Journal: Annals of surgical oncology
This study evaluated surgical nodal management in women aged 70 years or older with early to locally advanced HR-/HER2+ breast cancer, using data from the National Cancer Database (2017-2019).
Among 1,853 patients:
- 10.5% underwent omission of nodal surgery
- 68.1% had sentinel lymph node biopsy (SLNB)
- 9.8% had axillary lymph node dissection (ALND)
Patients who omitted nodal surgery tended to be older than 81 years or have stage III disease.
Importantly, omission of nodal staging was associated with significantly worse 3-year overall survival:
- 58% with omission of nodal surgery
- 88% with SLNB
- 69% with ALND
These data suggest that surgical nodal staging should remain standard in this population to optimize survival, except in cases where it would not impact management or outcomes.