Axillary treatment for operable primary breast cancer.
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ABSTRACT:
SUBMITTER: Bromham N
PROVIDER: S-EPMC6464919 | biostudies-literature | 2017 Jan
REPOSITORIES: biostudies-literature
Publications
Axillary treatment for operable primary breast cancer.
Bromham Nathan N Schmidt-Hansen Mia M Astin Margaret M Hasler Elise E Reed Malcolm W MW
The Cochrane database of systematic reviews 20170104
<h4>Background</h4>Axillary surgery is an established part of the management of primary breast cancer. It provides staging information to guide adjuvant therapy and potentially local control of axillary disease. Several alternative approaches to axillary surgery are available, most of which aim to spare a proportion of women the morbidity of complete axillary dissection.<h4>Objectives</h4>To assess the benefits and harms of alternative approaches to axillary surgery (including omitting such surg ...[more]
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Project description: Not available
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Project description:PurposeWe conducted this study to investigate the prognosis and failure pattern after breast-conserving treatment (BCT) in patients with occult breast cancer (OBC) with negative breast magnetic resonance imaging (MRI) (MRI-OBC).Materials and methodsSurvival rates and failure patterns in 66 patients who received axillary lymph node dissection (ALND) and BCT for MRI-OBC between 2001 and 2013 at seven hospitals were analyzed. OBC was defined as adenocarcinoma in the axillary lymph node (ALN) +/- supraclavicular (SCN) or internal mammary lymph node (IMN) with a negative breast MRI.ResultsFifty-four patients had only ALN metastasis (ALN only), and 12 patients had ALN metastasis along with SCN or IMN metastasis (ALN + SCN/IMN). Median follow-up was 82 months. The 5-year overall, disease-free, and breast cancer-free survival rates were 93.4%, 92.1%, and 96.8%, respectively. Nine patients experienced recurrence: breast (n = 4), regional lymph nodes (RLN, n = 1), distant metastases (DM, n = 2), breast/RLN (n = 1), and breast/RLN/DM (n = 1). Five-year disease-free survival was significantly higher in ALN only patients compared to ALN + SCN/IMN patients (96.1% vs. 75.0%; p = 0.02).ConclusionsPatients with MRI-OBC were successfully treated with BCT. There was a small risk of ipsilateral breast cancer recurrence. Failure patterns depended on the extent of initial disease.
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