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 dissection has on outcome in patients treated with breast-conserving therapy for early-stage invasive breast cancer.

Materials And Methods: The authors evaluated 492 patients with breast cancer treated with (n = 32) and without (n = 456) axillary lymph node dissection. The primary tumor characteristics of the two groups were similar, though the median age was different. All patients received whole-breast radiation (mean dose, 50 Gy); additional tumor bed boosts and nodal irradiation were used more often in patients without dissection.

Results: Median follow-up in patients without and with dissection was 60 and 52 months, respectively. The 5-year survival was 88% and 93%, respectively. There were no regional failures in the group treated without dissection. Crude rates of local and distant failure were similar for both groups.

Conclusion: Omission of axillary lymph node dissection should be considered in patients whose pathologic nodal status will not influence decisions regarding adjuvant therapy.