SLNB Comparison with Routine Axillary LN Dissection in Breast Cancer
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Transcript of SLNB Comparison with Routine Axillary LN Dissection in Breast Cancer
DR. M.Dorchin
Seham Soleiman,Moha Manashi , Zahere Fahad
The 8th International Breast Cancer Congress
Tehran ,20-22 Feb, 2013
Contraindication
1-Node +
2-Previous Surgery?
3-Pregnancy
4-Skin Disease
Indications
1-Any T Base on
Breast Size
2- Node Negative
3-Stage I-II-III(No)
Methods:
From July 2007 to November 2009,
we randomly assigned 423 patients with PBC .
PBC: T< 2 cm (T1) in two groups.
1 - Sentinel-Lymph Node Biopsy group(SLNB)
2 - Axillary-Dissection group( AXD)
Al-Bairouni University Hospital
Study of the SLNB in Breast Cancer Al-Bairouni university Hospital in Damascus city,
and Comparison with Routine Axillary LN Dissection .
Statistical AnalysesTable 1 shows total new cancer cases referred to the
Al-bairouni hospital from 2007-2009:
Year New cases
Breast cancer
Pt,s in my study
Percentage
2007 8943 675 118 1.31%
2008 9058 689 109 1.21%
2009 9774 807 196 2.00%
Total 27775 2171 423 1.5%
Treatment & follow up
The patients were followed up 4 times, every 3
months for one year
39 patients didn’t followed and therefore
cancelled from the study. Only 384 patients
ended the treatment and the follow up
The median follow up was 12 months.
Geographic Distribution
The most patients that referred to
the Al-Bairouni Hospital were
from Damascus and Aleppo
provinces, and seaboard patients
were the less.
Smokers = 24% Alcoholic =11%
The median age was 43 years(24-73)
Positive Familial History = 19%
Axillary -dissection group
. A sentinel node was positive in 69 of the 208
patients in the Axillary -dissection group (33.17
percent)
Patients
AXD
SLN
positive
percentage
208 69 33.17
sentinel-node group
A sentinel node was positive in 74 of the 186
patients in the sentinel-node group (39.78
percent).
Patients
SLN
SLN
positive
percentage
176 74 42.04%
The Axillary dissection group
In the Axillary dissection group, the overall
accuracy of the sentinel-node status was 96.9
percent, the Sensitivity 91.2 percent and the
specificity 100 percent.
Accuracy Sensitivity Specificity
96.9% 91.2% 100%
Complications
There was less pain and better arm mobility
in the patients who underwent sentinel-node
biopsy only than in those who also underwent
Axillary dissection.
Complications Ax – Diss Group SN Group
Less Pain &
Better Arm
mobility
16 6
Among the 112 patients who did
not undergo Axillary dissection,
there were no cases of overt
axillary metastasis during follow-
up.