Sentinel lymph node biopsy versus observation in clinically and ultrasound node negative early stage breast cancer

Abstract Background: The gold standard for axillary staging in node-negative early-stage breast cancer is sentinel lymph node biopsy (SLNB). Axillary lymph node dissection (ALND), SLNB, and axillary radiotherapy have all been associated with axillary problems, but at a smaller incidence with SLNB alone than with ALND. The Z0011 trial demonstrated that there is no benefit from axillary dissection in the context of positive SLN. Aim: Compare locoregional recurrence, disease free survival (DFS), and overall survival (OS) between SLNB and observation in patients with early stage clinically node negative breast cancer by palpation and preoperative ultrasonography. Methodology: Candidates for Breast Conservative Surgery include 60 patients with clinically and radiologically node-negative early breast cancer, randomized to one of two groups: Study group (group A): 30 patients underwent BCS with no further axillary surgery. Control group (group B): 30 patients underwent BCS and SLNB. Follow up was done to detect the two years locoregional recurrence, DFS and OS. Results: After a two-year follow-up, there was no discernible difference between the two arms in terms of axillary, local, or metastatic recurrence. Regarding post-operative arm edema, both arms significantly differ from one another. Conclusion: Omission of axillary surgery in T1 and some cases of T2 N0 breast cancer patients appears safe and applicable without affecting locoregional recurrence and axillary/nodal recurrence. Longer term follow-up is needed