Clinical Edge Journal Scan

cALND may be avoided by choosing BCT instead of mastectomy


 

Key clinical point: By opting initially for breast-conserving therapy (BCT) over mastectomy, majority of women with T1-2 node-negative breast cancer with positive sentinel lymph node (SLN) can avoid completion axillary lymph node dissection (cALND), often done in mastectomy.

Major finding: Patients treated with mastectomy vs. BCT were more likely to receive cALND after positive SLN (71% vs. 26.6%; P less than .001). Extracapsular extension (ECE) in the SLN was observed in 31.6% of patients treated with mastectomy and cALND. However, remaining 68.4% of patients without ECE in the SLN could have avoided cALND if they had chosen BCT initially.

Study details : Findings are from an analysis of 306 women with T1-2 clinically node-negative breast cancer with metastases in the SLN who were treated with mastectomy (n=107) or BCT (n=199).

Disclosures: Programmatic support was provided by the Fashion Footwear Charitable Foundation of New York, Inc., the Margie and Robert E. Peterson Foundation, and the Linda and Jim Lippman. ML Smidt reported receiving a grant from Servier Pharma. The remaining authors had no disclosures.

Source: Vane MLG et al. Ann Surg Oncol. 2021 Feb 14. doi: 10.1245/s10434-021-09674-9 .

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