The high prevalence ratio in our study (41.5%) was inconsistent with other studies, particularly those in which SLND was performed and those that had low prevalence ratios (3%-5%) (20,21).
It is known that the lymphedema prevalence ratio in breast cancer patients after ALND is higher than those after SLND. In our opinion, physicians treating breast cancer should meticulously diagnose high-risk breast cancer patients who underwent ALND with respect to lymphedema before and after surgery to prevent the development of this condition.
Most patients underwent a sLND
(55%, n= 643), whereas 34% (n = 402) underwent eLND.
The biodistribution study on rabbits is quite useful in evaluating the potential of radiopharmaceutical as a promising candidate for SLND
. The dynamic study of 30 min immediately after intradermal injection was used to study the uptake/excretion pattern of the compound in lymph nodes and other organs of interest.
The 900-patient randomized, prospective trial found the five-year overall survival rate was 91.8% for patients with SLND
and ALND compared to 92.5% with SLND
alone, and the five-year disease-free survival was 82.2% with SLND
and ALND compared to 83.9% with SLND
Patients with SLN metastases identified by SLND were randomized to undergo ALND or no further axillary treatment.
The use of SLND alone compared with ALND did not appear to result in statistically inferior survival, with the 5-year over all survival rates being 92.5 percent in the SLND-alone group and 91.8 percent in the ALND group.
The cumulative incidence of nodal recurrences in the ALND group was 0.5% and it was 1.5% in the SLND
The overall findings from the randomised trials have shown noninferiority of SLND
compared to ALND.
(#): Preoperative clinical and postoperative pathological TNM stage (Clinical TNM stage before neoadjuvant therapy and postoperative pathological TNM stage was both given for patient number 4) AC: adriamycin+cyclophosphamide; ALND: axillary lymph node dissection; BC: breast cancer; CEF: Cyclophosphamide+Epirubicin+Flourouracil; DBRi: delayed breast reconstruction with implantation; DC: ductal carcinoma; DCIS: ductal carcinoma insitu; DT: docetaxel; ER: estrogen receptor; F: female; IBR: immediate breast reconstruction; LC: lobular carcinoma; M: male, MRM: modified radical mastectomy; PR: progesterone receptor; SM: simple mastectomy; SLND
: sentinel lymph node dissection; SM: segmental mastectomy; RT: radiotherapy; TT: total thyroidectomy; TZM: trastuzumab Table 2.
Studies have proved that SLND
alone is sufficient for management of axilla in early cancers if SLN is negative [4, 5].