Abstract 184P
Background
Early-stage breast cancer patients are increasingly choosing breast-conserving surgery (BCS) and sentinel lymph node biopsy (SLNB). There is, however, a 14.3% to 20% chance of developing local recurrences. A lack of studies has assessed the survival benefit of repeat sentinel lymph node biopsy (rSLNB) over axillary lymph node dissection (ALND) in patients with ipsilateral breast tumor recurrence (IBTR).
Methods
From 2000 to 2016, we identified IBTR patients from the Surveillance, Epidemiology, and End Results (SEER) database. We compared overall survival (OS) and breast cancer specific survival (BCSS) between Axilla-Surgery and Non-Surgery groups, and between rSLNB and ALND groups.
Results
Among 1,863 women with IBTR and negative axilla after BCS and SLNB, 488 Non-Surgery patients did not undergo axillary surgery, and 1375 of the Axilla-Surgery patients were administered either ALND or rSLNB (322 with ALND and 1053 with rSLNB). Axilla-Surgery group had a ten-year OS rate of 73.5% while Non-Surgery had a rate of 63.6% (P=0.026). Axilla-Surgery was an independent factor favoring OS after controlling for other factors (hazard ratio [HR], 0.73; 95% CI, 0.57-0.93; P=0.012). As part of the Axilla-Surgical group, rSLNB had a better ten-year OS than ALND (76.2% vs 67.0%, log-rank test P=0.026). Additionally, both multivariate Cox analyses and subgroup analyses concluded that rSLNB had similar long-term survival as ALND (ten-year OS HR, 1.28; 95% CI, 0.94-1.74; P=0.115).
Conclusions
Based on the findings of this cohort study, a second axillary surgery was helpful for IBTR patients with negative axillae, and rSLNB had a similar long-term survival outcome to ALND for IBTR patients with negative axilla. Therefore, rSLNB is an optional axillary treatment available to IBTR patients with clinically negative axilla after initial SLNB and BCS.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
West China Hospital, Sichuan University.
Disclosure
All authors have declared no conflicts of interest.