Trends, survival and regional control of sentinel lymph node biopsy versus axillary dissection in cN0 breast cancer: a multicenter cohort in China - Summary - MDSpire
Advertisement
Trends, survival and regional control of sentinel lymph node biopsy versus axillary dissection in cN0 breast cancer: a multicenter cohort in China
To quantify national trends in axillary de-escalation and assess long-term regional node control and survival associated with SLNB versus ALND in cN0, pN1 breast cancer.
Approach:
Study Design: A nationwide, multicenter hospital-based retrospective cohort study using the National Cancer Center Oncology Information Database (NCCOID) from 2013 to 2022.
Patient Population: Identified 53,758 female patients with cN0, pT1-3, pN0–1 breast cancer.
Statistical Methods: Used propensity score matching and competing-risks models to compare survival and regional nodal recurrence between SLNB and ALND.
Key Findings:
SLNB use increased from 18.8% to 75.3% in pN0 and from 9.7% to 48.2% in pN1.
In pN0, 5-year regional nodal recurrence (RNR) was similar for SLNB versus ALND (1.06% vs 0.96%).
In pN1, SLNB was associated with higher 5-year RNR after breast-conserving surgery (4.99% vs 1.27%).
In the mastectomy cohort, 5-year RNR did not differ between SLNB and ALND (3.01% vs 2.05%).
Interpretation:
SLNB is associated with a higher risk of regional nodal recurrence in pN1 patients treated with breast-conserving surgery.
Limitations:
Real-world evidence may not fully align with clinical trial results due to variations in treatment protocols.
The study is retrospective, which may introduce biases.
