Impact of the extent of axillary surgery in patients with N2–3 disease in the de-escalation era: a propensity score-matched study

alkiviadis.1961 shared this article with you from Inoreader Impact of the extent of axillary surgery in patients with N2–3 disease in the de-escalation era: a propensity score-matched study Via Latest Results for Clinical and Translational Oncology Abstract Background Reduction of surgeries in axillary has been proved feasible in breast cancer with negative and limited involved axillary lymph nodes. However, for women with a heavy axillary burden, the extent of dissection is still arguable. Patients and methods From a total of 7042 patients with breast cancer who underwent surgical treatments between 2008 and 2014, 692 (9.85%) patients with the axillary staging of N2–3M0 were classified into Level I–II dissection group and Level I–III dissection group. 203 pairs of patients were matched by the propensity score. Results The positive rate of level-III lymph nodes is 62.4% in patients who underwent Level I–III dissection. There are 67 (22.1%) patients who experienced rise in staging from N2 to N3 due to level-III dissection. With a median follow-up of 62.4 months, no significant difference was observed in RFS (P = 0.897), MFS (P = 0.610) and OS (P = 0.755) between level I–II group and level I–III group. The same results were observed in the independent analysis of neoadjuvant and non-neoadjuvant subgroups. The binary regression model showed the positivity of level-III is only associated with involved lymph nodes in level-II. Conclusion Additional level-III dissection has a limited impact on survival but still valuable in an accurate stage. The reduction of surgeries in axillary should be treated with discretion in breast cancer patients with a heavy axillary burden. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.