Regional Radiotherapy Versus an Axillary Lymph Node Dissection After Lumpectomy: a Safe Alternative for an Axillary Lymph Node Dissection in a Clinically Uninvolved Axilla in Breast Cancer. A Case Control Study with 10 Years Follow Up

Overview

Journal Radiat Oncol

Publisher Biomed Central

Specialties Oncology
Radiology

Date 2007 Nov 1

PMID 17971196

Citations 4

Authors

Patty H Spruit

Sabine Siesling

Marloes A G Elferink

Ernest J A Vonk

Carel J M Hoekstra

Affiliations

Soon will be listed here.

Abstract

Background: The standard treatment of the axilla in breast cancer used to be an axillary lymph node dissection. An axillary lymph node dissection is known to give substantial risks of morbidity. In recent years the sentinel node biopsy has become common practice. Future randomized study results will determine whether the expected decrease in morbidity can be proven.

Methods: Before the introduction of the sentinel node biopsy, we conducted a study in which 180 women of 50 years and older with T1/T2 cN0 breast cancer were treated with breast conserving therapy. Instead of an axillary lymph node dissection regional radiotherapy was given in combination with tamoxifen (RT-group). The study group was compared with 341 patients, with the same patient and tumour characteristics, treated with an axillary lymph node dissection (S-group).

Results: The treatment groups were comparable, except for age. The RT-group was significantly older than the S-group. The median follow up was 7.2 years. The regional relapse rates were low and equal in both treatment groups, 1.1% in RT-group versus 1.5% in S-group at 5 years. The overall survival was similar; the disease free survival was significant better in the RT-group.

Conclusion: Regional recurrence rates after regional radiotherapy are very low and equal to an axillary lymphnode dissection.

Citing Articles

Effects on lymph node size, staging and primary tumor histology on diagnostic accuracy of axillary lymph node aspirate of breast cancers.

Li J, Ng J, Hon N, See K, Tsang J, Tse G Breast Cancer Res Treat. 2024; 209(1):15-20.

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Can axillary radiotherapy replace axillary dissection for patients with positive sentinel nodes? A systematic review and meta-analysis.

Zhao M, Liu W, Zhang L, Jin Z, Li Z, Liu C Chronic Dis Transl Med. 2017; 3(1):41-50.

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Axillary Irradiation as an Imperative Alternative to Axillary Dissection in Clinically Lymph Node-Negative but Sentinel Node-Positive Breast Cancer Patients?.

Nitsche M, Hermann R Breast Care (Basel). 2012; 6(5):353-358.

PMID: 22619644 PMC: 3357141. DOI: 10.1159/000333835.

How do I deal with the axilla in patients with a positive sentinel lymph node?.

Falkson C Curr Treat Options Oncol. 2011; 12(4):389-402.

PMID: 21979858 DOI: 10.1007/s11864-011-0170-4.

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