Management of Isolated Axillary Recurrence in Breast Cancer: Is There a Role for Targeted Axillary Dissection?

Background The most optimal surgical strategy for ipsilateral isolated axillary recurrence (AR) in breast cancer is unknown. Axillary lymph node dissection (ALND) has historically been implemented; however, there may be an evolving role for targeted axillary dissection (TAD). Methods A retrospective analysis was conducted on patients with invasive breast cancer, followed by AR. Clinical and operative strategies were collected, with primary endpoints including overall survival (OS) and progression-free survival (PFS). Results In total, 21 (10.2%) patients were identified with AR. Of this subset of patients, 15 (71.4%) underwent ALND, and six (28.6%) underwent TAD. Univariable and multivariable analyses did not observe a significant association between TAD versus ALND at the time of recurrence with PFS. Univariable analysis demonstrated a significant association between adjuvant radiation and endocrine therapy at first recurrence and PFS benefit. Conclusions Following AR, no PFS benefit was observed between those managed with TAD versus ALND, which highlights an additional area of consideration for possible axillary de-escalation.