Cancer Communications
indexed by SCI
BMC

Original article
Is surgical axillary staging necessary in women with T1 breast cancer who are treated with breast-conserving therapy?
Jin Wang, Hailin Tang, Xing Li, Cailu Song, Zhenchong Xiong, Xi Wang, Xiaoming Xie and Jun Tang
Department of Breast Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng East Road, Yuexiu District, Guangzhou, 510060, Guangdong, P.R. China
[Abstract]

Background
In the post-Z0011 trial era, the need to perform surgical axillary staging for early-stage breast cancer patients, who are treated with breast-conserving therapy (BCT), is being questioned. We conducted a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database to evaluate the safety of waiving surgical axillary staging in patients with T1 breast cancer treated with BCT.
Methods
A total of 166,615 eligible patients diagnosed between 2000 and 2012 were divided into staging (sentinel lymph node biopsy or axillary lymph node dissection) and non-staging (no lymph node examined or only needle aspiration biopsy of lymph nodes) groups. Propensity score matching (PSM) was performed to balance disparities between the two groups. Multivariate analysis with the Cox proportional hazards model was used to assess factors related to breast cancer-specific survival (BCSS).
Results
Although the tumor size at time of presentation was decreasing over years, the rate of surgical axillary staging increased from 93.3% to 96.9%. The 5-year BCSS rates of the whole cohort (before PSM) and matched cohort (after PSM) were 98.0% and 97.5%. Within the matched cohort, the BCSS was significantly longer in the staging group than in the non-staging group (P < 0.001). However, surgical axillary staging did not benefit patients who were 50?C79 years old, had tumor size < 1 cm, histological grade I disease, or favorable histological types (tubular/mucinous/papillary) in stratified analyses (P > 0.05). Race, marital status, hormone receptors, and chemotherapy were not associated with the favorable impact of surgical axillary staging on BCSS (P > 0.05).
Conclusion
Although surgical axillary staging remains important for T1 breast cancer patients treated with BCT, it might be unnecessary for patients with old age, small tumor, grade I disease, or favorable histological types.
Cancer Communications   Epub date: 5/8/2019   doi:10.1186/s40880-019-0371-y
[PDF Full-text]

[ Html full-text] (BioMed Central)

[ PubMed]

Cite this article

Jin Wang, Hailin Tang, Xing Li, Cailu Song, Zhenchong Xiong, Xi Wang, Xiaoming Xie and Jun Tang. Is surgical axillary staging necessary in women with T1 breast cancer who are treated with breast-conserving therapy?. Cancer Commun (Lond). 2019, 39:25. doi:10.1186/s40880-019-0371-y


Export citations

EndNote

CJC Wechat 微信公众号


 

Editorial Manager


CC adopts Editorial Manager to manage its submissions from Dec.18, 2014

 Submission Guidelines  

 

Reference style for  

 EndNote,
 Reference Manager



Editorial Manager


 

Year:

 

Month:

Advanced search

Subscription


CC is now published by BioMed Central

© Cancer Communications

651 Dongfeng Road East, Guangzhou 510060, P. R. China