Axillary Lymph Node Dissection vs. Loco-regional Radiotherapy in Breast Cancer Treatment
Background
Recent years have seen major changes in how we manage the axilla (underarm area) in breast cancer treatment. The goal is to reduce surgery while still ensuring effective treatment and accurate diagnosis for patients. Advances in additional therapies have made this possible.
Objective
This study compares the effects of two treatments: axillary lymph node dissection (ALND) and loco-regional axillary radiotherapy (ART) on lymphedema (swelling) and disease recurrence in patients with locally advanced breast cancer (LABC) who improved after neoadjuvant chemotherapy (NACT).
Methods
Sixty patients with LABC, initially classified as cN1-2, were treated and then re-evaluated to cN0 after NACT. They were divided into two groups: one underwent ALND (control group), and the other had a sentinel lymph node biopsy (SLNB) followed by ART (study group). Patients with failed SLNB or positive SLNB results were not included. All patients were monitored for at least one year for recurrence and lymphedema.
Results
No significant difference was found in disease recurrence between the two groups. However, the control group had a higher incidence of arm lymphedema, with 46.7% affected compared to only 13.4% in the study group.
Conclusion
Using axillary radiation after SLNB does not increase the risk of recurrence compared to ALND. However, it significantly reduces the occurrence of lymphedema. This study supports the idea of minimizing surgical interventions in LABC treatment.
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