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Comparison of Mastoscopic and Conventional Axillary Lymph Node Dissection in Breast Cancer: Long-term Results From a Randomized, Multicenter Trial

Published:November 12, 2012DOI:https://doi.org/10.1016/j.mayocp.2012.07.022

      Abstract

      Objective

      To compare the long-term results of mastoscopic axillary lymph node dissection (MALND) and conventional axillary lymph node dissection (CALND).

      Patients and Methods

      From January 1, 2003, through December 31, 2005, a group of 1027 consecutive patients with operable breast cancer were randomly assigned to 1 of 2 study groups: MALND and CALND. The median follow-up was 63 months. The primary end points of the study were operative outcomes, complication reduction, function conservation, and cosmetics. The secondary end points were disease-free and overall survival.

      Results

      The mean operative blood loss in the MALND group was less than in the CALND group (P<.001). The patients who underwent MALND had less axillary pain, numbness or paresthesias, and arm swelling (P<.001). The aesthetic appearance of the axilla in the MALND group was much better than that in the CALND group (P=.001 at 6 months and P=.002 at 24 months). A significant difference was found between the 2 groups in distant metastasis (P=.04). The disease-free survival rate was 64.5% in the MALND group and 60.8% in the CALND group (P=.88). The overall survival rate was 81.7% in the MALND group and 78.6% in the CALND group (P=.95).

      Conclusion

      Compared with CALND, MALND has advantages in operative outcomes, complication reduction, function conservation, and cosmetics.

      Abbreviations and Acronyms:

      ALND (axillary lymph node dissection), CALND (conventional axillary lymph node dissection), MALND (mastoscopic axillary lymph node dissection)
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