Trends in Axillary Lymph Node Dissection After Mastectomy Among Patients With Limited Nodal Burden.

A previous NCDB study of patients with breast cancer treated from 2006 to 2014 showed a trend toward decreased rates of ALND and increased rates of PMRT among patients with 1 to 2 positive lymph nodes undergoing mastectomy after publication of the ACOSOG Z0011 trial in 2011. 20 Our findings in a more contemporary cohort of patients demonstrate continued acceptance of the safety of ALND omis

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Discussion Our study shows a clear trend in the US toward de-escalation of ALND and a corresponding increase in the use of PMRT alone for the management of limited axillary nodal metastases for patients receiving a mastectomy.

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pmc-status-qastatus 0 pmc-status-live yes pmc-status-embargo no pmc-status-released yes pmc-prop-open-access yes pmc-prop-olf no pmc-prop-manuscript no pmc-prop-legally-suppressed no pmc-prop-has-pdf no pmc-prop-has-supplement yes pmc-prop-pdf-only no pmc-prop-suppress-copyright no pmc-prop-is-real-version no pmc-prop-is-scanned-article no pmc-prop-preprint no pmc-prop-in-epmc yes pmc-license-ref CC BY Introduction Over the past 2 decades, management of the axilla for patients with breast cancer with axillary nodal metastases has evolved significantly, with an overall trend toward surgical de-escalation. 1 Axillary overtreatment can result in substantial morbidity and long-term harms, such as lymphedema, secondary malignant neoplasms, reduced quality of life, and financial toxicity, without reducing the risk of breast cancer recurrence or improving patient survival. 2 , 3 , 4 Consequently, eliminating unnecessary locoregional treatment can significantly improve cancer survivorship.

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