Is axillary dissection further required in clinically node negative breast cancer?

Abstract

Definitive radiotherapy of the axilla is a valid treatment option for patients without palpable axillary nodes with the potential advantage of being less cost intensive and better tolerated. If the indication for systemic therapy is no more dependent on the axillary status, axillary dissection may be replaced by axillary radiotherapy. In small tumors without risk factors and without indication for systemic therapy, SLND seems to be the best treatment option.

Development and Validation of a Risk Model for Breast Cancer–Related Lymphedema

“…As mentioned, older age is a main risk factor of vascular diseases, such as hypertension, which has been associated with lymphedema . These observations are supported by data from this current study, which observed a moderate correlation between age and vascular comorbidities (Spearman correlation coefficient, 0.48; P < .001) (eTable 1 in the Supplement), which encompassed the diagnoses of hypertension, hypercholesterolemia, and diabetes . High cholesterol levels have been mechanistically associated with the degeneration of lymphatic vessels, which has led to decreased lymphatic transport, increased leakiness, and increased edema .…”

Axilladissektion oder Axillabestrahlung bei postmenopausalen Patientinnen mit Mammakarzinom?

“…1500 (90% Power) Signifikanzniveau erreichen [26]. Klinisch wäre dies jedoch nicht relevant [4,6], weil aufgrund der hohen p-Werte im tumorfreien und Gesamtüberleben auch bei einer solch großen Fallzahl kein Unterschied zu erwarten wäre. Sogar bei völlig unbehandelter Axilla konnte kein Einfluss auf das Überleben nachgewiesen werden [3,33,36), wobei dann allerdings in ca.…”

Aktuarische Auswertung von Zeit-Ereignis-Daten und ihre Bedeutung bei der Beurteilung von Resultaten Qualitätsanalyse der Zeitschrift “Strahlentherapie und Onkologie”

“…In ebenfalls elf Arbeiten wurden die Ergebnisse lediglich nicht aktuarisch ("crude") ausgewertet [5,24,72,77,81,128,132,144,150,151,153]. In zwei Arbeiten [22,25] Table 2. Actuarial analysis of the data in Figure 1 according to the Kaplan-Meier method.…”