OMISSION OF AXILLARY LYMPH-NODE DISSECTION IN EARLY-STAGE BREAST-CANCER - EFFECT ON TREATMENT OUTCOME

PURPOSE: To determine the effect omission of axillary lymph node disse ction has on outcome in patients treated with breast-conserving therap y for early-stage invasive breast cancer. MATERIALS AND METHODS: The a uthors evaluated 492 patients with breast cancer treated with (n = 32) and without (n = 456) axillary lymph node dissection. The primary tum or characteristics of the two groups were similar, though the median a ge was different. All patients received whole-breast radiation (mean d ose, 50 Gy); additional tumor bed boosts and nodal irradiation were us ed more often in patients without dissection. RESULTS: Median follow-u p in patients without and with dissection was 60 and 52 months, respec tively. The 5-year survival was 88% and 93%, respectively. There were no regional failures in the group treated without dissection. Crude ra tes of local and distant failure were similar for both groups. CONCLUS ION: Omission of axillary lymph node dissection should be considered i n patients whose pathologic nodal status will not influence decisions regarding adjuvant therapy.