Abstract
Purpose: The steady move towards axillary conservatism in breast cancer is based on studies demonstrating that axillary node clearance affords no survival benefit in a subset of patients with a positive pre-operative axillary ultrasound (AUS). However, less attention has been paid to AUS-negative patients who receive sentinel node biopsy as standard. Methods: Previously assembled systematic review data was reassessed to evaluate nodal burden amongst patients with breast cancer and a clinically and radiologically negative axilla. Results: Pooled data from four cohort studies reporting pre-operative axillary ultrasound in 5139 patients with breast cancer show it has a negative predictive rate of 0.951 (95% confidence interval 0.941–0.960). Conclusions: Reconsidering the use of ultrasound in patients with early breast cancer and non-palpable axillae reveals that sentinel node biopsy itself may represent surgical over-treatment in patients with a negative axillary ultrasound. The implications of this on the future of surgical management of the axilla are discussed.
| Original language | English |
|---|---|
| Journal | Breast Cancer Research and Treatment |
| Volume | 177 |
| Issue number | 1 |
| Early online date | 31 May 2019 |
| DOIs | |
| Publication status | Published - 30 Aug 2019 |
Keywords
- Axillary conservatism
- Axillary node clearance
- Axillary node metastasis
- Axillary ultrasound
- Sentinel node biopsy
