ABS ePoster Library

P057
Topic: Breast surgery

Introduction: Pre-operative positive lymph node biopsy has been considered synchronous with high axillary disease burden and subsequent axillary clearance. Our study aimed to evaluate if a subgroup exists with minimal disease of <3 lymph nodes in patients with clinically node negative early breast cancer and biopsy proven axilla. Such patients could avoid axillary clearance and have treatment extrapolated on Z-11 and AMAROS trials. Methods :Prospectively collected 5 years data in a single centre was evaluated. Patients included had cT1-2 N0 breast cancer who underwent axillary dissection based on positive axillary ultrasound biopsy.Primary outcome was nodal count on final histology. Tumour characteristics and number of abnormal lymph nodes on ultrasound were recorded and compared with primary outcome. Statistical analysis used chi square and t-test. Results:Seventy patients with cT1-2N0 disease had axillary clearance for positive ultrasound guided lymph node biopsy. Thirty two (46%) women had 1-2 lymph nodes in the final histology of axillary clearance while 38 (54%) had >3 positive lymph nodes. Lymphovascular invasion was found in 35 (50%) patients and >1 abnormal lymph nodes were seen on ultrasound in 32 (46%) patients, both variables were significantly associated with final histology of >3 positive lymph nodes (p=0.05 and 0.009 respectively).Conclusion:Positive axillary node biopsy does not accurately predict extensive lymph node involvement in clinically node negative early breast cancer. A larger prospective study is needed to identify other predicting factors and patients eligible for sentinel lymph node biopsy instead of axillary clearance.