Background Data: Axillary dissection, an invasive procedure that may adversely affect quality of life, used to obtain prognostic information in breast cancer, is being supplanted by sentinel node biopsy. In older women with early breast cancer and no palpable axillary nodes, it may be safe to give no axillary treatment. We addressed this issue in a randomized trial comparing axillary dissection with no axillary dissection in older patients with T1N0 breast cancer. Methods: From 1996 to 2000, 219 women, 65 to 80 years of age, with early breast cancer and clinically negative axillary nodes were randomized to conservative breast surgery with or without axillary dissection. Tamoxifen was prescribed to all patients for 5 years. The primary endpoints were axillary events in the no axillary dissection arm, comparison of overall mortality (by log rank test), breast cancer mortality, and breast events (by Gray test). Results: Considering a follow-up of 60 months, there were no significant differences in overall or breast cancer mortality, or crude cumulative incidence of breast events, between the 2 groups. Only 2 patients in the no axillary dissection arm (8 and 40 months after surgery) developed overt axillary involvement during follow-up. Conclusions: Older patients with T1N0 breast cancer can be treated by conservative breast surgery and no axillary dissection without adversely affecting breast cancer mortality or overall survival. The very low cumulative incidence of axillary events suggests that even sentinel node biopsy is unnecessary, in these patients. Axillary dissection should be reserved for the small proportion of patients who later develop overt axillary disease.
|Titolo:||A randomized trial comparing axillary dissection to no axillary dissection in older patients with T1N0 breast cancer : Results after 5 years of follow-up|
|Autori interni:||BORACCHI, PATRIZIA (Secondo)|
|Parole Chiave:||aged; aging; article; axillary lymph node; breast cancer; cancer hormone therapy; cancer radiotherapy; cancer recurrence; cancer staging; clinical trial; comparative study; controlled study; female; follow up; gastrointestinal symptom; hot flush; human tissue; human; lymph node dissection; major clinical study; nausea; priority journal; prognosis; quality of life; randomized controlled trial; segmental mastectomy; sentinel lymph node biopsy; thromboembolism; tamoxifen|
|Settore Scientifico Disciplinare:||Settore MED/01 - Statistica Medica|
|Data di pubblicazione:||2005|
|Digital Object Identifier (DOI):||10.1097/01.sla.0000167759.15670.14|
|Appare nelle tipologie:||01 - Articolo su periodico|