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G. H. Lyman, A. E. Giuliano, M. R. Somerfield, A. B. 3rd Benson, D. C. Bodurka, H. J. Burstein, A. V. Cochran, H. S. 3rd Cody, S. B. Edge, S. Galper, J. A. Hayman, T. Y. Kim, C. L. Perkins, D. A. Podoloff, V. H. Sivasubramaniam, R. R. Turner, R. Wahl, D. L. Weaver, A. C. Wolff and E. P. Winer, “American Society of Clinical Oncology: American Society of Clinical Oncology Guideline Recommendations for Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer,” Journal of Clinical Oncology, Vol. 23, No. 30, 2005, pp. 7703-7720. http://dx.doi.org/10.1200/JCO.2005.08.001

has been cited by the following article:

• TITLE: Early Results of Omitting Completion Axillary Lymph Node Dissection in Sentinel Lymph Node Metastasis-Positive Breast Cancer Patients

  AUTHORS: Junko Honda, Hisashi Matsuoka, Chieko Hirose, Taeko Nagao, Takahiro Yoshida, Masako Takahashi, Issei Imoto, Mitsunori Sasa

  KEYWORDS: Axillary Lymph Node Dissection; Breast Cancer; Sentinel Node Biopsy

  JOURNAL NAME: Advances in Breast Cancer Research, Vol.2 No.4, September 9, 2013

  ABSTRACT: Background: We investigated the early results of omitting completion axillary lymph node dissection (ALND) for axillary node metastasis-negative (N0), sentinel node (SN) metastasis-positive breast cancer patients. Patients and Methods: 489 patients had invasive N0 breast cancer treated without completion ALND, regardless of their SN metastasis status. Analyses included the associations between the SN metastasis status, clinicopathological findings and recurrence, between recurrence and clinicopathological findings, and recurrence-free survival. Results: 430 patients were SN biopsy (SNB)-negative, and 59 were SNB-positive. The SNB-positive patients received significantly more potent adjuvant therapy than the SNB-negative patients. Median follow-up was 3.7 years, and the axillary node recurrence was seen in 6 patients (1.2%) and recurrence in 21 patients. The SN status showed no associations with the clinicopathological findings or recurrence. Univariate analysis showed recurrence was associated with absence of hormonal therapy, ER-negative, PgR-negative, HER2-positive or triple-negative (TNBC) disease, a tumor ≥2.1 cm and higher nuclear grade. Multivariate analysis showed recurrence was associated with absence of hormonal therapy and a tumor ≥2.1 cm. Cox proportional hazards model showed recurrence was extremely early in ER-negative and TNBC patients. Conclusion: Completion ALND can be skipped in N0 breast cancer patients even if they are SNB-positive, but adjuvant therapy is essential.