BACKGROUND: We assess complication rates in node negative breast cancer patients treated with breast radiotherapy (RT) only after sentinel lymph node dissection (SLND) or axillary lymph node dissection (ALND). MATERIALS AND METHODS: Between 1995 and 2001, 226 women with AJCC stage I-II breast cancer were treated with lumpectomy, either SLND or SLND+ALND, and had available toxicities in follow-up: 111/136 (82%) and 115/129 (89%) in SLND and ALND groups, respectively. RT targeted the breast to median dose of 48.2 Gy (range, 46.0 to 50.4 Gy) without axillary RT. Chi-square tests compared complication rates of 2 groups for axillary web syndrome (AWS), seroma, wound infection, decreased range of motion of the ipsilateral shoulder, paresthesia, and lymphedema. RESULTS: Median follow-up was 9.9 years (range, 8.3-15.3 y). Median number of nodes assessed was 2 (range, 1-5) in SLND and 18 (range, 7-36) in ALND (P < 0.0001). Acute complications occurred during the first 2 years and were AWS, seroma, and wound infection. Incidences of seroma 5/111 (4.5%) in SLND and 16/115 (13.9%) in ALND (P < 0.02, respectively) and wound infection 3/111 (2.7%) in SLND and 10/115 (8.7%) in ALND (P < 0.05, respectively) differed significantly. AWS was not statistically different between the groups. At 10 years, the only chronic complications decreased were range of motion of the shoulder 46/111 (41.4%) in SLND and 92/115 (80.0%) in ALND (P < 0.0001), paresthesia 12/111 (10.8%) in SLND and 39/115 (33.9%) in ALND (P < 0.0001), and lymphedema assessed by patients 10/111 (10.0%) in SLND and 39/115 (33.9%) in ALND (P < 0.0001). Chronic lymphedema, assessed by clinicians, occurred in 6/111 (5.4%) in SLND and 21/115 (18.3%) in ALND cohorts, respectively (P < 0.0001). CONCLUSIONS: Our mature findings support that in patients with negative axillary nodal status SLND and breast RT provide excellent long-term cure rates while avoiding morbidities associated with ALND or addition of axillary RT field.
BACKGROUND: We assess complication rates in node negative breast cancerpatients treated with breast radiotherapy (RT) only after sentinel lymph node dissection (SLND) or axillary lymph node dissection (ALND). MATERIALS AND METHODS: Between 1995 and 2001, 226 women with AJCC stage I-II breast cancer were treated with lumpectomy, either SLND or SLND+ALND, and had available toxicities in follow-up: 111/136 (82%) and 115/129 (89%) in SLND and ALND groups, respectively. RT targeted the breast to median dose of 48.2 Gy (range, 46.0 to 50.4 Gy) without axillary RT. Chi-square tests compared complication rates of 2 groups for axillary web syndrome (AWS), seroma, wound infection, decreased range of motion of the ipsilateral shoulder, paresthesia, and lymphedema. RESULTS: Median follow-up was 9.9 years (range, 8.3-15.3 y). Median number of nodes assessed was 2 (range, 1-5) in SLND and 18 (range, 7-36) in ALND (P < 0.0001). Acute complications occurred during the first 2 years and were AWS, seroma, and wound infection. Incidences of seroma 5/111 (4.5%) in SLND and 16/115 (13.9%) in ALND (P < 0.02, respectively) and wound infection 3/111 (2.7%) in SLND and 10/115 (8.7%) in ALND (P < 0.05, respectively) differed significantly. AWS was not statistically different between the groups. At 10 years, the only chronic complications decreased were range of motion of the shoulder 46/111 (41.4%) in SLND and 92/115 (80.0%) in ALND (P < 0.0001), paresthesia 12/111 (10.8%) in SLND and 39/115 (33.9%) in ALND (P < 0.0001), and lymphedema assessed by patients 10/111 (10.0%) in SLND and 39/115 (33.9%) in ALND (P < 0.0001). Chronic lymphedema, assessed by clinicians, occurred in 6/111 (5.4%) in SLND and 21/115 (18.3%) in ALND cohorts, respectively (P < 0.0001). CONCLUSIONS: Our mature findings support that in patients with negative axillary nodal status SLND and breast RT provide excellent long-term cure rates while avoiding morbidities associated with ALND or addition of axillary RT field.
Authors: U Veronesi; G Paganelli; V Galimberti; G Viale; S Zurrida; M Bedoni; A Costa; C de Cicco; J G Geraghty; A Luini; V Sacchini; P Veronesi Journal: Lancet Date: 1997-06-28 Impact factor: 79.321
Authors: R Orecchia; A Huscher; M C Leonardi; R Gennari; V Galimberti; C Garibaldi; E Rondi; L C Bianchi; S Zurrida; S Franzetti Journal: Br J Radiol Date: 2005-01 Impact factor: 3.039
Authors: Anthony Lucci; Linda Mackie McCall; Peter D Beitsch; Patrick W Whitworth; Douglas S Reintgen; Peter W Blumencranz; A Marilyn Leitch; Sukumal Saha; Kelly K Hunt; Armando E Giuliano Journal: J Clin Oncol Date: 2007-05-07 Impact factor: 44.544
Authors: Sarah A McLaughlin; Mary J Wright; Katherine T Morris; Michelle R Sampson; Julia P Brockway; Karen E Hurley; Elyn R Riedel; Kimberly J Van Zee Journal: J Clin Oncol Date: 2008-10-06 Impact factor: 44.544
Authors: Umberto Veronesi; Viviana Galimberti; Giovanni Paganelli; Patrick Maisonneuve; Giuseppe Viale; Roberto Orecchia; Alberto Luini; Mattia Intra; Paolo Veronesi; Pietro Caldarella; Giuseppe Renne; Nicole Rotmensz; Claudia Sangalli; Luciana De Brito Lima; Marco Tullii; Stefano Zurrida Journal: Eur J Cancer Date: 2009-01-06 Impact factor: 9.162
Authors: F Baggi; Luiz Felipe Nevola Teixeira; S Gandini; M C Simoncini; E Bonacossa; F Sandrin; M Sciotto Marotta; G Lanni; P Dadda; D Colpani; A Luini Journal: Support Care Cancer Date: 2018-03-05 Impact factor: 3.603
Authors: Jean O'Toole; Lauren S Jammallo; Melissa N Skolny; Cynthia L Miller; Krista Elliott; Michelle C Specht; Alphonse G Taghian Journal: Crit Rev Oncol Hematol Date: 2013-06-16 Impact factor: 6.312
Authors: Betty Smoot; Bruce A Cooper; Yvette Conley; Kord Kober; Jon D Levine; Judy Mastick; Kimberly Topp; Christine Miaskowski Journal: J Cancer Surviv Date: 2015-12-18 Impact factor: 4.442