Objective: To compare the long-term results of mastoscopic axillary lymph node dissection (MALND) and conventional axillary lymph node dissection (CALND). Patients and Methods: From January 1, 2003, through December 31, 2005, a group of 1027 consecutive patients with operable breast cancer were randomly assigned to 1 of 2 study groups: MALND and CALND. The median follow-up was 63 months. The primary end points of the study were operative outcomes, complication reduction, function conservation, and cosmetics. The secondary end points were disease-free and overall survival. Results: The mean operative blood loss in the MALND group was less than in the CALND group (PϽ.001). The patients who underwent MALND had less axillary pain, numbness or paresthesias, and arm swelling (PϽ.001). The aesthetic appearance of the axilla in the MALND group was much better than that in the CALND group (Pϭ.001 at 6 months and Pϭ.002 at 24 months). A significant difference was found between the 2 groups in distant metastasis (Pϭ.04). The disease-free survival rate was 64.5% in the MALND group and 60.8% in the CALND group (Pϭ.88). The overall survival rate was 81.7% in the MALND group and 78.6% in the CALND group (Pϭ.95).

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