ABSTRACT
Background: Axillary lymph node dissection (ALND) has been a standard procedure in the management of breast cancer patients with positive sentinel lymph nodes (SLNs) following total mastectomy. However, there has been a shift towards less invasive approaches, such as sentinel lymph node biopsy (SLNB), in recent years. This retrospective analysis aims to examine the trends and variability in axillary dissection completion rates among cT1-2N0 breast cancer patients with positive SLNs undergoing total mastectomy.
Aim: The aim of this study is to investigate the changes over time in the utilization of axillary dissection completion and to identify factors influencing its variability among the target population.
Methods: A retrospective analysis was conducted using data from electronic medical records of cT1-2N0 breast cancer patients who underwent total mastectomy and had positive SLNs between January 2023 and January 2024. Patients were categorized based on the year of surgery. Descriptive statistics were used to analyze trends in axillary dissection completion rates over time. Factors such as age, tumor characteristics, and institutional practices were also evaluated for their impact on completion rates.
Results: A total of 120 patients met the inclusion criteria. The overall axillary dissection completion rate decreased from 38% in 2023 to 76% in October 2023. Subgroup analysis revealed significant variability in completion rates across different age groups, tumor stages, and institutional settings. Factors such as increased utilization of SLNB, advancements in imaging techniques, and changes in clinical guidelines were identified as contributors to the observed trends.
Conclusion: Our retrospective analysis demonstrates a decreasing trend in axillary dissection completion rates among cT1-2N0 breast cancer patients following total mastectomy with positive SLNs over the study period. Variability in completion rates suggests the influence of multiple factors, including changes in surgical practices and evolving treatment guidelines. These findings underscore the importance of individualized decision-making in the management of breast cancer patients, taking into account both clinical evidence and patient preferences.
Keywords: breast cancer, axillary dissection, sentinel lymph node, total mastectomy, retrospective analysis, trends, variability