Background: Breast cancer is the most prevalent malignancy among women and the leading cause of cancer-related mortality. Sentinel lymph node biopsy (SLNB) has emerged as an alternative to axillary lymph node dissection (ALND), with the ACOSOG Z0011 trial demonstrating that SLNB alone yields equivalent oncologic outcomes to ALND for patients with 1–2 positive sentinel lymph nodes (SLNs). Objective: This study evaluates the adoption of Z0011 recommendations at the American University of Beirut Medical Center (AUBMC) and their impact on oncologic outcomes. Methods: This retrospective cohort study includes female patients with early-stage breast cancer (T1–T2, N0, M0) who underwent breast-conserving surgery with SLNB at AUBMC, between January 2011 and December 2016. Data were extracted from the institutional breast cancer database, including demographics, tumor characteristics, surgical management, and follow-up outcomes. Results: SLNB alone was adopted, following publication of the Z0011 trial, in 93.4% of patients, with 6.6% undergoing ALND. Among patients with 1–2 positive SLNs, 27.1% underwent completion ALND. The median number of lymph nodes retrieved increased from two to four over the study period. The most common molecular subtypes observed were luminal A (54.1%), characterized by a predominant stage T1 presentation and small tumor sizes (median tumor size, 1.4 cm). Among patients with 1–2 positive SLNs who underwent ALND, no recurrences or metastatic events were reported. The 5-year overall survival (OS) and disease-free survival (DFS) rates were 95.9% and 93.4%, respectively. No notable differences in OS and DFS were observed between the SLNB alone and ALND groups. Conclusions: Our study demonstrates that SLNB alone provides comparable oncologic outcomes to ALND, supporting its safety and effectiveness as an alternative for early-stage breast cancer patients with 1–2 positive SLNs. These findings extend the Z0011 trial’s applicability to diverse populations, reinforcing SLNB as a less invasive, safe alternative to ALND.
背景：乳腺癌是女性中最常见的恶性肿瘤，也是癌症相关死亡的主要原因。前哨淋巴结活检（SLNB）已成为腋窝淋巴结清扫术（ALND）的替代方案，ACOSOG Z0011试验表明，对于1-2个前哨淋巴结（SLN）阳性的患者，仅进行SLNB可获得与ALND相当的肿瘤学结果。目的：本研究评估了贝鲁特美国大学医学中心（AUBMC）对Z0011建议的采纳情况及其对肿瘤学结果的影响。方法：这项回顾性队列研究纳入了2011年1月至2016年12月期间在AUBMC接受保乳手术并接受SLNB的早期乳腺癌女性患者（T1-T2，N0，M0）。数据从机构乳腺癌数据库中提取，包括人口统计学特征、肿瘤特征、手术管理和随访结果。结果：在Z0011试验发表后，93.4%的患者仅接受了SLNB，6.6%的患者接受了ALND。在1-2个SLN阳性的患者中，27.1%接受了补充性ALND。研究期间，淋巴结获取的中位数从两个增加到四个。最常见的分子亚型是luminal A型（54.1%），其特征主要为T1期表现和较小的肿瘤大小（中位肿瘤大小为1.4厘米）。在接受ALND的1-2个SLN阳性患者中，未报告复发或转移事件。5年总生存率（OS）和无病生存率（DFS）分别为95.9%和93.4%。仅接受SLNB组和ALND组在OS和DFS方面未观察到显著差异。结论：我们的研究表明，仅进行SLNB可获得与ALND相当的肿瘤学结果，支持其作为1-2个SLN阳性的早期乳腺癌患者的安全有效替代方案。这些发现扩展了Z0011试验在不同人群中的适用性，进一步证实了SLNB作为ALND的一种侵入性较小且安全的替代方案。
肿瘤(癌症)患者之家