Trends, survival and regional control of sentinel lymph node biopsy versus axillary dissection in cN0 breast cancer: a multicenter cohort in China - Report - MDSpire
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Trends, survival and regional control of sentinel lymph node biopsy versus axillary dissection in cN0 breast cancer: a multicenter cohort in China
Clinical Report: Regional Control and Survival Outcomes in Breast Cancer
Overview
This study evaluates the effectiveness of sentinel lymph node biopsy (SLNB) compared to axillary lymph node dissection (ALND) in patients with clinically node-negative (cN0) breast cancer.
Background
Breast cancer remains a leading cause of cancer-related morbidity and mortality among women globally. The shift from ALND to SLNB for cN0 patients aims to reduce surgical morbidity.
Data Highlights
Parameter
SLNB
ALND
5-year RNR (pN0)
1.06%
0.96%
5-year RNR (pN1, BCS)
4.99%
1.27%
5-year RNR (pN1, Mastectomy)
3.01%
2.05%
Key Findings
SLNB use increased significantly from 18.8% to 75.3% in pN0 patients.
In pN1 patients undergoing breast-conserving surgery, SLNB was associated with a higher 5-year regional nodal recurrence (RNR) rate (4.99% vs 1.27%; P = 0.033).
For pN1 patients treated with mastectomy, 5-year RNR did not differ significantly between SLNB and ALND (3.01% vs 2.05%; P = 0.946).
Higher RNR in pN1 patients was most pronounced for those with Ki-67 ≥30% and no special type histology.
Clinical Implications
Adherence to adjuvant treatment guidelines is essential to mitigate the risk of regional nodal recurrence in pN1 patients.
Conclusion
SLNB is effective for pN0 patients but may pose risks for pN1 patients undergoing breast-conserving surgery.
