Axillary surgical approach in T1-T2N0M0 clinical breast cancer staging: Survival in a women’s hospital cohort in Rio de Janeiro

Introduction: The concerns regarding the prognosis and quality of life of patients with early breast cancer staging without lymph node involvement have increased, especially with regard to the axillary surgical approach. The aim of the present study was to determine overall survival and disease-free survival according to the axillary surgical approach. Methods: Retrospective cohort study of 827 women with clinical T1-T2N0M0 diagnosis attended at the Cancer Hospital III of the Brazilian National Cancer Institute, from January 2007 to December 2009, with a follow-up period of 60 months. Data were obtained from the Hospital Registry of Cancer through the medical records. Results: 683 women underwent sentinel lymph node biopsy and 144 underwent sentinel lymph node biopsy followed by axillary lymphadenectomy. After 5 years of follow-up, considering adjustment, it was observed overall survival (96.2% vs 93.6%; HR 0.98; 95%CI 0.42–2.29) and disease-free survival (93.7% vs 91.2%; HR 0.78; 95%CI 0.39–1.48) similar among patients undergoing either one or the other approach. In patients with micrometastasis, both overall (93.3%) and diseasefree survival (100%) were higher in women who underwent only sentinel lymph node biopsy compared to those who underwent this procedure followed by axillary lymphadenectomy (OS: 87.5%; DFS: 90,7%), albeit not statistically significant. Conclusions: No difference was observed in overall or disease-free survival in patients with T1-T2N0M0 breast cancer staging according to axillary treatment (sentinel lymph node biopsy followed or not by axillary lymphadenectomy) in 60-month. In addition, no statistically significant differences in overall and disease-free survival were observed in women with sentinel node micrometastasis submitted to any of the approaches within 60 months.

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