Partial lower axillary dissection for patients with clinically node-negative breast cancer.

Area of Science:

• Surgical Oncology
• Breast Cancer Research
• Clinical Outcomes

Background:

• Axillary lymph node dissection is a standard procedure for breast cancer staging.
• Conventional dissection can lead to significant postoperative complications, including lymphedema.
• Minimally invasive techniques are being explored to reduce morbidity.

Purpose of the Study:

• To evaluate the outcomes of partial lower axillary lymph node dissection (ALND) caudal to the intercostobrachial nerve.
• To compare these outcomes with conventional ALND in clinically node-negative (N(0)) breast cancer patients.

Main Methods:

• Retrospective analysis of 1043 patients undergoing partial ALND and 1084 historical controls undergoing conventional ALND.
• Comparison of dissected/metastatic nodes, survival rates, complication rates, and axillary recurrence.
• Statistical analysis of surgical duration, blood loss, lymphatic drainage, and lymphedema incidence.

Main Results:

• Similar 5-year overall (95.6% vs 94.9%) and disease-free survival (89.7% vs 88.4%) rates between partial and conventional dissection groups.
• Significantly reduced surgical duration, blood loss, and lymphatic drainage volume with partial dissection.
• Markedly lower incidence of persistent arm lymphedema (0.0% vs 11.8%) in the partial dissection group.

Conclusions:

• Partial axillary lymph node dissection offers comparable survival outcomes to conventional dissection.
• Partial ALND is associated with significantly lower postoperative complication rates, particularly lymphedema.
• This technique is recommended for patients with clinically node-negative breast cancer.