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The axillary nodal harvest in breast cancer surgery is unchanged by sentinel node biopsy or the timing of surgery.

Byrne BE, Cutress RI, Gill J, Wise MH, Yiangou C, Agrawal A - Int J Breast Cancer (2012)

Bottom Line: The total pathological nodal count and the number of metastatic nodes were compared between the groups.Results.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Royal Bournemouth Hospital, Royal Bournemouth and Christchurch NHS Foundation Trust, Castle Lane East, Bournemouth BH7 7DW, UK.

ABSTRACT
Introduction. Patients with a positive sentinel lymph node biopsy may undergo delayed completion axillary dissection. Where intraoperative analysis is available, immediate completion axillary dissection can be performed. Alternatively, patients may undergo primary axillary dissection for breast cancer, historically or when preoperative assessment suggests axillary metastases. This study aims to determine if there is a difference in the total number of lymph nodes or the number of metastatic nodes harvested between the 3 possible approaches. Methods. Three consecutive comparable groups of 50 consecutive patients who underwent axillary dissection in each of the above contexts were identified from the Portsmouth Breast Unit Database. Patient demographics, clinicopathological variables, and surgical treatment were recorded. The total pathological nodal count and the number of metastatic nodes were compared between the groups. Results. There were no differences in clinico-pathological features between the three groups for all features studied with the exception of breast surgical procedure (P < 0.001). There were no differences in total nodal harvest (P = 0.822) or in the number of positive nodes harvested (P = 0.157) between the three groups. Conclusion. The three approaches to axillary clearance yield equivalent nodal harvests, suggesting oncological equivalence and robustness of surgical technique.

No MeSH data available.


Related in: MedlinePlus

Mean total number of nodes harvested in the three cohorts (±95% confidence interval). Group classification of patients by axillary procedure: group 1: rimary axillary clearance; group 2: SLNB and dALND; group 3: SLNB and iALND.
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fig1: Mean total number of nodes harvested in the three cohorts (±95% confidence interval). Group classification of patients by axillary procedure: group 1: rimary axillary clearance; group 2: SLNB and dALND; group 3: SLNB and iALND.

Mentions: All three patient groups were statistically similar regarding both outcome measures—total number of nodes harvested from the axilla and the total number of positive nodes harvested (Table 2 and Figures 1 and 2). The mean total number of nodes harvested ranged from 14.6 to 15.4 with clearly overlapping 95% confidence intervals as illustrated in Figure 1. The mean number of positive nodes was higher in group 1 at 5.1, compared with 3.2 and 3.52 in groups 2 and 3, respectively, but 95% confidence intervals overlap, and no statistically significant difference was found (Figure 2). Consistent with this the median total number of nodes harvested was 14 in all three groups. The median number of positive nodes was also 2 across all patient groups.


The axillary nodal harvest in breast cancer surgery is unchanged by sentinel node biopsy or the timing of surgery.

Byrne BE, Cutress RI, Gill J, Wise MH, Yiangou C, Agrawal A - Int J Breast Cancer (2012)

Mean total number of nodes harvested in the three cohorts (±95% confidence interval). Group classification of patients by axillary procedure: group 1: rimary axillary clearance; group 2: SLNB and dALND; group 3: SLNB and iALND.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3369471&req=5

fig1: Mean total number of nodes harvested in the three cohorts (±95% confidence interval). Group classification of patients by axillary procedure: group 1: rimary axillary clearance; group 2: SLNB and dALND; group 3: SLNB and iALND.
Mentions: All three patient groups were statistically similar regarding both outcome measures—total number of nodes harvested from the axilla and the total number of positive nodes harvested (Table 2 and Figures 1 and 2). The mean total number of nodes harvested ranged from 14.6 to 15.4 with clearly overlapping 95% confidence intervals as illustrated in Figure 1. The mean number of positive nodes was higher in group 1 at 5.1, compared with 3.2 and 3.52 in groups 2 and 3, respectively, but 95% confidence intervals overlap, and no statistically significant difference was found (Figure 2). Consistent with this the median total number of nodes harvested was 14 in all three groups. The median number of positive nodes was also 2 across all patient groups.

Bottom Line: The total pathological nodal count and the number of metastatic nodes were compared between the groups.Results.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Royal Bournemouth Hospital, Royal Bournemouth and Christchurch NHS Foundation Trust, Castle Lane East, Bournemouth BH7 7DW, UK.

ABSTRACT
Introduction. Patients with a positive sentinel lymph node biopsy may undergo delayed completion axillary dissection. Where intraoperative analysis is available, immediate completion axillary dissection can be performed. Alternatively, patients may undergo primary axillary dissection for breast cancer, historically or when preoperative assessment suggests axillary metastases. This study aims to determine if there is a difference in the total number of lymph nodes or the number of metastatic nodes harvested between the 3 possible approaches. Methods. Three consecutive comparable groups of 50 consecutive patients who underwent axillary dissection in each of the above contexts were identified from the Portsmouth Breast Unit Database. Patient demographics, clinicopathological variables, and surgical treatment were recorded. The total pathological nodal count and the number of metastatic nodes were compared between the groups. Results. There were no differences in clinico-pathological features between the three groups for all features studied with the exception of breast surgical procedure (P < 0.001). There were no differences in total nodal harvest (P = 0.822) or in the number of positive nodes harvested (P = 0.157) between the three groups. Conclusion. The three approaches to axillary clearance yield equivalent nodal harvests, suggesting oncological equivalence and robustness of surgical technique.

No MeSH data available.


Related in: MedlinePlus