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The Number of Axillary Nodes Removed as a Predictor of Regional Recurrence in Node Negative Breast Cancer
Radiotherapy and Oncology (2009)
  • Olga Vujovic, University of Western Ontario
  • Edward Yu, University of Western Ontario
  • Anil Cherian
  • A. Rashid Dar, University of Western Ontario
  • Larry Stitt, University of Western Ontario
  • Francisco Perera, University of Western Ontario
Purpose: To determine if the number of axillary nodes removed is a predictor of recurrence in node negative breast cancer. Materials and methods: Five hundred thirty-six patients with T1-T2, N0 invasive breast cancer, treated with lumpectomy and axillary node dissection (AND), were reviewed from January 1, 1986 to December 31, 1992. Patients received radiation to whole breast only, without regional nodal radiation. There was no adjuvant chemotherapy or Tamoxifen given. Patients were grouped according to the number of axillary nodes dissected as follows: 1-5 nodes (91 patients), 6-10 nodes (225 patients) and > 10 nodes (220 patients). Hazard ratios and p-values were determined for time to local recurrence, regional recurrence and for disease specific survival. Results: Median follow-up was 11.2 years. The overall local recurrence and regional recurrence rates for the three groups were: 1-5 nodes, 9.9% and 8.8%, respectively, 6-10 nodes, 10.2% and 2.2%, respectively, and > 10 nodes, 11.8% and 2.7%, respectively. The effect of number of axillary nodes removed was statistically significant only for regional recurrence (p = 0.017). There was no adverse effect on disease specific survival (p = 0.363). Conclusion: The number of axillary nodes removed predicts only for regional recurrence in node negative breast cancer patients, with less than 6 nodes removed associated with higher regional recurrence. This may have clinical implications with the current practice of sentinel node biopsy (SNB) replacing axillary node dissection in early stage breast cancer.
  • Adult,
  • Axilla,
  • Breast Neoplasms,
  • Female,
  • Follow-Up Studies,
  • Humans,
  • Lymph Node Excision,
  • Lymphatic Metastasis,
  • Neoplasm Recurrence,
  • Local,
  • Neoplasm Staging,
  • Predictive Value of Tests,
  • Proportional Hazards Models,
  • Survival Rate
Publication Date
April, 2009
Publisher Statement
Published in: Radiotherapy and Oncology, Volume 91, Issue 1, April 2009, Pages 38-41. doi: 10.1016/j.radonc.2008.05.003
Citation Information
Olga Vujovic, Edward Yu, Anil Cherian, A. Rashid Dar, et al.. "The Number of Axillary Nodes Removed as a Predictor of Regional Recurrence in Node Negative Breast Cancer" Radiotherapy and Oncology Vol. 91 Iss. 1 (2009)
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