Long-Term Effects of Partial Axillary Dissection in Modified Radical Mastectomy of Breast Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Xianyou , CHEN Yuquan

Department of General Surgery, Longhu People’s Hospital of Shantou City, Guangdong Province, Shantou 515041, China;

Corresponding author：

Keywords：

Breast cancer; Lymph node dissection; Prognosis; Recurrence; Upper limb dysfunction

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Objective To study the effects of partial axillary lymph node dissection (PALD) on prognosis and upper limb function in patients with breast cancer.
Methods Ninety-eight breast cancer patients with stage Ⅰ and Ⅱ were randomly divided into two groups and different surgical procedures following modified mastectomy were performed: partial axillary lymph node (level Ⅰ and Ⅱ) dissection (PALD) group (n=48) and total axillary lymph node (levelⅠ, Ⅱ and Ⅲ) dissection (TALD) group (n=50). The longterm positive relapse rate and upper limb function between 2 groups were compared.
Results During the follow-up of 5 to 10 years (average 4.5 years), there were 2 cases (4.2%) of local recurrence on chest wall and one case (2.1%) of recurrence in axillary lymph node and one case (2.1%) of recurrence in supraclavicular lymph node in PALD group, and 2 cases (4.0%) of local recurrence on chest wall and no axillary lymph node recurrence and one case (2.0%) of recurrence in supraclavicular lymph node happened in TALD group. There was no statistical difference between PALD group and TALD group (P gt;0.05). The incidence of upper limb edema and dysfunction was 4.2% (2/48) in PALD group and 16.0%(8/50) in TALD group (P＜0.01). There was no significant statistical difference of 5year and 10year survival rate between PALD group and TALD group (89.6% vs. 88.0%， 79.2% vs. 78.0%，P gt;0.05).
Conclusion PALD may reduce upper limb dysfunction after operation in patients with stage Ⅰ and Ⅱ breast cancer, and does not increase prognostic risk.

Citation： CHEN Xianyou,CHEN Yuquan. Long-Term Effects of Partial Axillary Dissection in Modified Radical Mastectomy of Breast Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(7): 527-530. doi: Copy

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7.	方志沂，刘君. 现代乳腺癌外科发展趋势 [Ｊ]. 国外医学肿瘤学分册， 2003; 30(1): 3437.
8.	Krag D, Weaver D, Ashikaga T, et al. The sentinel node in breast cancera multicenter validation study [Ｊ]. N Engl J Med, 1998; 339(14): 941946.
9.	Schwartz GF, Giuliano AE, Veronesi U, et al. Proceedings of the consensus conference on the role of sentinel lymph node biopsy in carcinoma of the breast, April 1922, 2001, Philadelphia, Pennsylvania [Ｊ]. Cancer, 2002; 94(10): 25422551.
10.	Lyman GH, Giuliano AE, Somerfield MR, et al. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in earlystage breast cancer [Ｊ]. J Clin Oncol, 2005; 23(30): 77037720.
11.	王水，刘晓安，赵佳，等. 染料法乳腺癌前哨淋巴通道的研究 [Ｊ]. 中华外科杂志， 2006; 44(11): 748750.
12.	张建国，仲雷，李传乐，等. 前哨淋巴结活检术检测乳腺癌腋窝淋巴结转移的效果评价 [Ｊ]. 中华肿瘤杂志， 2007; 29(3): 235236.
13.	Siegel BM, Mayzel KA, Love SM. Level Ⅰ and Ⅱ axillary dissection in the treatment of earlystage breast cancer. An analysis of 259 consecutive patients [Ｊ]. Arch Surg, 1990; 125(9): 11441147.
14.	徐宏，张斌，张强，等. Ⅰ、Ⅱ期乳腺癌单纯乳房切除并腋淋巴结清扫与根治术疗效比较（附192例随机对照研究） [Ｊ]. 中国实用外科杂志， 2003; 23(10): 614616.

1. 段建中，王晓亮，蒋友华. N0-1乳腺癌腋窝淋巴结清扫范围与预后关系的临床探讨 [Ｊ]. 中国综合临床， 2003; 19(7): 647648.
2. 薛卫成，阚秀. 介绍乳腺癌TNM分期系统（第6版） [Ｊ]. 诊断病理学杂志， 2008; 15(3): 161止页.
3. 马榕，孙靖中，王建丽，等. 保留乳头改良根治术治疗乳腺癌中远期疗效 [Ｊ]. 中国实用外科杂志， 2003; 23(10): 606607.
4. 沈镇宙，陆劲松. 乳腺癌临床研究新进展 [Ｊ]. 中国癌症杂志， 2001； 11(5): 388392.
5. Robinson DS, Senofsky GM, Ketcham AS. Role and extent of lymphadenectomy for early breast cancer [Ｊ]. Semin Surg Oncol, 1992; 8(2): 7882.
6. Fisher B, Redmond C, Fisher ER, et al. Tenyear results of a randomized clinical trial comparing radical mastectomy and to TALD mastectomy with or without radiation [Ｊ]. N Engl J Med, 1985; 312(11): 674681.
7. 方志沂，刘君. 现代乳腺癌外科发展趋势 [Ｊ]. 国外医学肿瘤学分册， 2003; 30(1): 3437.
8. Krag D, Weaver D, Ashikaga T, et al. The sentinel node in breast cancera multicenter validation study [Ｊ]. N Engl J Med, 1998; 339(14): 941946.
9. Schwartz GF, Giuliano AE, Veronesi U, et al. Proceedings of the consensus conference on the role of sentinel lymph node biopsy in carcinoma of the breast, April 1922, 2001, Philadelphia, Pennsylvania [Ｊ]. Cancer, 2002; 94(10): 25422551.
10. Lyman GH, Giuliano AE, Somerfield MR, et al. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in earlystage breast cancer [Ｊ]. J Clin Oncol, 2005; 23(30): 77037720.
11. 王水，刘晓安，赵佳，等. 染料法乳腺癌前哨淋巴通道的研究 [Ｊ]. 中华外科杂志， 2006; 44(11): 748750.
12. 张建国，仲雷，李传乐，等. 前哨淋巴结活检术检测乳腺癌腋窝淋巴结转移的效果评价 [Ｊ]. 中华肿瘤杂志， 2007; 29(3): 235236.
13. Siegel BM, Mayzel KA, Love SM. Level Ⅰ and Ⅱ axillary dissection in the treatment of earlystage breast cancer. An analysis of 259 consecutive patients [Ｊ]. Arch Surg, 1990; 125(9): 11441147.
14. 徐宏，张斌，张强，等. Ⅰ、Ⅱ期乳腺癌单纯乳房切除并腋淋巴结清扫与根治术疗效比较（附192例随机对照研究） [Ｊ]. 中国实用外科杂志， 2003; 23(10): 614616.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Long-Term Effects of Partial Axillary Dissection in Modified Radical Mastectomy of Breast Cancer

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