstract

Purpose

Early-stage breast cancer patients with minimal axillary disease identified by sentinel lymph node dissection (SLND) have low regional recurrence rates when treated with breast-conserving surgery and radiation therapy (XRT) and many avoid a completion axillary lymph node dissection (CLND). As the incidence of total mastectomy (TM) has increased, it has become important to characterize which TM patients with a positive SLN may not benefit from further axillary treatment.

Methods

An institutional database was utilized to identify patients treated with a TM for invasive breast cancer and who had a positive SLN from 1994 to 2010. Clinicopathologic factors were analyzed. Regional recurrence rate, recurrence-free survival (RFS), and overall survival (OS) were determined.

Results

A total of 525 patients with invasive breast cancer and a positive SLN were treated with TM, including 58 patients who did not have CLND or XRT and 12 patients who did not have CLND but did receive XRT. Median follow-up was 66 months. The incidence of regional recurrence was not significantly different for patients who received no further axillary treatment compared to those who underwent CLND without XRT or those treated with XRT without CLND (10 years rate: 3.8 vs. 1.6 and 0 % respectively). RFS and OS were not significantly different among patients who received no further axillary treatment compared to those who underwent CLND, XRT, or both.

Conclusions

In select patients with early-stage breast cancer treated with mastectomy with a positive SLN, CLND may be avoided without adversely affecting recurrence or survival.

Supplementary material

10434_2016_5605_MOESM1_ESM.mp3 (2.7 mb)
Supplementary material 1 (MP3 2743 KB)

Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Elizabeth FitzSullivan
    • 1
  • Roland L. Bassett
    • 2
  • Henry M. Kuerer
    • 1
  • Elizabeth A. Mittendorf
    • 1
  • Min Yi
    • 1
  • Kelly K. Hunt
    • 1
  • Gildy V. Babiera
    • 1
  • Abigail S. Caudle
    • 1
  • Dalliah M. Black
    • 1
  • Isabelle Bedrosian
    • 1
  • Chantal Reyna
    • 1
  • Mediget Teshome
    • 1
  • Funda Meric-Bernstam
    • 1
  • Rosa Hwang
    • 1
  1. 1.Department of Breast Surgical OncologyThe University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of BiostatisticsThe University of Texas MD Anderson Cancer CenterHoustonUSA