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Regional Disease Control in Selected Patients with Sentinel Lymph Node Involvement and Omission of Axillary Lymph Node Dissection

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Pathology & Oncology Research

Abstract

Whether an axillary lymph node dissection (ALND) is needed for breast cancer patients with minimal sentinel lymph node (SLN) involvement is arguable despite recent data supporting the omission of axillary clearance in these patients. Data on disease recurrence of 111 patients with SLN involvement and no ALND were analysed. Patients with minimal SLN involvement were assessed for their risk of non-SLN metastasis by means of several nomograms. The series included patients with isolated tumour cells (n = 76), micrmetastasis (n = 33) and macrometastasis (n = 2) who were followed for a median of 37 months (range 12–148 months). Six patients died, 3 of disease and 3 of unrelated causes. Eight further patients had breast cancer related events: 1 local breast recurrence and seven distant metastases. No axillary regional recurrence was detected. Disease related events were not associated with the risk of non-SLN metastasis. The presented data suggest that omitting ALND in patients with low volume SLN metastasis may be a safe procedure, and support the observation that systemic disease recurrence may not be associated with axillary recurrence or the risk of NSLN involvement predicted by nomograms.

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Acknowledgments

The authors acknowledge the general support of Drs József Pap-Szekeres and Gábor Pajkos, heads of the Departments of Surgery and Oncology at the Bács-Kiskun County Teaching Hospital, respectively. The help of Gábor Fejes, Department of Informatics is also kindly acknowledged.

Conflict of Interest

The authors have no conflict of interest to report.

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Authors and Affiliations

  1. Department of Pathology, Bács-Kiskun County Teaching Hospital, Nyiri ut 38, H-6000, Kecskemét, Hungary

    Gábor Cserni

  2. Department of Pathology, University of Szeged, Allomas u. 2, H-6720, Szeged, Hungary

    Gábor Cserni

  3. Department of Surgery, Bács-Kiskun County Teaching Hospital, Nyiri ut 38, H-6000, Kecskemét, Hungary

    Róbert Maráz

  4. Department of Oncology, Bács-Kiskun County Teaching Hospital, Nyiri ut 38, H-6000, Kecskemét, Hungary

    Róbert Maráz

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  1. Gábor Cserni
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Correspondence to Gábor Cserni.

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Cserni, G., Maráz, R. Regional Disease Control in Selected Patients with Sentinel Lymph Node Involvement and Omission of Axillary Lymph Node Dissection. Pathol. Oncol. Res. 21, 861–866 (2015). https://doi.org/10.1007/s12253-015-9899-6

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  • DOI: https://doi.org/10.1007/s12253-015-9899-6

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