Impact of Axillary Dissection on Clinical Outcomes of Breast Cancer Surgery
Abstract
We studied 26,290 women with early-stage breast cancer aged >25 in 1983-1993 who received BCS, using data from the Surveillance, Epidemiology and End Results Program and Medicare. Twenty seven percent of women aged >25 receiving BCS did not receive axillary dissection, most of whom (74%) were age >65. Women receiving BCS with axillary dissection had lower 7-year breast cancer- specific mortality than did those without dissection (hazard ratio--0.53, 95% confidence interval: 0.44-0.63). We found an interaction between receipt of axillary dissection and radiotherapy on survival of older women after BCS. Women who received either axillary dissection or radiotherapy experienced similar survivals to those who received both axillary dissection and radiation, while women who received neither treatment experienced poorer survival (hazard ratio--i .76, 1.23-2.52), after controlling for demographics, tumor size and comorbidity. In conclusion, the combination of no axillary dissection plus no radiation after BCS is associated with an unacceptably high level of deaths from breast cancer. The lack of improvement in the past two decades in survival of older women with breast cancer may be explained in part by the increasing use of treatments that do not address potential tumor in axillary nodes.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 01, 2000
- Accession Number
- ADA382511
Entities
People
- Xianglin Du
Organizations
- University of Texas Medical Branch