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Related Concept Videos

Cancer Survival Analysis01:21

Cancer Survival Analysis

Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...

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Updated: May 12, 2026

Intraductal Delivery to the Rabbit Mammary Gland
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Management of Isolated Axillary Recurrence in Breast Cancer: Is There a Role for Targeted Axillary Dissection?

Christina M Paluskievicz1, Mahtab Vasigh1, Piyush Rath2

  • 1Surgical Oncology, Johns Hopkins University School of Medicine, Baltimore, USA.

Cureus
|August 27, 2025
PubMed
Summary

For breast cancer recurrence in the axilla, targeted axillary dissection (TAD) showed no difference in progression-free survival compared to axillary lymph node dissection (ALND). This suggests potential for axillary de-escalation strategies.

Keywords:
axillaaxillary lymph node dissectionbreast cancerisolated axillary recurrencesurvivaltargeted axillary dissection

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Breast Cancer Research

Background:

  • Optimal surgical management for ipsilateral isolated axillary recurrence (AR) in breast cancer remains undetermined.
  • Axillary lymph node dissection (ALND) is traditional, but targeted axillary dissection (TAD) is emerging.
  • Understanding recurrence patterns is crucial for refining breast cancer treatment.

Purpose of the Study:

  • To compare the efficacy of TAD versus ALND in patients experiencing isolated axillary recurrence of breast cancer.
  • To evaluate the impact of surgical strategy on overall survival (OS) and progression-free survival (PFS).

Main Methods:

  • Retrospective analysis of invasive breast cancer patients with isolated axillary recurrence.
  • Collection of clinical and operative data, including surgical approach (ALND vs. TAD).
  • Statistical analysis using univariable and multivariable models to assess survival outcomes.

Main Results:

  • 21 patients (10.2%) experienced isolated axillary recurrence.
  • 15 patients (71.4%) underwent ALND, while 6 (28.6%) underwent TAD.
  • No significant difference in PFS was found between TAD and ALND groups at the time of recurrence.

Conclusions:

  • Targeted axillary dissection (TAD) is a viable alternative to axillary lymph node dissection (ALND) for isolated axillary recurrence, without compromising progression-free survival.
  • Adjuvant radiation and endocrine therapy at first recurrence were associated with improved PFS.
  • Findings support further investigation into axillary de-escalation strategies for breast cancer recurrence.