title: Outcomes with and without axillary node dissection for node-positive lumpectomy and mastectomy patients.
abstract: BACKGROUND
  American College of Surgeons Oncology Group Z0011 trial of select node-positive breast cancer patients demonstrated no survival or recurrence differences between SLN/axillary lymph node dissection (ALND) vs SLN. Our comparable node-positive lumpectomy and mastectomy populations should have similar outcomes.
  
  
  METHODS
  An Institutional Review Board approved, retrospective review of pathologic SLN (N1) cases was performed. Treatment, recurrence, and survival were collected. Statistics was analyzed via exact chi-square test with Monte Carlo estimation, Kaplan-Meier curves, and log-rank tests.
  
  
  RESULTS
  Of 528 node-positive patients, 318 patients met criteria: 28 (21.7%) lumpectomy, 32 (16.9%) mastectomy had SLN; 101 (78.2%) lumpectomy, 157 (83.0%) mastectomy had SLN + ALND. Median age was 57.5 years for SLN and 53 years for SLN + ALND (P = .003). Mean positive nodes were 1.1 for SLN and 1.47 for SLN + ALND (P = .0018). Chemotherapy use differed (SLN = 73.5%, SLN + ALND = 89.7%, P = .0032). Stage and recurrence were higher for SLN + ALND (P = .0001, P = .007). No difference in comorbidities, nodes retrieved, extracapsular extension, radiation, hormone therapy, or overall survival was observed.
  
  
  CONCLUSIONS
  In clinically node-negative breast cancer patients, ALND for N1 disease has no impact on short-term recurrence or survival.
authors.affiliation: Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
authors.forename: Rachael
authors.initials: R
authors.lastname: Snow
authors.affiliation: Department of Breast Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
authors.forename: Chantal
authors.initials: C
authors.lastname: Reyna
authors.affiliation: Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Johns
authors.affiliation: Department of Breast Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
authors.forename: M Catherine
authors.initials: MC
authors.lastname: Lee
authors.affiliation: Department of Breast Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
authors.forename: Weihong
authors.initials: W
authors.lastname: Sun
authors.affiliation: Department of Biostatistics, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Fulp
authors.affiliation: Morsani College of Medicine, University of South Florida, Tampa, FL, USA; Department of Breast Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
authors.forename: John V
authors.initials: JV
authors.lastname: Kiluk
authors.affiliation: Morsani College of Medicine, University of South Florida, Tampa, FL, USA; Department of Breast Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA. Electronic address: christine.laronga@moffitt.org.
authors.forename: Christine
authors.initials: C
authors.lastname: Laronga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D002277:Carcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008408:Mastectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
keywords: Axillary lymph node dissection; Lumpectomy; Mastectomy