[A Study on Omission of Axillary Lymph Node Dissection in Japanese Patients with Sentinel Node Metastasis]

Clinical trials such as the Z0011 trial have shown that axillary lymph node dissection(Ax)can be omitted even in patients with sentinel node(SN)macrometastasis. The 2022 edition of the Japanese guidelines for breast cancer treatment only weakly recommends omitting Ax in cases of SN macrometastasis, and we examined whether Ax could be omitted in 46 Japanese patients in our hospital. The average age of the patients was 60 years, the average tumor diameter was 2.2 cm, 90% were of the luminal type, the average number of SNs sampled was 3.2, and the average number of SN metastases was 1.4. At an average follow-up of 1,672 days, there were 2 cases of distant recurrence, 1 death due to cancer of other organs, and 2 cases of contralateral breast cancer development. There was no axillary lymph node recurrence nor any case where lymphedema developed. Thus, Ax can be safely omitted in Japanese patients with SN macrometastasis under certain conditions.