Differences in survival rates in patients with early breast cancer (cT1–2N0–1) with sentinel lymph node biopsy and lymphadenectomy

Background. The era of sentinel lymph node diagnostics has a vector of reducing surgical aggression in the area of regional lymph outflow. This was due to the studies that have been conducted, which have made it possible to understand that lymph node involvement is not always a call for removal of the entire lymphatic collector, as it does not affect the treatment results.
Aim. To study the effects of sentinel lymph node biopsy and lymphadenectomy on survival rates in patients with primary operable breast cancer (сT0–2N0/N0–1).
Materials and methods. The retrospective study included 524 women with ductal/lobular breast cancer stage I–IIB. Depending on the extent of surgical intervention on the lymphatic collector, patients were divided into the following groups: group 1, where sentinel lymph node biopsy was performed in 111 (21.2 %) patients; group 2, where axillary lymph node dissection was performed in 413 (78.8 %) patients (280 patients after sentinel lymph node biopsy).
Results. The average follow-up time for patients was 61.3 ± 22.8 months (from 18.1 to 140 months, median 57.7 months). The median age was 51 [42.0; 61.0] years. Depending on the clinical stage according to TNM, the distribution of patients was as follows: T1N0M0 – 277 patients, T2N0M0 – 213, T1N1M0 – 3, T2N1M0 – 31. Neoadjuvant chemotherapy was administered to 137 (26.2 %) patients. The frequency of neoadjuvant chemotherapy statistically significantly increased with increasing clinical stage, from 2.2 % (n = 6) for T1N0M0 to 100 % (n = 31) for T2N1M (p = 0.00001). Surgical treatment included sectoral resection in 50.6 % (n = 265) and radical mastectomy in 49.4 % (n = 259). Death occurred in 14 (2.7 %) patients, progression was detected in 36 (6.9 %) patients. The 5-year progression-free survival and overall survival rates in groups 1 and 2 did not differ significantly, amounting 98.2 ± 1.3 % versus 92.93 ± 1.6 % and 100 % versus 97.9 ± 0.9 %, respectively. The median overall survival and progression-free survival were not reached.
Conclusion. In patients with T0–2N0/N0–1 breast cancer who underwent lymphadenectomy, overall survival and progression-free survival were not inferior to those who underwent sentinel lymph node biopsy.

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