Inequality in sentinel lymph node dissection for elderly women with early stage breast cancer: Results from a French prospective cohort study

Abstract

Abstract Objective To identify factors associated with under-use of sentinel lymph node dissection (SLND). Materials and Methods This study was performed in ELIPPSE 65, a representative cohort of women aged ≥65 with breast cancer. We included all women eligible for SLND. Characteristics of those who had received SLND – whether or not axillary lymph node dissection (ALND) was subsequently carried out – were compared with those having received immediate ALND without prior SLND. Results A total of 349 women were eligible for SLND. After excluding those without surgery or with unknown axillary surgery type, 337 women were analyzed. Immediate ALND was performed in 20% of cases. Immediate ALND had been performed more frequently in women aged ≥75 and in those who had poor family support. Conclusion Although SLND is a widespread surgical practice, many women still have unnecessary ALND. This is particularly detrimental for elderly women as their life may be strongly impaired by lymphedema.