Axillary radiotherapy is non inferior to completion axillary clearance in patients with positive sentinel lymph node biopsy - a single-centre observational cohort study
Association of Breast Surgery ePoster Library. Kremel D. 05/13/19; 257049; P005
Ms. Darja Kremel
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P005
Topic: Axilla
Introduction: A decade ago, gold standard treatment for patients with a positive sentinel lymph node biopsy (SLNB) was completion axillary node clearance (cANC). Recently, this practice has been challenged, with several studies showing comparable outcomes following axillary radiotherapy or systemic treatment for limited nodal disease. Results of trials such as POSNOC are awaited. Our aim was to study outcomes of SLNB-positive patients treated with or without cANC or in our unit. Methods : This is an observational cohort study of all SLNB-positive patients treated for invasive breast cancer at a single centre between 2010-2012. Data were collected retrospectively from patient records. Primary outcomes were axillary recurrence (AR), overall survival (OS) and disease-free survival (DFS). Results: Of 289 patients, n=129 patients proceeded to ANC (cANC group). N=160 did not undergo ANC (noANC group), of whom 91.2% had radiotherapy to the axilla. Median follow up was 76 months (IQR=69-87). AR was 1.6% in the cANC group and 1.9% in the noANC group (p=0.83). Kaplan-Meier analysis demonstrated that OS did not differ significantly between groups (cANC: 81.4%, noANC: 86.2%, p=0.26) and neither did DFS (cANC: 85.3%, noANC: 93.8%, p=0.12). There was no significant difference in the proportion of Grade 2 or 3 cancers and ER-/Her2+ tumours.Conclusion: In our cohort, outcome following axillary irradiation was non-inferior to cANC in terms of AR, OS and DFS at 6 years. While the groups were not matched in terms of prognostic factors, this study provides encouraging real-life data to support further research into more conservative axillary treatment.
Topic: Axilla
Introduction: A decade ago, gold standard treatment for patients with a positive sentinel lymph node biopsy (SLNB) was completion axillary node clearance (cANC). Recently, this practice has been challenged, with several studies showing comparable outcomes following axillary radiotherapy or systemic treatment for limited nodal disease. Results of trials such as POSNOC are awaited. Our aim was to study outcomes of SLNB-positive patients treated with or without cANC or in our unit. Methods : This is an observational cohort study of all SLNB-positive patients treated for invasive breast cancer at a single centre between 2010-2012. Data were collected retrospectively from patient records. Primary outcomes were axillary recurrence (AR), overall survival (OS) and disease-free survival (DFS). Results: Of 289 patients, n=129 patients proceeded to ANC (cANC group). N=160 did not undergo ANC (noANC group), of whom 91.2% had radiotherapy to the axilla. Median follow up was 76 months (IQR=69-87). AR was 1.6% in the cANC group and 1.9% in the noANC group (p=0.83). Kaplan-Meier analysis demonstrated that OS did not differ significantly between groups (cANC: 81.4%, noANC: 86.2%, p=0.26) and neither did DFS (cANC: 85.3%, noANC: 93.8%, p=0.12). There was no significant difference in the proportion of Grade 2 or 3 cancers and ER-/Her2+ tumours.Conclusion: In our cohort, outcome following axillary irradiation was non-inferior to cANC in terms of AR, OS and DFS at 6 years. While the groups were not matched in terms of prognostic factors, this study provides encouraging real-life data to support further research into more conservative axillary treatment.
P005
Topic: Axilla
Introduction: A decade ago, gold standard treatment for patients with a positive sentinel lymph node biopsy (SLNB) was completion axillary node clearance (cANC). Recently, this practice has been challenged, with several studies showing comparable outcomes following axillary radiotherapy or systemic treatment for limited nodal disease. Results of trials such as POSNOC are awaited. Our aim was to study outcomes of SLNB-positive patients treated with or without cANC or in our unit. Methods : This is an observational cohort study of all SLNB-positive patients treated for invasive breast cancer at a single centre between 2010-2012. Data were collected retrospectively from patient records. Primary outcomes were axillary recurrence (AR), overall survival (OS) and disease-free survival (DFS). Results: Of 289 patients, n=129 patients proceeded to ANC (cANC group). N=160 did not undergo ANC (noANC group), of whom 91.2% had radiotherapy to the axilla. Median follow up was 76 months (IQR=69-87). AR was 1.6% in the cANC group and 1.9% in the noANC group (p=0.83). Kaplan-Meier analysis demonstrated that OS did not differ significantly between groups (cANC: 81.4%, noANC: 86.2%, p=0.26) and neither did DFS (cANC: 85.3%, noANC: 93.8%, p=0.12). There was no significant difference in the proportion of Grade 2 or 3 cancers and ER-/Her2+ tumours.Conclusion: In our cohort, outcome following axillary irradiation was non-inferior to cANC in terms of AR, OS and DFS at 6 years. While the groups were not matched in terms of prognostic factors, this study provides encouraging real-life data to support further research into more conservative axillary treatment.
Topic: Axilla
Introduction: A decade ago, gold standard treatment for patients with a positive sentinel lymph node biopsy (SLNB) was completion axillary node clearance (cANC). Recently, this practice has been challenged, with several studies showing comparable outcomes following axillary radiotherapy or systemic treatment for limited nodal disease. Results of trials such as POSNOC are awaited. Our aim was to study outcomes of SLNB-positive patients treated with or without cANC or in our unit. Methods : This is an observational cohort study of all SLNB-positive patients treated for invasive breast cancer at a single centre between 2010-2012. Data were collected retrospectively from patient records. Primary outcomes were axillary recurrence (AR), overall survival (OS) and disease-free survival (DFS). Results: Of 289 patients, n=129 patients proceeded to ANC (cANC group). N=160 did not undergo ANC (noANC group), of whom 91.2% had radiotherapy to the axilla. Median follow up was 76 months (IQR=69-87). AR was 1.6% in the cANC group and 1.9% in the noANC group (p=0.83). Kaplan-Meier analysis demonstrated that OS did not differ significantly between groups (cANC: 81.4%, noANC: 86.2%, p=0.26) and neither did DFS (cANC: 85.3%, noANC: 93.8%, p=0.12). There was no significant difference in the proportion of Grade 2 or 3 cancers and ER-/Her2+ tumours.Conclusion: In our cohort, outcome following axillary irradiation was non-inferior to cANC in terms of AR, OS and DFS at 6 years. While the groups were not matched in terms of prognostic factors, this study provides encouraging real-life data to support further research into more conservative axillary treatment.
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