Axillary Lymph Node Dissection Does Not Affect Survival

TUESDAY, Feb. 8 (HealthDay News) -- Patients who have limited sentinel lymph node (SLN) metastatic breast cancer have similar survival rates when treated with sentinel lymph node dissection (SLND) or axillary lymph node dissection (ALND), according to a study published in the Feb. 9 issue of the Journal of the American Medical Association.

Armando E. Giuliano, M.D., from Saint John's Health Center in Santa Monica, Calif., and colleagues studied women enrolled in the American College of Surgeons Oncology Group Z0011 trial between 1999 and 2004. All women had clinical T1-T2 invasive breast cancer, and underwent lumpectomy and tangential whole-breast irradiation. Women with SLN metastases noted from the SLND were randomly assigned to undergo ALND, involving dissection of 10 or more nodes, or not to have additional axillary treatment.

The researchers found that the clinical and tumor characteristics were similar for women treated with ALND or with SLND. On average, 17 nodes were removed with ALND, and two with SLND. There was an average follow-up of 6.3 years. The five-year survival rate for ALND was 91.8 percent and for SLND was 92.5 percent. The five-year disease-free survival was 82.2 percent for the ALND group and 83.9 percent with SLND. After adjusting for age and adjuvant therapy, the hazard ratio for treatment-related overall survival was 0.87.

"Results from Z0011 indicate that women with a positive SLN and clinical T1-T2 tumors undergoing lumpectomy with radiation therapy followed by systemic therapy do not benefit from the addition of ALND in terms of local control, disease-free survival, or overall survival," the authors write.

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