Evidence map›Paper›PMID 40457311›Full record

ArticleBMC surgery2025

Outcomes of targeted axillary radiation therapy with omission of axillary dissection in early breast cancer patients with one or two positive sentinel lymph nodes and extracapsular extension.

Ahmed Orabi, Asmaa G Ellaithy, Maha Guimei, Maher H Ibraheem, Waleed Mohamed M Fadlalla, Mohamed Fathy Abdelfattah Abdelrahman Elithy, Yasmine Hany Abdel Moamen Elzohery, Ahmed S Abdelmomen, Sherif Nasser Taha

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Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Ahmed OrabiSurgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt. Ahmed.orabi@nci.cu.edu.eg.
Asmaa G EllaithyBaheya Centre for Early Detection and Treatment of Breast Cancer, Cairo, Egypt.
Maha GuimeiAssociate Professor of Pathology, Faculty of Medicine, Alexandria University, Cairo, Egypt.
Maher H IbraheemSurgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
Waleed Mohamed M FadlallaSurgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
Mohamed Fathy Abdelfattah Abdelrahman ElithyLecturer of surgical oncology, Faculty of Medicine, Al Azhar University, Cairo, Egypt.
Yasmine Hany Abdel Moamen ElzoheryAssociate Professor of General Surgery, Faculty of Medicine, Ain shams university, Cairo, Egypt.
Ahmed S AbdelmomenRadiation Therapy Department, National Cancer Institute, Cairo University, Cairo, Egypt.
Sherif Nasser TahaSurgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAxillary dissection has been shown to be equivalent to axillary radiotherapy in the AMAROS trial; however, extracapsular invasion of sentinel lymph nodes was not considered among the evaluated variables. The clinical significance of extracapsular extension (ECE) in one or two positive sentinel lymph nodes remains under investigation. This study aims to evaluate the impact of targeted axillary radiation therapy while omitting completion axillary lymph node dissection (ALND) in the presence of extracapsular extension.

methodsA retrospective study was conducted between 2016 and 2023 involving cT1-2N0 breast cancer patients who did not receive neoadjuvant chemotherapy and underwent either breast-conserving surgery or mastectomy, with extracapsular extension present in one or two positive sentinel lymph nodes.

resultsOur study included 213 patients treated between 2016 and 2023, with a median follow-up of 48.07 months (range: 9.07-103.10 months). ECE was ≤ 2 mm in 201 patients (94.4%) and > 2 mm in 12 patients (5.6%). A total of 112 patients (52.6%) underwent completion ALND. Systemic recurrence occurred in 24 patients (11.3%), while local recurrence occurred in one patient (0.5%). The 5-year disease-free survival (DFS) rates were 86% in the completion axillary clearance (AC) group and 89% in the non-AC group. The estimated DFS rates for the entire study at 1, 3, and 5 years were 97%, 89%, and 86%, respectively.

conclusionsWithin this single-institution study of early breast cancer patients with predominantly luminal A subtype and mostly limited ECE (≤ 2 mm) treated with targeted axillary radiation, omission of ALND did not result in inferior DFS compared to completion ALND. However, these findings are preliminary, hypothesis-generating, and limited by the retrospective design, short follow-up, and specific patient population studied. Prospective studies are needed to confirm these observations.

trial registrationRetrospectively registered after the approval of Baheya Ethical Committee, IRB no. 202,304,030,017.

Indexed as

Breast NeoplasmsSentinel Lymph NodeAdultAgedAged, 80 and overAxillaFemaleFollow-Up StudiesHumansLymphatic MetastasisLymph Node ExcisionMastectomyMastectomy, SegmentalMiddle AgedRadiotherapy, AdjuvantRetrospective StudiesAxillary lymph node dissection.Breast cancerExtracapsular extensionSentinel lymph node

Identifiers

PMID40457311
PMCPMC12128341

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.