The application of simplified axillary lymph nodes dissection on the treatment of early breast cancer

HUANG Wei; WANG Yabing; YIN Zhaocai; LIU Sanbao; CHEN Jie; CHEN Xiaolin

doi:10.3969/j.issn.1674-4136.2015.02.004

Abstract：Objective To explore the application and effect of simplified axillary lymph node dissection ( ALND) in the operation of breast cancer . Methods Through the analysis of 327 cases of breast cancer pa-tients with clinical data in our department from Jan. 2009 to Jun. 2013 receiving sentinel lymph node biopsy (SLNB), according to the sentinel lymph node (SLN) frozen pathological results which were used methylene blue staining of SLNB , the patients who were SLN positive did the standard ALND, and the SLN negative pa-tients did the simplified ALND ( only clean up Level I) , Differences on operative time, postoperative hospitali-zation time, axillary drainage time and postoperative complications were compared between the two groups. Re-sults Among 327 cases, 314 cases successfully carried out SLNB, ALND in 119 cases with SLN positive and 195 cases of ALND negative SLN for simplified ALND. Above all, there were 11 SLN negative cases with the metastasis in Level I tissue lymph node. Compared to the standard ALND, the simplified ALND ( only clean up Level I) has shortened the operative time, postoperative hospitalization time, axillary drainage time obviously, and the armpit dropsy, decreased muscle strength, activity limitation, pain, numbness, swelling and other post-operative complications were reduced significantly. Patients were followed up 3 to 60 months after operation;none of patients were found axillary lymph node recurrence and distant metastasis. Conclusion Methylene blue staining of SLNB is an important detecting technique of valuing the metastasis of the axillary lymph node. Using simplified ALND on breast cancer patients who are SLN negative will save medical resources and reduce the postoperative complications.