Favorable Outcome of Secondary Axillary Dissection in Breast Cancer Patients with Axillary Nodal Relapse

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• 作者：Shih-Che Shen MD (1)
  Chien-Hung Liao MD (1)
  Yung-Feng Lo MD (1)
  Hsiu-Pei Tsai MD (1)
  Wen-Lin Kuo MD (1)
  Chi-Chang Yu MD (1)
  Tzu-Chieh Chao MD (1)
  Miin-Fu Chen MD (1)
  Hsien-Kun Chang MD (2)
  Yung-Chang Lin MD (2)
  Wen-Chi Shen MD (2)
  Shir-Hwa Ueng MD (3)
  Li-Yu Lee MD (3)
  Swei Hsueh MD (3)
  Yi-Ting Huang MD (4)
  Shin-Cheh Chen MD (1)
  
• 刊名：Annals of Surgical Oncology
• 出版年：2012
• 出版时间：April 2012
• 年：2012
• 卷：19
• 期：4
• 页码：1122-1128
• 全文大小：304KB
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• 作者单位：Shih-Che Shen MD (1)
  Chien-Hung Liao MD (1)
  Yung-Feng Lo MD (1)
  Hsiu-Pei Tsai MD (1)
  Wen-Lin Kuo MD (1)
  Chi-Chang Yu MD (1)
  Tzu-Chieh Chao MD (1)
  Miin-Fu Chen MD (1)
  Hsien-Kun Chang MD (2)
  Yung-Chang Lin MD (2)
  Wen-Chi Shen MD (2)
  Shir-Hwa Ueng MD (3)
  Li-Yu Lee MD (3)
  Swei Hsueh MD (3)
  Yi-Ting Huang MD (4)
  Shin-Cheh Chen MD (1)
  
  1. Division of Breast Surgery, Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University Medical College, Taoyuan, Taiwan
  2. Division of Medical Oncology, Chang Gung Memorial Hospital, Chang Gung University Medical College, Taoyuan, Taiwan
  3. Department of Pathology, Chang Gung Memorial Hospital, Chang Gung University Medical College, Taoyuan, Taiwan
  4. Department of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung University Medical College, Taoyuan, Taiwan
  

文摘

Purpose Little evidence can be found about the long-term outcome of breast cancer patients after axillary lymph node recurrence (ALNR) and its survival benefit after different kinds of management. The present study intends to evaluate the risk factors associated with axillary recurrence after definite surgery for primary breast cancer. The prognosis after ALNR and particularly outcome of different management methods also were studied. Methods We retrospectively reviewed data from 4,473 patients who were diagnosed with primary breast cancer and received surgical intervention in a single institute from January 1990 to December 2002. Medical files were reviewed and data on survival were updated annually. Risk factors and prognosis of patients with axillary recurrence were analyzed. Breast–cancer-specific survival of patients with ALNR and outcomes after different management methods also were studied. Results After a median follow-up of 70.2?months, axillary recurrence developed in 0.8% of patients. Factors associated with ALNR included: age younger than 40?years, medial tumor location, no initial standard level I & II axillary dissection, and not receiving hormonal therapy. The 5-year breast–cancer-specific survival after ALNR was 57.9%. For patients who received further axillary dissection, the 5-year survival rate was 82.5% compared with 44.9% for patients who did not receive further dissection. Conclusions ALNR is a rare event in treating breast cancer. Young age at diagnosis and medially located tumor are associated with higher risk, but standardized initial axillary dissection to level II and adjuvant hormonal therapy is protective against ALNR. In patients with ALNR, the outcome is not dismal and survival may be improved if further axillary dissection is given.