Kuznetsova M, Graybill J C, Zusag T W, Hartsell W F, Griem K L
Department of Radiation Oncology, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL 60612, USA.
Radiology. 1995 Nov;197(2):507-10. doi: 10.1148/radiology.197.2.7480703.
To determine the effect omission of axillary lymph node dissection has on outcome in patients treated with breast-conserving therapy for early-stage invasive breast cancer.
The authors evaluated 492 patients with breast cancer treated with (n = 32) and without (n = 456) axillary lymph node dissection. The primary tumor characteristics of the two groups were similar, though the median age was different. All patients received whole-breast radiation (mean dose, 50 Gy); additional tumor bed boosts and nodal irradiation were used more often in patients without dissection.
Median follow-up in patients without and with dissection was 60 and 52 months, respectively. The 5-year survival was 88% and 93%, respectively. There were no regional failures in the group treated without dissection. Crude rates of local and distant failure were similar for both groups.
Omission of axillary lymph node dissection should be considered in patients whose pathologic nodal status will not influence decisions regarding adjuvant therapy.
确定省略腋窝淋巴结清扫术对早期浸润性乳腺癌保乳治疗患者预后的影响。
作者评估了492例接受（n = 32）和未接受（n = 456）腋窝淋巴结清扫术的乳腺癌患者。两组的原发肿瘤特征相似，尽管中位年龄不同。所有患者均接受全乳放疗（平均剂量，50 Gy）；未行清扫术的患者更常使用额外的瘤床加量放疗和淋巴结照射。
未行清扫术和行清扫术患者的中位随访时间分别为60个月和52个月。5年生存率分别为88%和93%。未行清扫术治疗的组中无区域复发。两组的局部和远处复发粗率相似。
对于病理淋巴结状态不会影响辅助治疗决策的患者，应考虑省略腋窝淋巴结清扫术。
