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Evidence summaries

Prophylactic Axillary Node Dissection in Breast Cancer

Axillary node dissection improves survival in women with operable breast cancer. However, there are insufficient data for conclusions in women with T1a cancers or in women treated with adjuvant chemotherapy in current practice. Level of evidence: "A"

A systematic review 1 including 6 studies with a total of 2936 subjects was abstracted in DARE. The tumour size ranged from 1.5 Cm to 3.7 cm, percentage T1 ranged from 17% to 67%, and node positive rates ranged from 18% to 54%. The difference in survival rates in favour of prophylactic dissection was 5.45% (95% CI 2.65% to 8.1%). After correction for adjuvant chemotherapy the difference was 5.4% (95% CI 2.8% to 8.1%).

    References

    • Orr RK. The impact of prophylactic axillary node dissection on breast cancer survival--a Bayesian meta-analysis. Ann Surg Oncol 1999 Jan-Feb;6(1):109-16. [PubMed][DARE]

Primary/Secondary Keywords