ArticleBMC cancer2019
Does the number of removed axillary lymphnodes in high risk breast cancer patients influence the survival?
Article in BMC cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 19 citations in OpenAlex.
- Optimizing axillary lymph node management in early-stage HR+/HER2- breast cancer: Practical strategies for enhanced detection rates.Breast (Edinburgh, Scotland) · 2026Article
- Locoregional Recurrence-Free Survival in Postmastectomy Breast Cancer: A Comparative Longitudinal Study of Hypofractionated Versus Conventional Fractionated Radiation Therapy.Indian journal of surgical oncology · 2025Article
- Effects of Athletic Nutritional Supplements on the Human Gut Microbiota: A Narrative Review.Nutrients · 2025Review
- Is There a Therapeutic Benefit of Axillary Surgery in Non-Metastatic Breast Cancer? A SEER Cohort Database Study.Journal of clinical medicine · 2025Article
- Axillary lymph node removal inGland surgery · 2024Article
- European quality indicators developed by the European Commission Initiative on Breast Cancer: a first nationwide assessment for the Dutch setting.Breast cancer research and treatment · 2024Observational
- Implications for surveillance for breast cancer patients based on the internally and externally validated BRENDA-metastatic recurrence score.Breast cancer research and treatment · 2023Article
- Simultaneous integrated boost within the lymphatic drainage system in breast cancer: A single center study on toxicity and oncologic outcome.Frontiers in oncology · 2023Article
- Axillary nodal metastasis and resection margins as predictors of Loco Regional Recurrence in Breast Cancer Patients.African health sciences · 2022Article
- Article
- The role of different lymph node staging systems in predicting prognosis and determining indications for postmastectomy radiotherapy in patients with T1-T2pN1 breast carcinoma.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2020Article
- Comparison of indocyanine green fluorescence and methylene blue dye in the detection of sentinel lymph nodes in breast cancer.Gland surgery · 2020Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe decision making process for axillary dissection has changed in recent years for patients with early breast cancer and positive sentinel lymph nodes (LN). The question now arises, what is the optimal surgical treatment for patients with positive axillary LN (pN+). This article tries to answer the following questions: (1) Is there a survival benefit for breast cancer patients with 3 or more positive LN (pN3+) and with more than 10 removed LN? (2) Is there a survival benefit for high risk breast cancer patients (triple negative or Her2 + breast cancer) and with 3 or more positive LN (pN3+) with more than 10 removed LN? (3) In pN + patients is the prognostic value of the lymph node ratio (LNR) of pN+/pN removed impaired if 10 or less LN are removed?
methodsA retrospective database analysis of the multi center cohort database BRENDA (breast cancer under evidence based guidelines) with data from 9625 patients from 17 breast centers was carried out. Guideline adherence was defined by the 2008 German National consensus guidelines.
results2992 out of 9625 patients had histological confirmed positive lymph nodes. The most important factors for survival were intrinsic sub types, tumor size and guideline adherent chemo- and hormonal treatment (and age at diagnosis for overall survival (OAS)). Uni-and multivariable analyses for recurrence free survival (RFS) and OAS showed no significant survival benefit when removing more than 10 lymph nodes even for high-risk patients. The mean and median of LNR were significantly higher in the pN+ patients with ≤10 excised LN compared to patients with > 10 excised LN. LNR was in both, uni-and multivariable, analysis a highly significant prognostic factor for RFS and OAS in both subgroups of pN + patients with less respective more than 10 excised LN. Multivariable COX regression analysis was adjusted by age, tumor size, intrinsic sub types and guideline adherent adjuvant systemic therapy.
conclusionThe removal of more than 10 LN did not result in a significant survival benefit even in high risk pN + breast cancer patients.
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