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Updated: Aug 13, 2026
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Single-port Non-liposuction Endoscopic Axillary Lymph Node Dissection in Breast Cancer Surgery
Published on: April 3, 2026
The significance of one positive axillary node
G P Kuijt1, L V van de Poll-Franse, R M H Roumen
1Department of Surgery, Maxima Medical Centre, P.O. Box 7777, 5500 MB Veldhoven, The Netherlands. gert.kuijt@skynet.be
Summary
This study sought to identify breast cancer patients who could avoid axillary dissection. While no definitive subgroup was found, smaller tumors and absence of extranodal extension indicated fewer positive lymph nodes.
Area of Science:
- Oncology
- Surgical Oncology
Background:
- Axillary lymph node status is critical for breast cancer staging and treatment decisions.
- Complete axillary dissection is a standard procedure but can lead to morbidity.
Purpose of the Study:
- To identify specific patient subgroups with breast cancer who may safely omit axillary dissection.
- To determine predictors for limited axillary lymph node metastasis.
Main Methods:
- Retrospective analysis of 1206 breast cancer patients from the Eindhoven Cancer Registry.
- Comparison of clinico-pathological features between patients with one positive lymph node (n=489) and those with multiple positive lymph nodes (n=817).
- All patients underwent complete axillary dissection without prior sentinel node biopsy.
Main Results:
- Tumor size >1cm, >15 lymph nodes examined, metastasis size >2mm, extranodal extension, and axillary apex involvement are linked to multiple positive nodes.
- Tumor size <1cm, micrometastasis, and absence of extranodal extension are associated with only one positive lymph node.
Conclusions:
- No patient subgroup was identified where axillary dissection can always be omitted.
- Predictors for limited nodal involvement (one positive node) include smaller tumor size, micrometastasis, and lack of extranodal extension, suggesting potential for de-escalation in select cases.
