Therapeutic effect of axillary lymph node dissection and local radiotherapy on patients with stage I-II sentinel lymph node-positive breast cancer

Abstract

Objective To compare the recurrence rate and survival rate of axillary lymphadenectomy and axillary local radiotherapy after breast-conserving surgery in patients with stage Ⅰ-Ⅱ breast cancer who were positive for sentinel lymph node biopsy. Methods A retrospective analysis of 137 patients with stage Ⅰ-Ⅱ breast cancer who were positive for sentinel lymph node biopsy from January 2010 to July 2015 in Yulin First Hospital was performed. Patients underwent axillary lymph node dissection (ALND) after breast-conserving surgery were assigned to the ALND group (n=92), patients with axillary local radiotherapy (RNI) after breast-conserving surgery were assigned to the RNI group (n=45), and the general clinical characteristics (mean age, menopause, clinical stage, etc.) were compared between the two groups, and prognosis (2-year recurrence rate, distant metastasis rate, cumulative 2-year event-free survival, cumulative 2-year overall survival). Measurement data were expressed as (±s), and t test was used for comparison between groups; count data was expressed as rate (%), and chi-square test was used for comparison between groups. Results There were no statistical differences in general clinical characteristics (mean age, menopausal number, clinical stage, etc.) between the two groups. For patients with stage Ⅰ-Ⅱ sentinel lymph node-positive adenocarcinoma, breast-conserving surgery plus axillary lymph node dissection (ALND group) and breast-conserving 2-year recurrence rate (4.4%, 6.7%, P=0.87) and distant metastasis rate (9.7%, 15.6%, P=0.48) and cumulative 2 years of surgery plus axillary local radiotherapy (RNI group) There were no statistically significant differences in event-free survival (85.9%, 75.6%, P=0.14) and cumulative 2-year overall survival (90.2%, 86.7%, P=0.53). Conclusion For patients with stage Ⅰ-Ⅱ sentinel-positive breast cancer, axillary RNI may be a new treatment for ALND. Key words: Breast neoplasms; Lymph nodes; Lymph node excision; Radiotherapy; Sentinel lymph node biopsy; Axillary lymph node dissection; Breast conserving surgery