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Updated: Jun 12, 2026
Single-port Non-liposuction Endoscopic Axillary Lymph Node Dissection in Breast Cancer Surgery
Published on: April 3, 2026
Completion axillary lymph node dissection not required for regional control in patients with breast cancer who have
Sara Yegiyants1, Lina M Romero, Philip I Haigh
1Department of Surgery, Kaiser Permanente, Los Angeles Medical Center, 4760 Sunset Blvd, 3rd Floor, Los Angeles, CA 90027, USA.
Hypothesis:
Completion axillary lymph node dissection (ALND) is not required for regional control in patients with metastases in the sentinel lymph node (SLN).
Design:
Prospective cohort study.
Setting:
Urban teaching hospital.
Patients:
Fifty patients with breast cancer who underwent breast-conserving surgery, had an SLN positive for metastasis, and did not undergo completion ALND.
Interventions:
Breast-conserving surgery with SLN biopsy, breast irradiation, and systemic therapy.
Main Outcome Measures:
Locoregional and distant recurrence and survival.
Results:
The mean patient age was 57 years (range, 29-83 years). The mean tumor size was 1.9 cm (range, 0.4-5 cm). The mean number of positive nodes was 1.3 (median, 1; range, 1-2). Fourteen patients (30%) had macrometastases (>2 mm), and 33 patients (71%) had micrometastases. The mean duration of follow-up was 82 months (median, 79 months; range, 6-142 months). One patient with an SLN micrometastasis (1 of 33; 3%) and 1 patient with an SLN macrometastasis (1 of 14; 7%) developed an axillary recurrence with distant metastasis at 84 months and 28 months, respectively. There was 1 death (2%) not related to breast cancer.
Conclusions:
Patients with SLN metastases who do not undergo ALND have a low incidence of regional recurrence. Axillary lymph node dissection is not necessary for regional control in patients with micrometastatic disease.
