Comparison of Mastoscopic and Conventional Axillary Lymph Node Dissection in Breast Cancer: Long-term Results From a Randomized, Multicenter Trial

Luo, Chengyu; Guo, Wenhui; Yang, Jie; Sun, Qiuru; Wei, Wei; Wu, Suhua; Fang, Shubing; Zeng, Qingliang; Zhao, Zhen-sheng; Meng, Fanjie; Huang, Xuandong; Zhang, Xianlan; Li, Ruihua; Ma, Xiufeng; Chao-ying, Luo; Yang, Yun

doi:10.1016/j.mayocp.2012.07.022

Cited by 24 publications

(43 citation statements)

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“…The distribution of patients for 996 patients nally evaluable between MALND group and CALND group according to age, histologic, tumor grade, estrogen-receptor, proliferation rate and peritumoral vascular invasion was similar, reported previously. 7 The nal cohort of 996 patients was followed for an average of 184 months (range,164 to 191 months) during which time. The patients' outcomes at 15 years are summarized in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…The protocol was approved by institutional review board committees of all institutions in compliance with the Declaration of Helsinki and guidelines for good clinical practice. 7 To be included in study, patients had to have no axillary lymph node disease on preoperative clinical examination or lymph nodes less than 1 cm by color ultrasonic inspection.…”

Section: Methodsmentioning

confidence: 99%

“…MALND operation was performed according to the method reported previously. [1][2][3]5,7 All surgeons used the same standardized technique.…”

Section: Methodsmentioning

confidence: 99%

“…It also showed no signi cant differences in disease free survival and overall survival between two groups. 7 We now present information through an average of 15 years of post-randomization follow-up.…”

Section: Introductionmentioning

confidence: 99%

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15-year Follow-up of Comparing Mastoscopic and Conventional Axillary Dissection in Breast Cancer: A Multicentres, Randomized Controlled Trial

Luo

Cao

Guo

et al. 2020

Preprint

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Backgroud: Longer follow-up was necessary to testify the exact value of mastoscopic axillary lymph node dissection (MALND).Methods：From January 1, 2003 to December 31, 2005,1027 patients with operable breast cancer were randomly assigned to two groups: MALND and CALND. 996 eligible patients were enrolled. The end points are disease free survival and overall survival.Results：The final cohort of 996 patients was followed for an average of 184 months. The distribution of all events was fairly similar between two groups of patients. The incidence of local in-breast events did not differ in a significant manner between two cohorts. Similarly, the rate of distant metastases was not significantly different with 30.0% in MLND and 32.6% in CALND. And no significant difference was observed in other primary tumor between two groups (p=0.46). Patients who remain alive with no event comprise a total of 37.2% in MALND and 35.4% in CALND. Other primary cancers and deaths from other causes were distributed equally between two groups. The 15-year disease-free survival rates were41.1 percent for the MALND group and 39.6 percent for the CALND group (p=0.79). MALND was found to be not inferior for overall survival (P =0.54). The 15-year overall survival rates were 49.5 percentafter MALND and 51.2 percentafter CALND (p=0.86). Probability of overall survival was not significantly different between two groups.Conclusions：MALND does not increase unfavorable events, and also does not affect the long-term survival of patients. Therefore, MALND should be one of the preferred approaches for breast cancer surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…MALND operation was performed according to the method reported previously. [1][2][3]5,7 All surgeons used the same standardized technique.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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15-year Follow-up of Comparing Mastoscopic and Conventional Axillary Dissection in Breast Cancer: A Multicentres, Randomized Controlled Trial

Luo

Cao

Guo

et al. 2020

Preprint

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“…Recent studies have demonstrated that mastoscopic sentinel lymph node biopsy (MSLNB) has similar disease-free survival and overall-survival to that of conventional ALND, but it can reduce postoperative complications and enhance aesthetic appearance of the axilla [9]. Compared to conventional approaches, surgeries in conjunction with endoscopic techniques are minimally invasive, thereby restricting scars.…”

Section: Introductionmentioning

confidence: 99%

Mastoscopic sentinel lymph node biopsy in breast cancer

Ding

Zhang

et al. 2015

Open Medicine

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BackgroundPrevious studies have demonstrated that mastoscopic sentinel lymph node biopsy (MSLNB) has good identification rate (IR) and low false negative rate (FNR). However, few studies have directly compared the surgical performance and peri- and post-operative factors of MSLNB with conventional sentinel lymph node biopsy (SLNB).MethodologySixty patients diagnosed with breast cancer were recruited and randomly assigned to one of the three groups: MSLNB, SLNB and SLNB with lipolysis injection. Peri- and post-operative parameters were compared using general linear models. To examine the effect of age on these parameters, we performed separate analysis stratified by age (≤50 years old vs. >50 years old).ResultsPatients in the MSLNB group experienced longer surgery and suffered higher surgical cost than patients who underwent conventional SLNB or SLNB with lipolysis injection (p<0.0001). Despite this, they had significantly less blood loss than those who underwent conventional SLNB (22.0±7.0 ml vs.73.5±39.6 ml; p<0.0001). Analysis by age group indicates a similar pattern of difference among the three groups. MSLNB and conventional SLNB have similar IR and FNR.ConclusionAs a minimally invasive technique, MSLNB can significantly reduce blood loss while providing similar IR and FNR, indicating that it can be a promising alternative to conventional SLNB.ConclusionVariations in popliteal artery terminal branching pattern occurred in 7.4% to 17.6% of patients. Pre-surgical detection of these variations with MD CTA may help to reduce the risk of iatrogenic arterial injury by enabling a better surgical treatment plan.

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Association of Long-term Oncologic Prognosis With Minimal Access Breast Surgery vs Conventional Breast Surgery

et al. 2022

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ImportanceMinimal access breast surgery (MABS) has been used in breast cancer management. However, long-term prognostic data associated with MABS vs conventional breast surgery (CBS) are lacking.ObjectiveTo investigate long-term therapeutic outcomes associated with MABS vs CBS for breast cancer management.Design, Setting, and ParticipantsIn this single-center retrospective cohort study, 9184 individuals were assessed for inclusion. After exclusions, 2412 adult female individuals were included who were diagnosed with stage 0 to III breast cancer, underwent unilateral breast surgery between January 2004 and December 2017, and had no distant metastasis or history of severe underlying disease. Propensity score matching was performed to minimize selection bias. Data were analyzed from January 1, 2004, to December 31, 2019.ExposuresMABS or CBS.Main Outcomes and MeasuresData on demographic and tumor characteristics and long-term outcomes were collected and analyzed.ResultsThis study included 2412 patients (100% female; median [IQR] age, 44 [40-49] years). Of these, 603 patients underwent MABS (endoscopic, endoscopy-assisted, or robot-assisted procedures in 289, 302, and 12 patients, respectively) and 1809 patients underwent CBS. The median follow-up time was 84 months (93 in the MABS group and 80 months in the CBS group). Intergroup differences were not significant for the following parameters: 10-year local recurrence-free survival (93.3% vs 96.3%; hazard ratio [HR], 1.39; 95% CI, 0.86-2.27; P = .18), regional recurrence-free survival (95.5% vs 96.7%; HR, 1.38; 95% CI, 0.81-2.36; P = .23), and distant metastasis-free survival (81.0% vs 82.0%; HR, 0.95; 95% CI, 0.74-1.23; P = .72). The 5-, 10-, and 15-year disease-free survival rates in the MABS group were 85.9%, 72.6%, and 69.1%, respectively. The corresponding rates in the CBS group were 85.0%, 76.6%, and 70.7%. The intergroup differences were not significant (HR, 1.07; 95% CI, 0.86-1.31; P = .55). The 5-, 10-, and 15-year overall survival rates in the MABS group were 92.0%, 83.7%, and 83.0%, respectively. The corresponding rates in the CBS group were 93.6%, 88.7%, and 81.0%. The intergroup differences were not significant (HR, 1.29; 95% CI, 0.97-1.72; P = .09). Post hoc subgroup analysis showed no significant intergroup differences in disease-free survival.Conclusions and RelevanceIn this cohort study, long-term outcomes following MABS were not significantly different from those following CBS in patients with early-stage breast cancer. MABS may be a safe and feasible alternative in this patient population.

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Comparison of Mastoscopic and Conventional Axillary Lymph Node Dissection in Breast Cancer: Long-term Results From a Randomized, Multicenter Trial

Cited by 24 publications

References 40 publications

15-year Follow-up of Comparing Mastoscopic and Conventional Axillary Dissection in Breast Cancer: A Multicentres, Randomized Controlled Trial

15-year Follow-up of Comparing Mastoscopic and Conventional Axillary Dissection in Breast Cancer: A Multicentres, Randomized Controlled Trial

Mastoscopic sentinel lymph node biopsy in breast cancer

Association of Long-term Oncologic Prognosis With Minimal Access Breast Surgery vs Conventional Breast Surgery

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