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Annals of Surgical Oncology

, Volume 20, Issue 2, pp 627–632 | Cite as

When is a Lymph Node Dissection a Lymph Node Dissection? The Number of Lymph Nodes Resected in Sentinel and Axillary Lymph Node Dissections

  • Windy Olaya
  • Jasmine Wong
  • Jan Wong
  • John Morgan
  • Kevork Kazanjian
  • Sharon LumEmail author
Breast Oncology

Abstract

Purpose

We sought to compare the number of lymph nodes (LN) resected in axillary lymph node dissections (ALND) and sentinel lymph node dissections (SLND), and to assess the validity of registry reporting for axillary staging in breast cancer.

Methods

Women in the California Cancer Registry who underwent surgical axillary staging for T1/T2, M0 breast cancer between 2004 and 2008 were evaluated. The number of LN resected in patients reported as having SLND+ALND and ALND were assessed for compliance with 6 and 10 LN threshold definitions for ALND. The proportion of patients with ≤3 LN removed was assessed for patients receiving SLND only.

Results

Of 71,907 patients, 45.5 % had SLND, 24.0 %, SLND+ALND, and 30.5 %, ALND. The median number of LN resected with SLND cases was 2 (range 1–41); SLND+ALND, 9 (range 1–63); and ALND, 11 (range 1–81) (p < 0.0001). Of patients undergoing ALND, 56.7 % had ≥10 LN removed; 46.2 % of patients with SLND+ALND had ≥10 LN removed (p < 0.0001). Overall, 75.5 % of patients with ALND had ≥6 LN removed and 67.8 % of patients with SLND+ALND had ≥6 LN removed (p < 0.0001). Of those receiving only SLND, 83.4 % had ≤3 LN removed.

Conclusions

A significant proportion of patients did not meet the minimum LN count thresholds for full ALND or had excess LN removed in a SLND. Further investigation is required to determine whether absolute LN number or reported operative procedure and implied surgical technique better defines axillary staging in a registry database.

Keywords

Sentinel Node Axillary Lymph Node Dissection Lymph Node Count Sentinel Lymph Node Dissection Axillary Staging 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

Supported in part by NCI/SEER contracts N01-PC-35136, N01-PC-35139, and N02-PC-15105; CDC/National Program for Cancer Registries contract U58DP000807-01; and the California Department of Public Health, Cancer Surveillance Branch.

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Copyright information

© Society of Surgical Oncology 2012

Authors and Affiliations

  • Windy Olaya
    • 1
  • Jasmine Wong
    • 1
  • Jan Wong
    • 2
  • John Morgan
    • 3
    • 4
  • Kevork Kazanjian
    • 1
  • Sharon Lum
    • 1
    • 4
    Email author
  1. 1.Division of Surgical Oncology, Department of SurgeryLoma Linda University School of MedicineLoma LindaUSA
  2. 2.Division of Surgical Oncology, Department of SurgeryBrody School of Medicine, East Carolina UniversityGreenvilleUSA
  3. 3.Loma Linda University School of Public HealthLoma LindaUSA
  4. 4.Desert Sierra Cancer Surveillance Program, California Cancer RegistryLoma Linda UniversityLoma LindaUSA

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