Endoscopic sentinel lymph node biopsy and endoscopic axillary lymphadenectomy without liposuction in patients with early stage breast cancer

Surg Oncol. 2017 Dec;26(4):338-344. doi: 10.1016/j.suronc.2017.07.005. Epub 2017 Jul 14.

Abstract

Background: Our purpose was to present a new method of endoscopic sentinel lymph node biopsy (ESLNB) and endoscopic axillary lymphadenectomy (EALND) without liposuction for treating early-stage breast cancer, and compare results with traditional open dissection.

Methods: The medical records of patients with early-stage breast cancer who underwent EALND/ESLNB without liposuction or traditional open dissection between March 2015 and September 2016 were retrospectively reviewed. Outcomes between the 2 groups were compared.

Results: A total 65 patients with a mean age of 41.2 ± 9.3 years (range, 23-60 years) were included. Thirty-three patients underwent traditional open lymph node dissection and 32 patients underwent endoscopic treatment. The 2 groups were similar with respect to age, body mass index (BMI), menopausal status, tumor location, and tumor disease stage (all, p > 0.05). The mean operating time was significantly higher in the endoscopic group (91.2 vs. 75.2 min, p = 0.022), while the mean blood loss was significantly lower (28.7 vs. 37.0 ml, p = 0.034). The mean number of SLNs harvested in the open (2.4 ± 1.6) and the endoscopic (2.3 ± 1.4) groups were not different (p = 0.829), with a sentinel lymph node retrieval rate of 80%. The mean number of axillary lymph nodes harvested in the open (13.8 ± 3.3) and the endoscopic (13.3 ± 3.1) groups were not different (p = 0.457). Scars were minimal in the endoscopic group.

Conclusion: ESLNB and EALND without liposuction for early-stage breast cancer is feasible, has a low complication rate, a lymph node harvest rate similar to that of open dissection, and has good cosmetic results. Future studies, however, are required to evaluate oncological outcomes.

Keywords: Axillary lymphadenectomy; Breast cancer; Endoscopic; Sentinel lymph node biopsy.

MeSH terms

  • Adult
  • Axilla
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Endoscopy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Lipectomy
  • Lymph Node Excision / methods*
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery*
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Sentinel Lymph Node / pathology
  • Sentinel Lymph Node / surgery*
  • Sentinel Lymph Node Biopsy / methods*
  • Young Adult