caa a22 4500 445333022 CHVBK 20180317142743.0 cr unu---uuuuu 170323e20110101xx s 000 0 eng 10.1245/s10434-010-1217-7 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1217-7 Axillary Dissection Versus No Axillary Dissection in Elderly Patients with Breast Cancer and No Palpable Axillary Nodes: Results After 15 Years of Follow-Up [Elektronische Daten] [Gabriele Martelli, Rosalba Miceli, Maria Daidone, Gaetano Vetrella, Anna Cerrotta, Domenico Piromalli, Roberto Agresti] Objective: To assess the long-term safety of no axillary clearance in elderly patients with breast cancer and nonpalpable axillary nodes. Background: Lymph node evaluation in elderly patients with early breast cancer and clinically negative axillary nodes is controversial. Our randomized trial with 5-year follow-up showed no breast cancer mortality advantage for axillary clearance compared with observation in older patients with T1N0 disease. Methods: We further investigated axillary treatment in a retrospective analysis of 671 consecutive patients, aged ≥70years, with operable breast cancer and a clinically clear axilla, treated between 1987 and 1992; 172 received and 499 did not receive axillary dissection; 20mg/day tamoxifen was prescribed for at least 2years. We used multivariable analysis to take account of the lack of randomization. Results: After median follow-up of 15years (interquartile range 14-17years) there was no significant difference in breast cancer mortality between the axillary and no axillary clearance groups. Crude cumulative 15-year incidence of axillary disease in the no axillary dissection group was low: 5.8% overall and 3.7% for pT1 patients. Conclusions: Elderly patients with early breast cancer and clinically negative nodes did not benefit in terms of breast cancer mortality from immediate axillary dissection in this nonrandomized study. Sentinel node biopsy could also be foregone due to the very low cumulative incidence of axillary disease in this age group. Axillary dissection should be restricted to the small number of patients who later develop overt axillary disease. The Author(s), 2010 Martelli Gabriele Breast Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian 1, Milan, Italy aut Miceli Rosalba Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy aut Daidone Maria Unit of Biomolecular Determinants in Prognosis and Therapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy aut Vetrella Gaetano Unit of Preventive Gynecology, Melegnano Hospital, Melegnano, Italy aut Cerrotta Anna Unit of Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy aut Piromalli Domenico Breast Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian 1, Milan, Italy aut Agresti Roberto Breast Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian 1, Milan, Italy aut Annals of Surgical Oncology Springer-Verlag 18/1(2011-01-01), 125-133 1068-9265 18:1<125 2011 18 10434 https://doi.org/10.1245/s10434-010-1217-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1217-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Martelli Gabriele Breast Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian 1, Milan, Italy aut NATIONALLICENCE 700 1- Miceli Rosalba Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy aut NATIONALLICENCE 700 1- Daidone Maria Unit of Biomolecular Determinants in Prognosis and Therapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy aut NATIONALLICENCE 700 1- Vetrella Gaetano Unit of Preventive Gynecology, Melegnano Hospital, Melegnano, Italy aut NATIONALLICENCE 700 1- Cerrotta Anna Unit of Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy aut NATIONALLICENCE 700 1- Piromalli Domenico Breast Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian 1, Milan, Italy aut NATIONALLICENCE 700 1- Agresti Roberto Breast Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian 1, Milan, Italy aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/1(2011-01-01), 125-133 1068-9265 18:1<125 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer